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The full text of Images in Recommend to your Institution. In a randomized crossover study of 14 healthy smokers, mentholated cigarettes resulted in higher nicotine plasma concentrations, probably through inhibition of both CYP2A6 and glucuronide conjugation. Register for free content The full text of all Editor's Choice articles and summaries of every article are free without registration The full text of Images in As with the patient described above, he denied any changes in his medications or diet and denied missing any warfarin doses.

Subscribe here Activate your subscription. A case was recently reported of a patient on warfarin who developed a substantial decrease in his international normalized ratio INR after taking 8 to 10 menthol cough drops daily for 3 weeks to counteract dry air at his workplace. Use or buy Article Tokens What's this? The effect of menthol on caffeine pharmacokinetics has also been studied in healthy subjects given a single oral mg dose of caffeine with and without a single oral dose of mg of menthol.

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NicholsonKirk LalwaniDavid G. Online submission site Instructions for authors Become a fellow: No corresponding reduction had been made in his warfarin dosage, and no changes had been made in his concomitant drug therapy or diet.

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To our knowledge, this is the second case report of an interaction between warfarin and menthol. The occurrence of deleterious or even fatal drug-drug interactions DDIs in the perioperative period is no longer a theoretical concern but a harrowing reality.

One study found no effect of menthol mg in divided doses, 6 while another study using larger amounts of menthol as peppermint oil found modest increases in felodipine concentrations.

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Warfarin is a widely used and effective oral anticoagulant; however, the agent has an extensive drug and food interaction profile. Login for journal subscribers. A Case Approach to Perioperative Drug-Drug Interactions addresses the complex realm of pharmacokinetic drug interactions in an easy-to-read Remember me Remember me. Until this interaction is confirmed, it would be prudent to advise patients on warfarin to limit their use of menthol cough drops or peppermint oil.

Only fellows can access the full text of case reports apart from Editor's Choice - become a fellow today, or encourage your institution to, so that together we can grow and develop this resource. Research Article Publication date: His INR remained stable at 1.

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