I emphasize that the only difference between marijuana and hemp is the concentration of THC. Hemp (Cannabis sativa), also called industrial hemp, a plant of the Cannabaceae family cultivated for its bast fiber or its edible seeds. Hemp is sometimes confused with cannabis plants that serve as sources of the drug, marijuana and prepared hashish. Although all three products (hemp, marijuana and hashish) contain tetrahydrocannabinol (THC), a compound that produces psychoactive effects on humans, the cannabis strain cultivated for hemp contains only small amounts of THC compared to that grown for the production of marijuana or hashish.
Cannabidiol (CBD) is a compound found in marijuana. CBD is not harmful, meaning it doesn't cause a “high”. In this case, the healthcare provider will want to question the use of tobacco products, as well as refer to the list of interactions between cannabinoids and drugs (see Table. This comprehensive list of drug interactions is intended to provide a reference when reviewing a patient's medication regimen containing over-the-counter, herbal and prescription drugs and, perhaps, also considers the illicit or unregulated use of products containing cannabinoids.
In addition, other possible drug interactions result from drugs that are highly protein-bound, those metabolized by the enzyme CYP1A2 (SUBSTRATE) and further induced by smoking. This list of potential drug interactions is intended to provide a reference when reviewing a patient's medication regimen containing over-the-counter, herbal and prescription drugs and, perhaps, also considers the illicit or unregulated use of products containing cannabinoids. The frequency of cannabinoid use, the route of administration, gastrointestinal absorption, hepatic metabolism, renal excretion and the patient's genomic profile may influence cannabinoid metabolism and influence the degree of interaction between drugs and any resulting adverse events. In addition, the increase in recreational cannabis use represents a major concern for healthcare providers when it comes to knowing when to worry about unwanted drug interactions.
Products containing cannabinoids, together with over-the-counter, herbal, or concurrently prescribed medications, can compete as a SUBSTRATE for the same metabolic enzyme, resulting in an increase in their relative drug concentrations (which work effectively as INHIBITORS). However, Marinol and Cesamet are listed as Schedule III and Schedule II drugs, respectively, meaning that the FDA recognizes their clinical benefits and their potential for abuse is believed to be lower. If a possible drug interaction is identified, it does not necessarily result in a contraindicated combination or a clinically significant interaction, but rather an opportunity to evaluate the dose of the cannabinoid or the concomitant IP. Sometimes, the IP format of the cannabinoids Δ9-THC and CBD varied; therefore, information on drug interactions was difficult to compare and contrast.
A more complete list of possible drug interactions is provided in the online supplementary material (together with specific details of the enzymes involved). While the restricted use of prescription cannabinoids presents a potential problem for drug interactions, another major concern arises from the increase in the use of cannabis and cannabis extracts as therapeutic agents (p. Therefore, in an effort to reduce any possible false alerts, alert to fatigue, and provide a manageable list of drug interactions, this report highlights drugs that have only one NTI. In any case, this continues to prompt the healthcare provider to conduct more research to identify potential drug interactions.
Drug interactions, associated with cannabinoid-containing products, should not simply be limited to additional dizziness, confusion, sedation, and sleepiness when taken concomitantly with alcohol or other central nervous system sedative medications (e.g. .
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