Given the increasing acceptance and prevalence of cannabis as a therapeutic option, it’s important for physicians and patients to understand how various cannabis components interact with commonly consumed pharmaceuticals.
Project CBD, a California-based educational non-profit, has published an in-depth primer on Cannabinoid-Drug Interactions for health professionals, patients, and public policy-makers. The 33-page report, summarized below, is available for free download below.
The Project CBD primer includes a discussion of various “substrates” or drugs that are metabolized by cytochrome P450, a large family of non-specific enzymes that are involved in breaking down an estimated 60 to 80 percent of all pharmaceuticals. Cytochrome P450 enzymes may be inhibited or amplified by CBD, THC and other plant cannabinoids, thereby reducing or prolonging the activity of another drug.
By suppressing or inducing specific cytochrome P450 enzymes, CBD and THC can alter how one metabolizes a wide range of substances. Much depends on the particular substrate involved in the drug interaction. Some pharmaceuticals, known as “prodrugs,” don’t become functional until they are metabolized into an active component. If CBD or THC inhibits the breakdown of a prodrug, the latter will remain inactive – whereas inhibiting the metabolism of a regular drug will result in higher blood levels of the active substance.
Several variables make precise predictions about drug interactions difficult, even for practiced physicians. “It is much easier to assess whether drug interactions are likely than to predict their exact effect,” the Project CBD primer asserts.
Project CBD, a California-based educational non-profit, has published an in-depth primer on Cannabinoid-Drug Interactions for health professionals, patients, and public policy-makers. The 33-page report, summarized below, is available for free download below.
The Project CBD primer includes a discussion of various “substrates” or drugs that are metabolized by cytochrome P450, a large family of non-specific enzymes that are involved in breaking down an estimated 60 to 80 percent of all pharmaceuticals. Cytochrome P450 enzymes may be inhibited or amplified by CBD, THC and other plant cannabinoids, thereby reducing or prolonging the activity of another drug.
By suppressing or inducing specific cytochrome P450 enzymes, CBD and THC can alter how one metabolizes a wide range of substances. Much depends on the particular substrate involved in the drug interaction. Some pharmaceuticals, known as “prodrugs,” don’t become functional until they are metabolized into an active component. If CBD or THC inhibits the breakdown of a prodrug, the latter will remain inactive – whereas inhibiting the metabolism of a regular drug will result in higher blood levels of the active substance.
Several variables make precise predictions about drug interactions difficult, even for practiced physicians. “It is much easier to assess whether drug interactions are likely than to predict their exact effect,” the Project CBD primer asserts.
| cannabinoid-drug-interactions_2018-10-11.pdf |