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Cigarette Abstinence, Nicotine Gum, and Theophylline Disposition

BELLE L. LEE, Pharm.D.; NEAL L. BENOWITZ, M.D.; and PEYTON JACOB III, Ph.D.
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Grant support: in part by grants DA02277 and DA01696 from the National Institutes of Health. Dr. Lee was supported by Training Grant GM07546. Studies were done at the General Clinical Research Center at San Francisco General Hospital with support from the Division of Research Resources, National Institutes of Health (grant RR-00083).

▸Requests for reprints should be addressed to Neal L. Benowitz, M.D.; San Francisco General Hospital Medical Center, Building 30, Fifth Floor, 1001 Potrero Avenue, San Francisco, CA 94110.


San Francisco, California


© 1987 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1987;106(4):553-555. doi:10.7326/0003-4819-106-4-553
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When cigarette smokers with chronic lung disease become acutely ill or require surgery, they are often forced to stop smoking and may use nicotine gum. Smoking is known to accelerate the metabolism of theophylline, but the effects of short-term abstinence or nicotine gum on theophylline metabolism have not been reported. We studied the effects of brief tobacco abstinence and nicotine gum on theophylline elimination in healthy volunteers. Abstinence from smoking for 1 week resulted in a 37.6% decrease in clearance and a 35.8% increase in half-life. Nicotine gum had no effect on theophylline clearance. Our data indicate that at least partial normalization of the enzyme-inducing effects of smoking can be seen after brief cigarette abstinence. For smokers who are taking theophylline chronically, their dose of theophylline will need to be reduced by one fourth to one third after brief tobacco abstinence. Plasma concentration monitoring may be necessary for optimal dosing of theophylline in such patients.

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Nicotine gum and theophylline metabolism. Biomed Pharmacother 1989;43(1):1-3.
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