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Smoking and warfarin disposition

K Bachmann, R Shapiro, R Fulton

    Clinical Pharmacology and Therapeutics
    |March 1, 1979
    PubMed
    Summary
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    Cigarette smoking impacts warfarin pharmacokinetics, altering drug levels and clearance. However, these changes did not significantly affect prothrombin time, indicating minimal clinical impact.

    Area of Science:

    • Pharmacology
    • Toxicology

    Background:

    • Warfarin is a commonly prescribed anticoagulant.
    • Cigarette smoking is known to affect drug metabolism.

    Purpose of the Study:

    • To investigate the effect of cigarette smoking on warfarin pharmacokinetics and pharmacodynamics.

    Main Methods:

    • Nine smokers were given warfarin during smoking and non-smoking phases.
    • Measurements included plasma warfarin levels, clearance, half-life, volume of distribution, prothrombin time, and thiocyanate levels.

    Main Results:

    • Smoking decreased warfarin clearance by 13% and increased its half-life by 23%.
    • Warfarin's apparent volume of distribution increased by 11% during smoking.
    • Prothrombin time and pharmacodynamic activity remained unchanged.

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    Conclusions:

    • Cigarette smoking alters warfarin's pharmacokinetic parameters.
    • Despite pharmacokinetic changes, the clinical effect of warfarin appears negligible in smokers at the studied doses.