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Medizinische Interaktionen:

Interactions

THC and CBD are metabolized by CYP3A4 and CYP2C9

CBD, but not THC, is metabolized by CYP2C19

THC is a CYP1A2 inducer. Theoretically, THC can decrease serum concentrations of clozapine, duloxetine, naproxen, cyclobenzaprine, olanzapine, haloperidol, and chlorpromazine, amongst others.

CBD is a potent inhibitor of CYP3A4 and CYP2D6.

As CYP3A4 metabolizes about a quarter of all drugs, CBD may increase serum concentrations of:

  • Macrolides
  • Calcium channel blockers
  • Benzodiazepines
  • Cyclosporine
  • Sildenafil (and other PDE5 inhibitors)
  • Antihistamines
  • Haloperidol
  • Antiretrovirals
  • Some statins (atorvastatin and simvastatin, but not pravastatin or rosuvastatin)

CYP2D6 metabolizes many antidepressants, so CBD may increase serum concentrations of:

  • SSRIs
  • Tricyclic antidepressants
  • beta-blockers
  • opioids (including codeine and oxycodone)

However, in practical terms THC and CBD are very safe to be taken simultaneously with most drugs. The most important interactions are as follows:

  • THC and CBD increase warfarin levels.
  • Frequent cannabis use has been associated with increased INR.
  • Alcohol may increase THC levels.
  • Smoked cannabis can decrease theophylline levels.
  • In children treated with CBD for epilepsy, CBD increased clobazam levels.