National Center for Natural Products Research, Research Institute of Pharmaceutical Sciences, School of Pharmacy, University of Mississippi, University, MS, USA.
Department of Pharmaceutics and Drug Delivery, School of Pharmacy, University of Mississippi, University, MS, USA.
J Gen Intern Med. 2021 Jul;36(7):2074-2084. doi: 10.1007/s11606-020-06504-8. Epub 2021 Jan 29.
Cannabidiol, a non-intoxicating phytocannabinoid, has potential therapeutic effects over a broad range of disorders. Recently, there has been increased interest in CBD, as several studies showed promising anticonvulsant efficacy with few side effects. In 2018, a CBD-based oral solution, Epidiolex®, was approved by the FDA to treat two severe forms of pediatric epilepsy, Dravet syndrome, and Lennox-Gastaut syndrome. Although only these two syndromes are recognized indications for CBD, it has been consumed in an unregulated fashion for a variety of indications including chronic pain, muscle stiffness, inflammation, anxiety, smoking cessation, and even cancer. While CBD legislation in the USA is confusing due to the differences in state and federal laws, CBD has proliferated in the US market in several forms such as CBD oil or capsules, hemp oil/extract, and also as an ingredient in several dietary supplements, syrups, teas, and creams. With the ever-increasing use of CBD and its widespread availability to the general public, it is important to examine and report on possible drug-drug interactions between CBD and other therapeutic agents as well as addictive substances such as alcohol and tobacco. A detailed literature search for CBD's possible interactions was conducted using online databases. As expected, CBD has been reported to interact with anti-epileptic drugs, antidepressants, opioid analgesics, and THC, but surprisingly, it interacts with several other common medications, e.g. acetaminophen, and substances including alcohol. This review provides a comprehensive list of interacting drugs. The possible mechanisms for these drug-drug interactions are presented in table format. Given the growing popularity of CBD as a medication and the dearth of available information on CBD drug-drug interactions, it is critical to be aware of current drug-drug interactions and it will be important to investigate the impact of CBD upon concomitant medication use in future randomized, controlled trials.
大麻二酚（CBD）是一种非成瘾性植物大麻素，对多种疾病具有潜在的治疗作用。最近，人们对 CBD 的兴趣日益浓厚，因为几项研究显示出具有良好的抗惊厥疗效，且副作用较少。2018 年，一种基于 CBD 的口服溶液——Epidiolex®获得了 FDA 的批准，用于治疗两种严重的儿童癫痫，即 Dravet 综合征和 Lennox-Gastaut 综合征。尽管只有这两种综合征被认为是 CBD 的适应证，但它已被用于治疗多种疾病，包括慢性疼痛、肌肉僵硬、炎症、焦虑、戒烟，甚至癌症，而且使用方式不规范。由于州和联邦法律存在差异，美国的 CBD 立法令人困惑，但 CBD 已以多种形式在美国市场上大量出现，如 CBD 油或胶囊、大麻油/提取物，以及作为几种膳食补充剂、糖浆、茶和乳膏的成分。随着 CBD 的使用不断增加，以及 CBD 在公众中的广泛可获得性，有必要检查并报告 CBD 与其他治疗药物以及酒精和烟草等成瘾物质之间可能发生的药物相互作用。使用在线数据库对 CBD 可能发生的相互作用进行了详细的文献检索。正如预期的那样，CBD 已被报道与抗癫痫药物、抗抑郁药、阿片类镇痛药和 THC 相互作用，但令人惊讶的是，它还与几种其他常见药物相互作用，如对乙酰氨基酚，以及包括酒精在内的物质。本综述提供了相互作用药物的综合清单。以表格形式呈现了这些药物相互作用的可能机制。鉴于 CBD 作为一种药物越来越受欢迎，而关于 CBD 药物相互作用的信息却很少，因此了解当前的药物相互作用至关重要，在未来的随机对照试验中，研究 CBD 对伴随药物使用的影响也将非常重要。
