Important drug interactions exist between cannabidiol oil and commonly prescribed drugs in rheumatology practice

Wilson-Morkeh, Harold; Al-Abdulla, Ahmad; Sien, Lauren; Mohamed, H. T.; Youngstein, Taryn

doi:10.1093/rheumatology/kez304

Cited by 16 publications

(16 citation statements)

References 7 publications

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“…Amitriptyline, a tricyclic antidepressant, is metabolized by cytochrome P450 isozymes CYP2D6, CYP2C19, CYP3A4, CYP1A2 and CYP2C9, and CBD inhibits these enzymes, which may increase adverse effects simultaneously (e.g., anticholinergic syndrome, drowsiness, and QT interval prolongation) 47 .…”

Section: Cannabidiol's Interaction With Antidepressantsmentioning

confidence: 99%

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Cannabidiol Interactions with Medications, Illicit Substances, and Alcohol: a Comprehensive Review

2021

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Section: Cannabidiol's Interaction With Antidepressantsmentioning

confidence: 99%

“…Additionally, gabapentin, pregabalin, citalopram, paroxetine, and mirtazapine are all metabolized by cytochrome enzymes that are known to be inhibited by CBD and coadministration of CBD with these medications may have adverse effects 47 .…”

Section: Cannabidiol's Interaction With Antidepressantsmentioning

confidence: 99%

Cannabidiol Interactions with Medications, Illicit Substances, and Alcohol: a Comprehensive Review

2021

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“…Before CBD is used for the treatment of COVID-19, its possible interaction with the frontline therapy against COVID-19 should be carefully checked. The combination of CBD and glucocorticoids might lead to an increased plasma concentration of dexamethasone, since some glucocorticoids are substrates for CYP3A4 [185]. Due to the high therapeutic index of acutely administered glucocorticoids, this drug interaction may be tolerated.…”

Section: Opportunities Challenges and Pitfalls Of Cannabidiol Use Asmentioning

confidence: 99%

Opportunities, Challenges and Pitfalls of Using Cannabidiol as an Adjuvant Drug in COVID-19

Malinowska

Baranowska-Kuczko

Kicman

et al. 2021

IJMS

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may lead to coronavirus disease 2019 (COVID-19) which, in turn, may be associated with multiple organ dysfunction. In this review, we present advantages and disadvantages of cannabidiol (CBD), a non-intoxicating phytocannabinoid from the cannabis plant, as a potential agent for the treatment of COVID-19. CBD has been shown to downregulate proteins responsible for viral entry and to inhibit SARS-CoV-2 replication. Preclinical studies have demonstrated its effectiveness against diseases of the respiratory system as well as its cardioprotective, nephroprotective, hepatoprotective, neuroprotective and anti-convulsant properties, that is, effects that may be beneficial for COVID-19. Only the latter two properties have been demonstrated in clinical studies, which also revealed anxiolytic and antinociceptive effects of CBD (given alone or together with Δ9-tetrahydrocannabinol), which may be important for an adjuvant treatment to improve the quality of life in patients with COVID-19 and to limit post-traumatic stress symptoms. However, one should be aware of side effects of CBD (which are rarely serious), drug interactions (also extending to drugs acting against COVID-19) and the proper route of its administration (vaping may be dangerous). Clearly, further clinical studies are necessary to prove the suitability of CBD for the treatment of COVID-19.

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“… $ Primidone is metabolized by CYP3A4 to phenobarbital, which induces CYP3A4. # Cannabidiol inhibits CYP3A4 and thus concomitant admnistration with glucocorticoids like hydroxycortisone and prednisolone decrease glucocorticoid clearance, thereby increasing their systemic concentration ( Wilson-Morkeh et al, 2019 ). …”

Section: Potential Drug-drug Interactions Between Asms and Covid-19 Candidate Drugsmentioning

confidence: 99%

Management of COVID-19 in patients with seizures: Mechanisms of action of potential COVID-19 drug treatments and consideration for potential drug-drug interactions with anti-seizure medications

et al. 2021

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In regard to the global pandemic of COVID-19, it seems that persons with epilepsy (PWE) are not more vulnerable to get infected by SARS-CoV-2, nor are they more susceptible to a critical course of the disease. However, management of acute seizures in patients with COVID-19 as well as management of PWE and COVID-19 needs to consider potential drug-drug interactions between antiseizure drugs and candidate drugs currently assessed as therapeutic options for COVID-19. Repurposing of several licensed and investigational drugs is discussed for therapeutic management of COVID-19. While for none of these approaches, efficacy and tolerability has been confirmed yet in sufficiently powered and controlled clinical studies, testing is ongoing with multiple clinical trials worldwide. Here, we have summarized the possible mechanisms of action of drugs currently considered as potential therapeutic options for COVID-19 management along with possible and confirmed drug-drug interactions that should be considered for a combination of antiseizure drugs and COVID-19 candidate drugs. Our review suggests that potential drug-drug interactions should be taken into account with drugs such as chloroquine/hydroxychloroquine and lopinavir/ritonavir while remdesivir and tocilizumab may be less prone to clinically relevant interactions with ASMs.

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Important drug interactions exist between cannabidiol oil and commonly prescribed drugs in rheumatology practice

Cited by 16 publications

References 7 publications

Cannabidiol Interactions with Medications, Illicit Substances, and Alcohol: a Comprehensive Review

Cannabidiol Interactions with Medications, Illicit Substances, and Alcohol: a Comprehensive Review

Opportunities, Challenges and Pitfalls of Using Cannabidiol as an Adjuvant Drug in COVID-19

Management of COVID-19 in patients with seizures: Mechanisms of action of potential COVID-19 drug treatments and consideration for potential drug-drug interactions with anti-seizure medications

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