Drug Interactions between cannabidiol and rifapentine
This report displays the potential drug interactions for the following 2 drugs:
- cannabidiol
- rifapentine
Interactions between your drugs
rifapentine cannabidiol
Applies to: rifapentine and cannabidiol
ADJUST DOSE: Coadministration with potent inducers of CYP450 3A4 and/or CYP450 2C19 may decrease the plasma concentrations of cannabidiol. The proposed mechanism of action is induction of CYP450 3A4 and/or 2C19-mediated metabolism of cannabidiol. A drug interaction study evaluating coadministration of rifampin 600 mg once daily with cannabidiol showed a decrease in systemic exposure (AUC) and peak plasma concentration (Cmax) of cannabidiol by 32% and 34%, respectively. Moderate change to the active metabolite 7-OH-CBD was also observed (AUC decreased by 63%; Cmax decreased by 67%). The impact of these changes on cannabidiol efficacy is unknown.
MANAGEMENT: A dosage increase of cannabidiol up to 2-fold may be required when coadministered with potent inducers of CYP450 3A4 and/or CYP450 2C19 based on clinical response and tolerability.
References
- Cerner Multum, Inc. "UK Summary of Product Characteristics."
- (2018) "Product Information. Epidiolex (cannabidiol)." Greenwich Biosciences LLC
Drug and food interactions
rifapentine food
Applies to: rifapentine
ADJUST DOSING INTERVAL: Administration with food may increase the oral bioavailability of rifapentine and reduce the incidence of gastrointestinal adverse events. Administration with a high fat meal typically increases rifapentine's maximum concentration (Cmax) and systemic exposure (AUC) by approximately 40% to 50% over that observed when rifapentine is administered under fasting conditions. Rifapentine is often prescribed in combination with isoniazid. When single doses of rifapentine (900 mg) and isoniazid (900 mg) were administered with a low fat, high carbohydrate breakfast, the Cmax and AUC of rifapentine increased by 47% and 51%, respectively. On the other hand, isoniazid's Cmax and AUC decreased by 46% and 23%, respectively.
MANAGEMENT: Products containing oral rifapentine as the sole ingredient recommend administration with a meal to increase bioavailability and reduce the occurrence of gastrointestinal upset, nausea, and/or vomiting. Consultation of product labeling for combination products and/or relevant guidelines may be helpful if rifapentine is combined with a medication that is typically taken on an empty stomach.
References
- (2021) "Product Information. Isoniazid/Rifapentine 300 mg/300 mg (Macleods) (isoniazid-rifapentine)." Imported (India), 2
- (2021) "Product Information. Priftin (rifapentine)." sanofi-aventis
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
- (2018) "Product Information. Epidiolex (cannabidiol)." Greenwich Biosciences LLC
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.
See also
Drug Interaction Classification
Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
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. | |
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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