Interazioni tra farmaci
Cannabidiol + Phenytoin
Gravità: Maggiore
Cannabidiol and Phenytoin: major interaction.
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Sintesi
The interaction runs in both directions. Phenytoin may lower cannabidiol exposure through CYP3A4 induction, reducing seizure control. Cannabidiol may raise phenytoin concentrations through inhibition of CYP2C19 and CYP2C9, which can lead to phenytoin toxicity given its narrow therapeutic index.
Cosa significa questa interazione in parole semplici
Cannabidiol and Phenytoin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Cannabidiol belongs to Central Nervous System; Phenytoin belongs to Central Nervous System.
Perché avviene
Phenytoin induces CYP3A4 and CYP2C19 metabolism of cannabidiol, while cannabidiol inhibits CYP2C19 and CYP2C9 metabolism of phenytoin.
Cosa fare
Monitor phenytoin serum levels and signs of toxicity such as nystagmus, ataxia and sedation when cannabidiol is started or changed, and reduce the phenytoin dose as needed. Consider raising the cannabidiol dose according to response and tolerability.
Cosa chiedere al farmacista
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Altre interazioni di Phenytoin
- Artemether / lumefantrine + Phenytoin Controindicata
- Bictegravir + Phenytoin Controindicata
- Cabotegravir + Phenytoin Controindicata
- Doravirine + Phenytoin Controindicata
- Elbasvir / grazoprevir + Phenytoin Controindicata
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Phenytoin Controindicata
Altre interazioni di Cannabidiol
- Cannabidiol + Sodium valproate Maggiore
- Cannabidiol + Tacrolimus Maggiore
- Abiraterone + Cannabidiol Moderata
- Alogliptin-pioglitazone + Cannabidiol Moderata
- Amiodarone + Cannabidiol Moderata
- Amobarbital + Cannabidiol Moderata
Domande frequenti
Can I take Cannabidiol with Phenytoin?
MediHelp rates the interaction as major. Cannabidiol and Phenytoin can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. The interaction runs in both directions. Phenytoin may lower cannabidiol exposure through CYP3A4 induction, reducing seizure control. Cannabidiol may raise phenytoin concentrations through inhibition of CYP2C19 and CYP2C9, which can lead to phenytoin toxicity given its narrow therapeutic index.
How serious is the interaction between Cannabidiol and Phenytoin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor phenytoin serum levels and signs of toxicity such as nystagmus, ataxia and sedation when cannabidiol is started or changed, and reduce the phenytoin dose as needed. Consider raising the cannabidiol dose according to response and tolerability.
What other medicines interact with Phenytoin?
MediHelp also lists interactions of Phenytoin with, for example, Artemether / lumefantrine, Bictegravir, Cabotegravir. The full list is on the Phenytoin page.
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