Evaluation of the Drug–Drug Interaction Potential of Cannabidiol Against UGT2B7-Mediated Morphine Metabolism Using Physiologically Based Pharmacokinetic Modeling
2024

Cannabidiol's Effect on Morphine Metabolism

Sample size: 400 publication Evidence: moderate

Author Information

Author(s): Shelby Coates, Keti Bardhi, Bhagwat Prasad, Philip Lazarus

Primary Institution: Washington State University

Hypothesis

Does cannabidiol (CBD) affect the metabolism of morphine through drug-drug interactions?

Conclusion

Cannabidiol may mildly increase morphine exposure by 5-10% in both healthy and cirrhotic populations, which could be clinically relevant.

Supporting Evidence

  • Up to 50% of chronic pain patients report co-using cannabis with prescribed opioids.
  • Cannabidiol is a potent inhibitor of UGT2B7, affecting morphine metabolism.
  • Predicted increases in morphine exposure are below FDA's cutoff for significant drug interactions.

Takeaway

When people take CBD with morphine, it can make the morphine work a little stronger, which might be important for safety.

Methodology

Physiologically based pharmacokinetic (PBPK) modeling was used to predict drug-drug interactions between CBD and morphine in healthy and cirrhotic populations.

Limitations

The study may not accurately predict interactions for individuals using higher doses of CBD or for chronic CBD administration.

Participant Demographics

Healthy adults aged 20-40 and adults with severe hepatic impairment.

Digital Object Identifier (DOI)

10.3390/pharmaceutics16121599

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