Interações medicamentosas
Cannabidiol + Phenytoin
Gravidade: Grave
Cannabidiol and Phenytoin: major interaction.
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Resumo
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.
O que esta interação significa em palavras simples
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.
Por que acontece
Phenytoin induces CYP3A4 and CYP2C19 metabolism of cannabidiol, while cannabidiol inhibits CYP2C19 and CYP2C9 metabolism of phenytoin.
O que fazer
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.
O que perguntar ao farmacêutico
- 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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Outras interações de Phenytoin
- Artemether / lumefantrine + Phenytoin Contraindicada
- Bictegravir + Phenytoin Contraindicada
- Cabotegravir + Phenytoin Contraindicada
- Doravirine + Phenytoin Contraindicada
- Elbasvir / grazoprevir + Phenytoin Contraindicada
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Phenytoin Contraindicada
Outras interações de Cannabidiol
- Cannabidiol + Sodium valproate Grave
- Cannabidiol + Tacrolimus Grave
- Abiraterone + Cannabidiol Moderada
- Alogliptin-pioglitazone + Cannabidiol Moderada
- Amiodarone + Cannabidiol Moderada
- Amobarbital + Cannabidiol Moderada
Perguntas frequentes
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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