相互作用
Cannabidiol + Phenytoin
重症度: 重大
Cannabidiol and Phenytoin: major interaction.
最終更新日
医療従事者向け・参照専用。このページは簡潔な要約であり、医学的助言ではなく、公式の添付文書や臨床判断に代わるものではありません。処方・調剤の前に必ず確認してください。
このページの臨床コンテンツは英語でのみ提供されています。
概要
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.
この相互作用をわかりやすく説明すると
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.
なぜ起こるのか
Phenytoin induces CYP3A4 and CYP2C19 metabolism of cannabidiol, while cannabidiol inhibits CYP2C19 and CYP2C9 metabolism of phenytoin.
対処法
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.
薬剤師に尋ねること
- 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?
Pro+会員向け
ページ全体を見る
アカウントを作成してPro+トライアルを始めると、CannabidiolとPhenytoinの臨床対応の詳細なアドバイス、追加の注記、エビデンスの詳細、処方全体を対象とした相互作用チェッカーを利用できます。
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
WebでPro+を14日間無料でお試し。カード登録不要。
Phenytoinのその他の相互作用
Cannabidiolのその他の相互作用
よくある質問
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.
完全なモノグラフ、用量、相互作用チェッカーはMediHelpアプリで
MediHelpアプリで、完全なリファレンスを開き、複数薬剤の相互作用をチェックし、用量ツールを利用できます。