Version 1
: Received: 7 February 2024 / Approved: 7 February 2024 / Online: 7 February 2024 (17:38:44 CET)
How to cite:
Campos, M.G.; China, M.; Claudio, M.; Capinha, M.; Torres, R.; Oliveira, S.; Fortuna, A. Potential Drug Interactions with Cannabinoids in Selected Chronic Diseases: Epilepsy, Autism Spectrum Disorders, Oncology, Multiple Sclerosis and Pain. Preprints2024, 2024020458. https://doi.org/10.20944/preprints202402.0458.v1
Campos, M.G.; China, M.; Claudio, M.; Capinha, M.; Torres, R.; Oliveira, S.; Fortuna, A. Potential Drug Interactions with Cannabinoids in Selected Chronic Diseases: Epilepsy, Autism Spectrum Disorders, Oncology, Multiple Sclerosis and Pain. Preprints 2024, 2024020458. https://doi.org/10.20944/preprints202402.0458.v1
Campos, M.G.; China, M.; Claudio, M.; Capinha, M.; Torres, R.; Oliveira, S.; Fortuna, A. Potential Drug Interactions with Cannabinoids in Selected Chronic Diseases: Epilepsy, Autism Spectrum Disorders, Oncology, Multiple Sclerosis and Pain. Preprints2024, 2024020458. https://doi.org/10.20944/preprints202402.0458.v1
APA Style
Campos, M.G., China, M., Claudio, M., Capinha, M., Torres, R., Oliveira, S., & Fortuna, A. (2024). Potential Drug Interactions with Cannabinoids in Selected Chronic Diseases: Epilepsy, Autism Spectrum Disorders, Oncology, Multiple Sclerosis and Pain. Preprints. https://doi.org/10.20944/preprints202402.0458.v1
Chicago/Turabian Style
Campos, M.G., Simao Oliveira and Ana Fortuna. 2024 "Potential Drug Interactions with Cannabinoids in Selected Chronic Diseases: Epilepsy, Autism Spectrum Disorders, Oncology, Multiple Sclerosis and Pain" Preprints. https://doi.org/10.20944/preprints202402.0458.v1
Abstract
The clinical practice implies a research translation that helps the use of scientific data and thera-peutic evidence for patient benefits. This review critically summarizes the potential impact of cannabinoids in concomitance with other drugs in the following chronic diseases as Epilepsy, Au-tism Spectrum Disorders (ASD), Oncology, Multiple Sclerosis, and Chronic Pain. The potential in-teractions can change the predicted clinical outcomes of therapeutic protocols and need to be evaluated. Some of the effects would be additive, synergistic or antagonistic, but can also enroll changes in absorption, distribution, metabolism, particularly via cytochrome P450 (CYP) isoen-zymes (e.g CYP2C9 and CYP3A4) and excretion. For instance, the combination of canna-bis-derived compounds and the antifungal drug ketoconazole, a CYP3A4 inhibitor, increases plasma concentration of Δ-9-tetrahydrocannabinol (THC) and CBD (CBD). Opposable, rifampic-in, a CYP3A4 inducer, stands out for the approximately 20-40% reduction in plasma THC levels and 50% to 60% for CBD. Other CYP3A4 inhibitors and inducers are likely to have a similar effect on plasma concentrations if co-administered. Indeed, pharmacokinetic interactions have been also reported with antiseizure drugs. Moreover, pharmacodynamic interactions between cannabinoids and drugs with sympathomimetic effects (eg tachycardia, hypertension), central nervous system depressants (eg drowsiness, ataxia), and anticholinergics (eg tachycardia and drowsiness) are also expected. Even though pending further studies, there is currently clinical evidence supporting drug interaction with cannabinoids, demanding doctors evaluate the risk of drug combinations with cannabinoids. The tables herein provided were designed to facilitate the identification of bi-orelevant interactions that may compromise therapeutic efficacy and toxicity.
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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