Issues for Surgery
Risk of withdrawal symptoms if omitted (see Further Information).
Advice in the Perioperative period
If recently commenced check if any of the patient’s other medicines will be affected by smoking cessation and require dose adjustments (see Further Information).
Monitor renal function – dose reduction may be necessary if renal function is impaired (consult current product literature)1, 2.
Interaction(s) with Common Anaesthetic Agents
Interaction(s) with other Common Medicines used in the Perioperative Period
However, if a patient decides to quit smoking during the perioperative period it must be remembered that smoking cessation can reduce clearance of some medicines due to tobacco’s effect on CYP1A2 (potential for increased plasma levels)2 – dosage adjustments and / or close monitoring are likely to be necessary with CYP1A2 substrates including agomelatine, clozapine, duloxetine, olanzapine, ropinirole and theophylline (consult current product literature)3.