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Drug Interactions between aminophylline and cannabidiol

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

aminophylline cannabidiol

Applies to: aminophylline and cannabidiol

MONITOR: Concomitant use of cannabis (marijuana) may decrease the plasma concentrations of theophylline. Smoking marijuana has been reported to increase theophylline clearance, with effect similar to that of smoking tobacco. The mechanism of interaction has not been established, but may involve induction of CYP450 1A2-mediated metabolism by the cannabinoids in marijuana. In one study, theophylline clearance was increased by an average of 42% in chronic smokers of either marijuana or tobacco administered single oral doses of theophylline compared to nonsmokers of either substance. There was an additive increase in total clearance of approximately 79% in subjects who smoked both marijuana and tobacco compared to nonsmokers. It is not known whether, and to what extent, the interaction may occur with other routes of administration of cannabis or any of its cannabinoids. In vitro data suggest that delta-9-tetrahydrocannabinol may induce CYP450 1A2, while cannabidiol may induce or inhibit CYP450 1A2 at clinically relevant concentrations.

MANAGEMENT: Theophylline levels should be monitored closely in patients who use marijuana or its cannabinoids. Dosage adjustments may be required following initiation, discontinuation, or change of cannabis/cannabinoid use.

References

  1. Jusko WJ, Schentag JJ, Clark JH, Gardner M, Yurchak AM (1978) "Enhanced biotransformation of theophylline in marijuana and tobacco smokers." Clin Pharmacol Ther, 24, p. 405-10
  2. Cerner Multum, Inc. "UK Summary of Product Characteristics."
  3. Cerner Multum, Inc. "Australian Product Information."
  4. (2017) "Product Information. Dronabinol (dronabinol)." Watson Pharmaceuticals
View all 4 references

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Drug and food interactions

Moderate

cannabidiol food

Applies to: cannabidiol

ADJUST DOSING INTERVAL: Food may affect the plasma concentrations of cannabidiol. In healthy volunteers, administration of cannabidiol with a high-fat/high-calorie meal increased cannabidiol peak plasma concentration (Cmax) by 5-fold and systemic exposure (AUC) by 4-fold and reduced the total variability compared with administration in the fasted state.

GENERALLY AVOID: Grapefruit juice may increase the plasma concentrations of cannabidiol. The proposed mechanism is inhibition of CYP450 3A4-mediated metabolism of cannabidiol by certain compounds present in grapefruit. The interaction has not been studied, but the product labeling for cannabidiol recommends consideration of a dosage reduction when used with strong or moderate inhibitors of CYP450 3A4. In general, the effect of grapefruit juice is concentration-, dose- and preparation-dependent, and can vary widely among brands. Certain preparations of grapefruit juice (e.g., high dose, double strength) have sometimes demonstrated potent inhibition of CYP450 3A4, while other preparations (e.g., low dose, single strength) have typically demonstrated moderate inhibition.

MANAGEMENT: Cannabidiol should be taken about the same time each day consistently either with or without food. Patients should limit the consumption of grapefruit and grapefruit juice. If they are coadministered, cannabidiol levels should be monitored and the dosage adjusted as necessary.

References

  1. (2018) "Product Information. Epidiolex (cannabidiol)." Greenwich Biosciences LLC

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Moderate

aminophylline food

Applies to: aminophylline

MONITOR: Coadministration of two or more sympathomimetic agents may increase the risk of adverse effects such as nervousness, irritability, and increased heart rate. Central nervous system (CNS) stimulants, particularly amphetamines, can potentiate the adrenergic response to vasopressors and other sympathomimetic agents. Additive increases in blood pressure and heart rate may occur due to enhanced peripheral sympathetic activity.

MANAGEMENT: Caution is advised if two or more sympathomimetic agents are coadministered. Pulse and blood pressure should be closely monitored.

References

  1. Rosenblatt JE, Lake CR, van Kammen DP, Ziegler MG, Bunney WE Jr (1979) "Interactions of amphetamine, pimozide, and lithium on plasma norepineophrine and dopamine-beta-hydroxylase in schizophrenic patients." Psychiatry Res, 1, p. 45-52
  2. Cavanaugh JH, Griffith JD, Oates JA (1970) "Effect of amphetamine on the pressor response to tyramine: formation of p-hydroxynorephedrine from amphetamine in man." Clin Pharmacol Ther, 11, p. 656
  3. (2001) "Product Information. Adderall (amphetamine-dextroamphetamine)." Shire Richwood Pharmaceutical Company Inc
  4. (2001) "Product Information. Tenuate (diethylpropion)." Aventis Pharmaceuticals
  5. (2001) "Product Information. Sanorex (mazindol)." Novartis Pharmaceuticals
  6. (2001) "Product Information. Focalin (dexmethylphenidate)." Mikart Inc
  7. (2002) "Product Information. Strattera (atomoxetine)." Lilly, Eli and Company
View all 7 references

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Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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