THC and gabapentin interactions in a mouse neuropathic pain model

Atwal, Nicholas; Casey, Sherelle L.; Mitchell, Vanessa; Vaughan, Christopher W.

doi:10.1016/j.neuropharm.2018.10.006

Cited by 42 publications

(37 citation statements)

References 40 publications

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“…Moreover, CBD inhibits P‐glycoprotein mediated transports in a dose‐dependent manner . Established cannabis‐related DDIs involve THC and psychotropic agents, CBD and anticancer agents, CBD and gabapentin, and cannabinoids and warfarin . In general, clinicians should always take into account that medical cannabis could bidirectionally interact with concomitant administered agents by affecting membrane transporters and/or metabolising enzymes …”

Section: Discussionmentioning

confidence: 99%

Adverse events following cannabis for medical use in Tuscany: An analysis of the Italian Phytovigilance database

Crescioli

Lombardi

Bettiol

et al. 2020

Brit J Clinical Pharma

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Aims: Despite a significant increase in using cannabis for medical purposes, current evidence on its safety in real-world clinical practice is still poorly characterised. By a case-by-case analysis of spontaneous reports of suspected adverse events (AEs) collected in Tuscany within the Italian Phytovigilance database, the aim of the present study was to describe AEs occurred in patients exposed to medical cannabis. Methods: We evaluated all reports of cannabis-related suspected AEs collected within the Phytovigilance database up to December 2018. Information regarding cannabis therapy, patient's demographic and clinical characteristics, concomitant medications, AE description according to the Medical Dictionary for Regulatory Activities (MedDRA) classification, AE seriousness and AE outcome, were collected. The causality assessment was performed following World Health Organisation-Uppsala Monitoring Centre criteria.Results: Fifty-three cannabis-related AE reports were analysed. The majority of patients were females (77.3%), with a mean age of 61.9 years. Thirty-nine (73.6%) cases were defined as nonserious and the majority of them (86.9%) showed a complete resolution or improvement. Forty-six (86.8%) cases were judged as probably related to cannabis consumption. The most frequently reported system organ class was psychiatric and nervous system disorders, and a potential drug-drug interaction was present in 16 cases. Conclusion:Cannabis was generally well tolerated and the majority of AEs were mild and transient. Our analysis highlighted important safety issues for clinical practice, in particular the need for an accurate prescription monitoring during the titration phase, particularly in the presence of concomitant medications. K E Y W O R D Sadverse drug reactions, clinical pharmacology, drug safety, general practice, medical cannabis Giada Crescioli and Niccolò Lombardi are co-first authors.

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Section: Discussionmentioning

confidence: 99%

Adverse events following cannabis for medical use in Tuscany: An analysis of the Italian Phytovigilance database

Crescioli

Lombardi

Bettiol

et al. 2020

Brit J Clinical Pharma

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“…After the optimization of preparation and delivery methods, another product, called Cannador ® , came to the market, delivering Δ9-THC:CBD within a narrow concentration range and at a two-to-one ratio, in the form of an orally administered capsule [ 45 ]. In relation to this, many of the recent studies on medical cannabis have focused on various forms of Δ9-THC + CBD administration [ 46 , 47 , 48 , 49 ] and co-administration of Δ9-THC with first-line neurotherapeutic drugs [ 50 ]. On the other hand, the synthesis of Δ9-THC analogs is another effective way to avoid or reduce its severe side effects.…”

Section: Phytocannabinoids and Synthetic Cannabinoidsmentioning

confidence: 99%

Targeting Cannabinoid Receptors: Current Status and Prospects of Natural Products

Peigneur

Hendrickx

et al. 2020

IJMS

131

114

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Cannabinoid receptors (CB1 and CB2), as part of the endocannabinoid system, play a critical role in numerous human physiological and pathological conditions. Thus, considerable efforts have been made to develop ligands for CB1 and CB2, resulting in hundreds of phyto- and synthetic cannabinoids which have shown varying affinities relevant for the treatment of various diseases. However, only a few of these ligands are clinically used. Recently, more detailed structural information for cannabinoid receptors was revealed thanks to the powerfulness of cryo-electron microscopy, which now can accelerate structure-based drug discovery. At the same time, novel peptide-type cannabinoids from animal sources have arrived at the scene, with their potential in vivo therapeutic effects in relation to cannabinoid receptors. From a natural products perspective, it is expected that more novel cannabinoids will be discovered and forecasted as promising drug leads from diverse natural sources and species, such as animal venoms which constitute a true pharmacopeia of toxins modulating diverse targets, including voltage- and ligand-gated ion channels, G protein-coupled receptors such as CB1 and CB2, with astonishing affinity and selectivity. Therefore, it is believed that discovering novel cannabinoids starting from studying the biodiversity of the species living on planet earth is an uncharted territory.

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“…A study in a mouse neuropathic pain model found a synergistic interaction between gabapentin and THC, where gabapentin not only improved the THC therapeutic window, but also effectively enhanced its anti-allodynic activity [61].…”

Section: Other Potential Drug Interactionsmentioning

confidence: 99%

Medicinal Cannabis—Potential Drug Interactions

Alsherbiny

2018

Medicines

125

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The endocannabinoids system (ECS) has garnered considerable interest as a potential therapeutic target in various carcinomas and cancer-related conditions alongside neurodegenerative diseases. Cannabinoids are implemented in several physiological processes such as appetite stimulation, energy balance, pain modulation and the control of chemotherapy-induced nausea and vomiting (CINV). However, pharmacokinetics and pharmacodynamics interactions could be perceived in drug combinations, so in this short review we tried to shed light on the potential drug interactions of medicinal cannabis. Hitherto, few data have been provided to the healthcare practitioners about the drug–drug interactions of cannabinoids with other prescription medications. In general, cannabinoids are usually well tolerated, but bidirectional effects may be expected with concomitant administered agents via affected membrane transporters (Glycoprotein p, breast cancer resistance proteins, and multidrug resistance proteins) and metabolizing enzymes (Cytochrome P450 and UDP-glucuronosyltransferases). Caution should be undertaken to closely monitor the responses of cannabis users with certain drugs to guard their safety, especially for the elderly and people with chronic diseases or kidney and liver conditions.

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THC and gabapentin interactions in a mouse neuropathic pain model

Cited by 42 publications

References 40 publications

Adverse events following cannabis for medical use in Tuscany: An analysis of the Italian Phytovigilance database

Adverse events following cannabis for medical use in Tuscany: An analysis of the Italian Phytovigilance database

Targeting Cannabinoid Receptors: Current Status and Prospects of Natural Products

Medicinal Cannabis—Potential Drug Interactions

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