Your Dose of Cannabis Education

Your Dose of Cannabis Education

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Your Dose of Cannabis Education is based on data from the studies and reviews published in the current peer-reviewed medical journals. Whether you are a healthcare provider, patient, caregiver, an individual working in the healthcare sector, or just a curious person, you can benefit from Your Dose of Cannabis Education. 

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2026-01-22
Are there any risks associated with the co-administration of CBD and amitriptyline?
When CBD is administered with amitriptyline, the risk of adverse effects such as anticholinergic syndrome, sedation, and QT interval prolongation may increase.
Balachandran, P., Elsohly, M., & Hill, K. P. (2021). Cannabidiol interactions with medications, illicit substances, and alcohol: A comprehensive review. Journal of General Internal Medicine. https://doi.org/10.1007/s11606-020-06504-8
2026-01-21
Does chronic cannabis smoking impact Theophylline levels?
Yes. Chronic cannabis smoking induces CYP1A2. As a result, the clearance of theophylline (and of aminophylline) is increased. Keep in mind that theophylline and aminophylline have a narrow therapeutic index.
Huestis, M. A. (2007). Human cannabinoid pharmacokinetics. Chemistry & Biodiversity, 4(8), 1770-1804. https://doi.org/10.1002/cbdv.200790152.
2026-01-20
CBD may inhibit the cytochrome P450 enzyme CYP2C19. Does that pose an issue for patients who take CBD along with methadone?
Yes. Methadone is metabolized by CYP2C19. If CYP2C19 activity is inhibited, the concentration of methadone will increase, and the combination of CBD and methadone may lead to an increase in sedation.
Madden, K., Tanco, K., & Bruera, E. (2020). Clinically significant drug-drug interaction between methadone and cannabidiol. Pediatrics, 145(5), e20194001. https://doi.org/10.1542/peds.2019-4001
2026-01-16
CBD may inhibit the cytochrome P450 enzyme CYP2C19. Does that pose an issue for patients who take CBD along with warfarin?
Yes. Warfarin has a narrow therapeutic window, and the inhibition of CYP2C19 by CBD can increase levels of warfarin. Multiple reports have indicated that the pharmacokinetic interaction between warfarin and CBD results in a greatly increased risk of bleeding.
Treese, N. M., & Flowers, M. (2020). Pharmacist's guide to CBD oil. U.S. Pharmacist, 45(3), 20-23.
2026-01-15
THC inhibits the cytochrome P450 enzyme CYP2C9. What commonly used drugs are substrates of CYP2C9? What's the potential clinical impact?
Some of the commonly used medications metabolized by CYP2C9 include: antidepressants, antiepileptics, proton pump inhibitors and warfarin. THC's inhibition of CYP2C9 may increase bioavailability and increase adverse effects of these substrates.
Brown, J. D. (2020). Potential adverse drug events with tetrahydrocannabinol (THC) due to drug-drug interactions. Journal of Clinical Medicine, 9(4), 919. https://doi.org/10.3390/jcm9040919

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