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Revista Científica Eletrônica do Conselho Regional de Farmácia da Bahia
Article . 2025 . Peer-reviewed
License: CC BY
Data sources: Crossref
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Interações medicamentosas do canabidiol: um guia farmacológico

Authors: Bruno José Dumêt Fernandes; Alena Pereira dos Santos;

Interações medicamentosas do canabidiol: um guia farmacológico

Abstract

Devido ao crescente uso de canabidiol (CBD), é provável que ocorra interações quando administrado junto a medicamentos. Produtos de cannabis medicinal contêm uma variedade de fitocanabinoides, incluindo 9-tetrahidrocanabinol (9-THC), que é psicoativo, e o CBD sem efeitos eufóricos. Interações farmacodinâmicas podem ocorrer se a cannabis medicinal for administrada junto a medicamentos depressores do sistema nervoso central. Objetivo: fornecer orientação clínica sobre possíveis interações medicamentosas entre o CBD e outros medicamentos prescritos simultaneamente. Método: Esse estudo é uma revisão narrativa que busca sintetizar e discutir a farmacocinética e as principais enzimas, transportadores e receptores celulares, responsáveis pelos mecanismos das interações medicamentosas do CBD. Conclusão: a interação medicamentosa não é um determinante da resposta clínica e, para cada paciente, o regime de dosagem do CBD, com base nas evidências científicas, deve ser individualizado e acompanhado pelo farmacêutico e pelo médico prescritor. Referências KICMAN, A. & TOCZEK, M. The Effects of Cannabidiol, a Non-Intoxicating Compound of Cannabis, on the Cardiovascular System in Health and Disease. Int J Mol Sci. 2020; 21: 6740. DOI: 10.3390/ijms21186740 PISANTI, S.; MALFITANO, A.M.; CIAGLIA, E. et al. Cannabidiol: State of the art and new challenges for therapeutic applications. Pharmacol Ther. 2017; 175: 133–150. DOI: 10.1016/j.pharmthera.2017.02.041. BROWN, J.D. & WINTERSTEIN, A.G. Potential adverse drug events and drug–drug interactions with medical and consumer cannabidiol (CBD) use. J Clin Med. 2019; 8: 989. DOI: 10.3390/jcm8070989. LUCAS, C.J.; GALETTIS, P.; SCHNEIDER, J. The pharmacokinetics and the pharmacodynamics of cannabinoids. Br J Clin Pharmacol. 2018; 84: 2477–2482. DOI: 10.1111/bcp.13710. FERREIRA-JUNIOR, N.C.; CAMPOS, A.C.; GUIMARÃES, F.S. et al. Biological bases for a possible effect of cannabidiol in Parkinson’s disease. Braz J Psychiatry. 2020; 42(2): 218-224. DOI: 10.1590/1516-4446-2019-0460. LANDMARK, C.J. & BRANDL, U. Pharmacology and drug interactions of cannabinoids. Epileptic Disord. 2020; 22 (Suppl. 1): S16-S22. DOI: 10.1684/epd.2019.1123. NASRIN, S.; WATSON, C.J.W.; BARDHI, K. et al. Inhibition of udp-glucuronosyltransferase enzymes by major cannabinoids and their metabolites. Drug Metab Dispos. 2021; 49: 1081–1089. DOI: 10.1124/dmd.121.000530. GROTENHERMEN, F. Pharmacokinetics and pharmacodynamics of cannabinoids. Clin Pharmacokinet. 2003; 42: 327–360. DOI: 10.2165/00003088-200342040-00003. OHLSSON, A.; LINDGREN, J.E.; ANDERSSON, S. et al. Single-dose kinetics of deuterium-labelled cannabidiol in man after smoking and intravenous administration. Biomed Environ Mass Spectrom. 1986; 13: 77–83. DOI: 10.1002/bms.1200130206. GASTON, T.E. & FRIEDMAN, D. Pharmacology of cannabinoids in the treatment of epilepsy. Epilepsy Behav. 2017; 70 (Pt B): 313–318. DOI: 10.1016/j.yebeh.2016.11.016. HUESTIS, M.A. Human cannabinoid pharmacokinetics. Chem Biodivers. 2007; 4: 1770–1804. DOI: 10.1002/cbdv.200790152. ZHU, H.J.; WANG, J.S.; MARKOWITZ, J.S. et al. Characterization of P-glycoprotein inhibition by major cannabinoids from marijuana. J Pharmacol Exp Ther. 2006; 317: 850–7. DOI: 10.1124/jpet.105.098541. BALACHANDRAN, P.; ELSOHLY, M.; HILL, K.P. Cannabidiol Interactions with Medications, Illicit Substances, and Alcohol: a Comprehensive Review. J Gen Intern Med. 2021; 36(7): 2074–2084. DOI: 10.1007/s11606-020-06504-8. US Food and Drug Administration. Drug Development and Drug Interactions | Table of Substrates, Inhibitors and Inducers 2023. Disponível em https://www.fda.gov/drugs/drug-interactions-labeling/drug-development-and-drug-interactions-table-substrates-inhibitors-and-inducers. Acesso em 3 jun 2024. FLOCKHART, D.A. Drug Interactions: Cytochrome P450 Drug Interaction Table. Indiana University School of Medicine 2007; Disponível em https://drug-interactions.medicine.iu.edu/MainTable.aspx. Acesso em 3 jun 2024. TURPEINEN, M.; RAUNIO, H.; PELKONEN, O. The functional role of CYP2B6 in human drug metabolism: substrates and inhibitors in vitro, in vivo and in silico. Curr Drug Metabol. 2006; 7 (7): 705-714. DOI: 10.2174/138920006778520633. MINERS, J.O. & BIRKETT, D.J. Cytochrome P4502C9: an enzyme of major importance in human drug metabolism. Br J Clin Pharmacol. 1998;45 (6):525-538. DOI: 10.1046/j.1365-2125.1998.00721.x. Cytochrome P-450 CYP2C9 Inducers. Disponível em https://go.drugbank.com/categories/DBCAT001245. Acesso em 3 jun 2024. VAN BOOVEN, D.; MARSH, S.; MCLEOD, H. et al. Cytochrome P450 2C9-CYP2C9. Pharmacogenet Genomics. 2010; 20 (4): 277-281. DOI: 10.1097/FPC.0b013e3283349e84. DYMOND, A.W.; SO, K.; MARTIN, P. et al. Effects of cytochrome P450 (CYP3A4 and CYP2C19) inhibition and induction on the exposure of selumetinib, a MEK1/2 inhibitor, in healthy subjects: results from two clinical trials. Eur J Clin Pharmacol. 2017; 73 (2): 175-184. DOI: 10.1007/s00228-016-2153-7. Cytochrome P-450 CYP2C19 Inducers. Disponível em https://go.drugbank.com/categories/DBCAT001246. Acesso em 3 jun 2024. ZANGER, U.M.;·RAIMUNDO, S.;·EICHELBAUM, M. Cytochrome P450 2D6: overview and update on pharmacology, genetics, biochemistry. Naunyn Schmiedebergs Arch Pharmacol. 2004; 369: 23–37. DOI: 10.1007/s00210-003-0832-2. UpToDate®: Inhibitors and inducers of P-glycoprotein (P-gp) drug efflux pump (P-gp multidrug resistance transporter 2024. In: UpToDate, Connor RF (Ed), Wolters Kluwer. Disponível em https://www.uptodate.com/contents/image?imageKey=DRUG/73326. Acesso em 10 junho 2024. SERA, L. & DUNCAN, N. Medical cannabis: Roles, responsibilities, and challenges for clinical pharmacists. J Am Coll Clin Pharm. 2023; 6:732–741. MacCALLUM, C.A & RUSSO, E.B. Practical considerations in medical cannabis administration and dosing. Eur J Intern Med. 2018; 49: 12-19. DOI: 10.1016/j.ejim.2018.01.004. UJVÁRY, I. & HANUŠ, L. Human Metabolites of Cannabidiol: A Review on Their Formation, Biological Activity, and Relevance in Therapy. Cannabis Cannabinoid Res. 2016; 1(1): 90-101. DOI: 10.1089/can.2015.0012. MacCALLUM, C.A; LO L.A.; BOIVIN, M. "Is medical cannabis safe for my patients?" A practical review of cannabis safety considerations. Eur J Intern Med. 2021; 89: 10–8. DOI: /10.1016/j.ejim.2021.05.002.

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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