Cannabidiol (CBD) and Tetrahydrocannabinol (THC) Drug Interactions: A Narrative Review
by Jessica L. Haase, 2025 PharmD Candidate, Adrian M. Bak, 2025 PharmD Candidate, Mathawan Balakrishnan, 2025 PharmD Candidate, Dejana Gligorevic, 2025 PharmD Candidate; Lucas Thao, 2025 PharmD Candidate
Abstract:
Cannabidiol (CBD) and tetrahydrocannabinol (THC) are seeing an increase in use, but their potential to induce drug-drug interactions remains largely unexplored. Through pharmacokinetics and enzyme metabolism, breast cancer resistance protein (BCRP), p-glycoprotein (p-gp), and UDP-glucuronosyltransferase (UGT) interactions that impact activity can be predicted. From this narrative review, a number of cytochrome P450 (CYP) isoenzymes have been identified that increase or decrease the half-life of the affected drug, CBD or THC. BRCP, p-gp, and UGT enzymatic activities are impacted similarly. The topic of CBD/THC drug interactions is a fairly recent topic that is not well studied, and many pharmacists are unaware of how to approach patient questions when they arise. With the growing use of CBD/THC products, it is imperative that pharmacists become aware of these interactions to better advise their patient populations. The purpose of this narrative review is to identify and provide summarized guidance for clinicians to consider when encountering drug interactions between medications and CBD or THC in practice. The hope is that a pharmacist will ask patients about CBD/THC use, allowing them to make educated suggestions that a patient or provider should consider.
Keywords: Cannabidiol, tetrahydrocannabinol, drug-drug interaction, cytochrome 450, breast cancer resistance protein, p-glycoprotein, UDP-glucuronosyltransferase,
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2024 November/December Table of Contents
Abstract:
Cannabidiol (CBD) and tetrahydrocannabinol (THC) are seeing an increase in use, but their potential to induce drug-drug interactions remains largely unexplored. Through pharmacokinetics and enzyme metabolism, breast cancer resistance protein (BCRP), p-glycoprotein (p-gp), and UDP-glucuronosyltransferase (UGT) interactions that impact activity can be predicted. From this narrative review, a number of cytochrome P450 (CYP) isoenzymes have been identified that increase or decrease the half-life of the affected drug, CBD or THC. BRCP, p-gp, and UGT enzymatic activities are impacted similarly. The topic of CBD/THC drug interactions is a fairly recent topic that is not well studied, and many pharmacists are unaware of how to approach patient questions when they arise. With the growing use of CBD/THC products, it is imperative that pharmacists become aware of these interactions to better advise their patient populations. The purpose of this narrative review is to identify and provide summarized guidance for clinicians to consider when encountering drug interactions between medications and CBD or THC in practice. The hope is that a pharmacist will ask patients about CBD/THC use, allowing them to make educated suggestions that a patient or provider should consider.
Keywords: Cannabidiol, tetrahydrocannabinol, drug-drug interaction, cytochrome 450, breast cancer resistance protein, p-glycoprotein, UDP-glucuronosyltransferase,
Download PDF
2024 November/December Table of Contents