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Clinical Relevance of Drug Interactions with Cannabis: A Systematic Review

Concomitant use of cannabis with other drugs may lead to cannabis–drug interactions, mainly due to the pharmacokinetic mechanism involving the family of CYP450 isoenzymes. This narrative systematic review aimed to systematize the available information regarding clinical relevance of cannabis–drug in...

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Detalles Bibliográficos
Autores principales: Lopera, Valentina, Rodríguez, Adriana, Amariles, Pedro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8911401/
https://www.ncbi.nlm.nih.gov/pubmed/35268245
http://dx.doi.org/10.3390/jcm11051154
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author Lopera, Valentina
Rodríguez, Adriana
Amariles, Pedro
author_facet Lopera, Valentina
Rodríguez, Adriana
Amariles, Pedro
author_sort Lopera, Valentina
collection PubMed
description Concomitant use of cannabis with other drugs may lead to cannabis–drug interactions, mainly due to the pharmacokinetic mechanism involving the family of CYP450 isoenzymes. This narrative systematic review aimed to systematize the available information regarding clinical relevance of cannabis–drug interactions. We utilized the PubMed/Medline database for this systematic review, using the terms drug interactions and cannabis, between June 2011 and June 2021. Articles with cannabis–drug interactions in humans, in English or Spanish, with full-text access were selected. Two researchers evaluated the article’s inclusion. The level of clinical relevance was determined according to the severity and probability of the interaction. Ninety-five articles were identified and twenty-six were included. Overall, 19 pairs of drug interactions with medicinal or recreational cannabis were identified in humans. According to severity and probability, 1, 2, 12, and 4 pairs of cannabis–drug interactions were classified at levels 1 (very high risk), 2 (high risk), 3 (medium risk), and 5 (without risk), respectively. Cannabis–warfarin was classified at level 1, and cannabis–buprenorphine and tacrolimus at level 2. This review provides evidence for both the low probability of the occurrence of clinically relevant drug interactions and the lack of evidence regarding cannabis–drug interactions.
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spelling pubmed-89114012022-03-11 Clinical Relevance of Drug Interactions with Cannabis: A Systematic Review Lopera, Valentina Rodríguez, Adriana Amariles, Pedro J Clin Med Review Concomitant use of cannabis with other drugs may lead to cannabis–drug interactions, mainly due to the pharmacokinetic mechanism involving the family of CYP450 isoenzymes. This narrative systematic review aimed to systematize the available information regarding clinical relevance of cannabis–drug interactions. We utilized the PubMed/Medline database for this systematic review, using the terms drug interactions and cannabis, between June 2011 and June 2021. Articles with cannabis–drug interactions in humans, in English or Spanish, with full-text access were selected. Two researchers evaluated the article’s inclusion. The level of clinical relevance was determined according to the severity and probability of the interaction. Ninety-five articles were identified and twenty-six were included. Overall, 19 pairs of drug interactions with medicinal or recreational cannabis were identified in humans. According to severity and probability, 1, 2, 12, and 4 pairs of cannabis–drug interactions were classified at levels 1 (very high risk), 2 (high risk), 3 (medium risk), and 5 (without risk), respectively. Cannabis–warfarin was classified at level 1, and cannabis–buprenorphine and tacrolimus at level 2. This review provides evidence for both the low probability of the occurrence of clinically relevant drug interactions and the lack of evidence regarding cannabis–drug interactions. MDPI 2022-02-22 /pmc/articles/PMC8911401/ /pubmed/35268245 http://dx.doi.org/10.3390/jcm11051154 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Lopera, Valentina
Rodríguez, Adriana
Amariles, Pedro
Clinical Relevance of Drug Interactions with Cannabis: A Systematic Review
title Clinical Relevance of Drug Interactions with Cannabis: A Systematic Review
title_full Clinical Relevance of Drug Interactions with Cannabis: A Systematic Review
title_fullStr Clinical Relevance of Drug Interactions with Cannabis: A Systematic Review
title_full_unstemmed Clinical Relevance of Drug Interactions with Cannabis: A Systematic Review
title_short Clinical Relevance of Drug Interactions with Cannabis: A Systematic Review
title_sort clinical relevance of drug interactions with cannabis: a systematic review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8911401/
https://www.ncbi.nlm.nih.gov/pubmed/35268245
http://dx.doi.org/10.3390/jcm11051154
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