Supplementary Material for: Delta-9-Tetrahydrocannabinol and Cannabidiol Drug-Drug Interactions

Although prescribing information (PI) is often the initial source of information when identifying potential drug-drug interactions, it may only provide a limited number of exemplars or only reference a class of medications without providing any specific medication examples. In the case of medical cannabis and medicinal cannabinoids, this is further complicated by the fact that the increased therapeutic use of marijuana extracts and cannabidiol oil will not have regulatory agency approved PI. The objective of this study was to provide a detailed and comprehensive drug-drug interaction list that is aligned with cannabinoid manufacturer PI. The cannabinoid drug-drug interaction information is listed in this article and online supplementary material as a PRECIPITANT (cannabinoid) medication that either INHIBITS/INDUCES the metabolism or competes for the same SUBSTRATE target (metabolic enzyme) of an OBJECT (OTHER) medication. In addition to a comprehensive list of drug-drug interactions, we also provide a list of 57 prescription medications displaying a narrow therapeutic index that are potentially impacted by concomitant cannabinoid use (whether through prescription use of cannabinoid medications or therapeutic/recreational use of cannabis and its extracts).

尽管处方信息 (Prescribing Information, PI) 是识别潜在药物相互作用时的首要信息来源，但其仅能提供有限的示例，或仅提及某类药物却未给出具体的药物实例。而就医用大麻与药用大麻素而言，由于大麻提取物及大麻二酚油的治疗性应用日益增多却未获得监管机构批准的处方信息，这一问题进一步复杂化。本研究的目标在于提供一份与大麻素生产商处方信息相符的详细且全面的药物相互作用清单。本文及在线补充材料中收录的大麻素类药物相互作用信息，将大麻素归类为促发药物（PRECIPITANT）：此类药物可抑制或诱导代谢过程，或与靶标药物（OBJECT, OTHER）的同一代谢酶底物靶点竞争。除全面的药物相互作用清单外，本研究还列出了57种治疗指数狭窄的处方药物，此类药物可能因合并使用大麻素（包括处方类大麻素药物，或治疗性、娱乐性使用大麻及其提取物）而受到潜在影响。