Schools of Medicine and Public Health, University of Newcastle, Hunter Medical Research Institute, Newcastle, New South Wales, Australia.
Clinical Pharmacology, Department of Medicine, The Royal Children's Hospital, Melbourne, Victoria, Australia.
Intern Med J. 2020 Jul;50(7):846-853. doi: 10.1111/imj.14415.
The most important two medicinal cannabinoids are Δ -tetrahydrocannabinol (THC) and cannabidiol (CBD). Vaporised administration is superior due to its higher systemic availability, lower individual variability and faster drug delivery. Although it is common THC is co-administered with CBD, the influence of CBD on the pharmacokinetics, especially the systemic availability of THC after vaporised administration, is unknown.
To investigate the influence of different doses of co-administered CBD on the systemic availability of THC, and to compare the availability of THC and CBD in a sample of frequent and infrequent cannabis users.
The study used a randomised, double-blind, crossover placebo-controlled design. THC and/or CBD in ethanol was vaporised and inhaled. Plasma concentrations of THC and CBD were analysed. The THC data created in this study were pooled together with published THC pharmacokinetic data in order to cover all the phases of THC disposition. Population pharmacokinetic model of THC was developed based on the pooled data. The model of CBD was developed based on the data created in this study.
Population pharmacokinetic models of THC and CBD were developed. With concomitant inhalation of high-dose CBD, the systemic availability of THC decreased significantly. Frequent cannabis users appeared to have higher systemic availability of THC and CBD when high-dose CBD was administered.
The results observed in this study are useful for guiding future pharmacokinetic studies of medicinal cannabinoids, and for development of dosing guidelines for medical use of cannabis in the 'real-world' setting.
最重要的两种药用大麻素是Δ-9-四氢大麻酚(THC)和大麻二酚(CBD)。由于其更高的全身利用率、更低的个体变异性和更快的药物递送,汽化给药更具优势。尽管 THC 通常与 CBD 共同给药,但 CBD 对药代动力学的影响,特别是汽化给药后 THC 的全身利用率,尚不清楚。
研究不同剂量的 CBD 共给药对 THC 全身利用率的影响,并比较频繁和不频繁使用大麻者样本中 THC 和 CBD 的可用性。
该研究采用随机、双盲、交叉安慰剂对照设计。将 THC 和/或 CBD 溶于乙醇中进行汽化和吸入。分析血浆中 THC 和 CBD 的浓度。本研究中创建的 THC 数据与已发表的 THC 药代动力学数据一起汇总,以涵盖 THC 处置的所有阶段。基于汇总数据开发了 THC 的群体药代动力学模型。基于本研究中创建的数据开发了 CBD 的模型。
开发了 THC 和 CBD 的群体药代动力学模型。同时吸入高剂量 CBD 时,THC 的全身利用率显著降低。当给予高剂量 CBD 时,频繁使用大麻者的 THC 和 CBD 全身利用率似乎更高。
本研究观察到的结果有助于指导未来药用大麻素的药代动力学研究,并为“真实世界”环境中大麻的医疗用途制定剂量指南。