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Recent studies indicate that CBD can potentially affect the metabolism of a variety of drugs via inhibition of CYP metabolizing enzymes. Data indicates that CBD may inhibit the following liver metabolizing enzymes:
Metabolizing enzyme inhibition often leads to increased drug concentrations (due to decreased enzyme activity).
Following the approval of Epidiolex for the treatment of Epilepsy in 2018, modern medicine has received a much-publicized boost. Within the first launch year, this cannabis-based drug was sold in large units as consumption immediately soared. First-year sales reportedly added $269 million to the global sales of CBD-based pharmaceuticals and supplement products. In the U.S. alone, GW Pharmaceuticals reported a sale value amounting to $106.1 million, as Epidiolex also gathered $10 million in Germany and the UK. Judging from the consumption rate and Epidiolex success in rare forms of epilepsy, it is safe to conclude that cannabis-derived drugs have formed a niche in modern medicine.
Cannabidiol interactions with other drugs
In 2010, the Food Drug Administration approved Oleptro (Trazodone) as an antidepressant for the management of major depressive disorders. Since its approval, Trazodone has also been used as an off-label medication for sleep disorders and PTSD. Trazodone works by inhibiting the biological activity of serotonin transported and serotonin type 2 receptors. In comparison with other popular antidepressants, trazodone has shown better efficacy and few side effects. This drug is particularly popular in the management of depression as it is better tolerated by patients. In addition to its antidepressant properties, Trazodone has also shown significant anti-inflammatory properties.
Effects of cannabidiol-Trazodone combination
In 2013, Drug Metabolism and Pharmacokinetics published the report of research investigating the inhibitory effects of cannabidiol on the catalytic activity of cytochrome p450 isoforms. Results published indicated that cannabidiol is a potent inhibitor of the cytochrome enzymes and, as such, can affect the bioavailability of drugs metabolized by these enzymes ( Rongrong Jigang et al., 2013 ). This conclusion validates the report of earlier research suggesting that cannabidiol markedly inhibits the metabolism of drugs in animal models by inactivating specific cytochrome p450 enzymes. In addition to its effects on the cytochrome enzymes, there are other research findings suggesting that cannabinoids can influence the activity of other enzyme systems in the body to affect the activity of co-administered drugs.