Chapin Maryann R, Kane-Gill Sandra L, Li Xiaotong, Abanyie Kojo, Taneja Sanya B, Egbert Susan, Paine Mary F, Boyce Richard D
School of Pharmacy, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Pharmacol Res Perspect. 2025 Feb;13(1):e70046. doi: 10.1002/prp2.70046.
Data addressing safety concerns related to potential drug interactions between cannabis-derived products and pharmaceutical medications in the pediatric population are lacking. In this study, we retrieved case reports through a published literature search using PubMed and spontaneous reporting data using the Food and Drug Administration's Adverse Event Reporting System (FAERS) to identify potential cannabis- and cannabinoid-drug interactions in individuals younger than 18 years old. To evaluate the published case reports, we used the Drug Interaction Probability Scale (DIPS), a 10-item questionnaire designed to discern the causal relationship between a potential drug interaction and adverse drug reactions (ADRs). FAERS reports were deduplicated and analyzed to gather information regarding patient demographics, associated drugs, nature of the ADRs, outcomes, professions of the reporters, and reporting timelines. Seven published case reports and 9142 FAERS ADRs reports were included in the final analysis. Based on the findings, caution is warranted when cannabis or cannabinoids are used in combination with prescribed medications, including methadone, everolimus, fluoxetine, and paroxetine. Cannabinoids may inhibit drug-metabolizing enzymes, including several cytochrome P450s, leading to increased drug exposure and potentially, an increased risk for ADRs.
缺乏关于大麻衍生产品与儿科人群药物之间潜在药物相互作用安全性问题的数据。在本研究中，我们通过使用PubMed进行公开文献检索以及使用美国食品药品监督管理局不良事件报告系统（FAERS）的自发报告数据来检索病例报告，以识别18岁以下个体中潜在的大麻和大麻素与药物的相互作用。为了评估已发表的病例报告，我们使用了药物相互作用概率量表（DIPS），这是一份旨在辨别潜在药物相互作用与药物不良反应（ADR）之间因果关系的10项问卷。对FAERS报告进行了重复数据删除和分析，以收集有关患者人口统计学、相关药物、ADR的性质、结果、报告者职业和报告时间线的信息。最终分析纳入了7份已发表的病例报告和9142份FAERS ADR报告。根据研究结果，当大麻或大麻素与包括美沙酮、依维莫司、氟西汀和帕罗西汀在内的处方药联合使用时，需要谨慎。大麻素可能会抑制药物代谢酶，包括几种细胞色素P450，从而导致药物暴露增加，并可能增加ADR的风险。
