Cannabis Drug Interactions

Polson, George; Chung, Matthew; Hirani, Salman; Le-Short, Christina

doi:10.1007/978-3-030-69186-8_13

Cited by 2 publications

(6 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This interplay is mediated by the inhibition of several CYP450 enzymes by cannabinoids ( 125 , 126 ). One of the most studied relationships is between cannabis and warfarin, which can be separated into two stereoisomers, S-warfarin and R-warfarin ( 127 – 131 ). CYP2C9, CYP2C19, and CPY3A are the enzymes responsible for the breakdown of S-warfarin, while R-warfarin is metabolized by CYP1A2 and CYP3A ( 46 ); all these enzymes are moderately inhibited by the three major cannabinoids (THC, CBD, and CBN) ( 49 , 127 , 130 , 131 ).…”

Section: Discussionmentioning

confidence: 99%

“…One of the most studied relationships is between cannabis and warfarin, which can be separated into two stereoisomers, S-warfarin and R-warfarin ( 127 – 131 ). CYP2C9, CYP2C19, and CPY3A are the enzymes responsible for the breakdown of S-warfarin, while R-warfarin is metabolized by CYP1A2 and CYP3A ( 46 ); all these enzymes are moderately inhibited by the three major cannabinoids (THC, CBD, and CBN) ( 49 , 127 , 130 , 131 ). CBD is a potent inhibitor of all the CYP enzymes involved in the metabolism of warfarin and can impact the degradation of warfarin and lead to higher plasmatic concentrations than needed ( 131 , 132 ).…”

Section: Discussionmentioning

confidence: 99%

“…CYP2C9, CYP2C19, and CPY3A are the enzymes responsible for the breakdown of S-warfarin, while R-warfarin is metabolized by CYP1A2 and CYP3A ( 46 ); all these enzymes are moderately inhibited by the three major cannabinoids (THC, CBD, and CBN) ( 49 , 127 , 130 , 131 ). CBD is a potent inhibitor of all the CYP enzymes involved in the metabolism of warfarin and can impact the degradation of warfarin and lead to higher plasmatic concentrations than needed ( 131 , 132 ). R-warfarin, the least potent stereoisomer, is metabolized mainly by CYP3A4 ( 127 , 132 ).…”

Section: Discussionmentioning

confidence: 99%

“…Clopidogrel is a popular antiplatelet agent that is used for the treatment of acute coronary syndrome, the prevention of heart attack, and cerebrovascular accidents ( 47 , 133 ). The metabolism of clopidogrel by the isoenzyme CYP2C19 is inhibited by CBD, which could lead to lower levels of the active metabolite and increase the risk for transient ischemic attacks ( 47 , 131 , 134 ). There is no evidence of interactions between cannabis products and heparin or fondaparinux because they are cleared by the kidneys and have no apparent interactions with CYP enzymes ( 126 , 131 , 134 ).…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Potential perioperative cardiovascular outcomes in cannabis/cannabinoid users. A call for caution

Echeverria-Villalobos,

Guevara,

Mitchell

et al. 2024

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

BackgroundCannabis is one of the most widely used psychoactive substances. Its components act through several pathways, producing a myriad of side effects, of which cardiovascular events are the most life-threatening. However, only a limited number of studies address cannabis's perioperative impact on patients during noncardiac surgery.MethodsStudies were identified by searching the PubMed, Medline, EMBASE, and Google Scholar databases using relevant keyword combinations pertinent to the topic.ResultsCurrent evidence shows that cannabis use may cause several cardiovascular events, including abnormalities in cardiac rhythm, myocardial infarction, heart failure, and cerebrovascular events. Additionally, cannabis interacts with anticoagulants and antiplatelet agents, decreasing their efficacy. Finally, the interplay of cannabis with inhalational and intravenous anesthetic agents may lead to adverse perioperative cardiovascular outcomes.ConclusionsThe use of cannabis can trigger cardiovascular events that may depend on factors such as the duration of consumption, the route of administration of the drug, and the dose consumed, which places these patients at risk of drug-drug interactions with anesthetic agents. However, large prospective randomized clinical trials are needed to further elucidate gaps in the body of knowledge regarding which patient population has a greater risk of perioperative complications after cannabis consumption.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Potential perioperative cardiovascular outcomes in cannabis/cannabinoid users. A call for caution

Echeverria-Villalobos,

Guevara,

Mitchell

et al. 2024

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

show abstract

“…In addition to these risks, there is also the potential for adverse drug interactions between Cannabis and other medications, particularly those that are metabolized by the liver ( Brown and Winterstein, 2019 ). Cannabis can interact with certain medications, such as blood thinners and antidepressants, leading to unintended side effects or reduced effectiveness of these drugs ( Polson et al, 2021 ). Furthermore, there are concerns about the potential for Cannabis to interact with other medications or supplements ( Wheeler et al, 2020 ).…”

Section: Risk and Safety Of Cannabismentioning

confidence: 99%

Cannabis: a multifaceted plant with endless potentials

et al. 2023

View full text Add to dashboard Cite

Cannabis sativa, also known as “hemp” or “weed,” is a versatile plant with various uses in medicine, agriculture, food, and cosmetics. This review attempts to evaluate the available literature on the ecology, chemical composition, phytochemistry, pharmacology, traditional uses, industrial uses, and toxicology of Cannabis sativa. So far, 566 chemical compounds have been isolated from Cannabis, including 125 cannabinoids and 198 non-cannabinoids. The psychoactive and physiologically active part of the plant is a cannabinoid, mostly found in the flowers, but also present in smaller amounts in the leaves, stems, and seeds. Of all phytochemicals, terpenes form the largest composition in the plant. Pharmacological evidence reveals that the plants contain cannabinoids which exhibit potential as antioxidants, antibacterial agents, anticancer agents, and anti-inflammatory agents. Furthermore, the compounds in the plants have reported applications in the food and cosmetic industries. Significantly, Cannabis cultivation has a minimal negative impact on the environment in terms of cultivation. Most of the studies focused on the chemical make-up, phytochemistry, and pharmacological effects, but not much is known about the toxic effects. Overall, the Cannabis plant has enormous potential for biological and industrial uses, as well as traditional and other medicinal uses. However, further research is necessary to fully understand and explore the uses and beneficial properties of Cannabis sativa.

show abstract

Cannabis Drug Interactions

Cited by 2 publications

References 43 publications

Potential perioperative cardiovascular outcomes in cannabis/cannabinoid users. A call for caution

Potential perioperative cardiovascular outcomes in cannabis/cannabinoid users. A call for caution

Cannabis: a multifaceted plant with endless potentials

Contact Info

Product

Resources

About