When the Smoke Clears, Relaxation Disappears
This case discusses the pharmacokinetic interaction between cyclobenzaprine and smoked tobacco resulting in cyclobenzaprine toxicity due to reversal of enzyme induction. Cyclobenzaprine is a cytochrome P450 1A2 substrate. Smoked tobacco is a 1A2 inducer.
KeywordsPharmacokinetic Induction Inducer CYP1A2 Cytochrome P450 1A2 Tobacco Smoked tobacco Smoking Polycyclic aromatic hydrocarbons Cyclobenzaprine Flexeril