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Drug Interactions between aminophylline / guaifenesin and cannabis

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

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Interactions between your drugs

Moderate

aminophylline cannabis (Schedule I substance)

Applies to: aminophylline / guaifenesin and cannabis

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

cannabis (Schedule I substance) food

Applies to: cannabis

GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

MANAGEMENT: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

References

  1. Warrington SJ, Ankier SI, Turner P (1986) "Evaluation of possible interactions between ethanol and trazodone or amitriptyline." Neuropsychobiology, 15, p. 31-7
  2. Gilman AG, eds., Nies AS, Rall TW, Taylor P (1990) "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc.
  3. (2012) "Product Information. Fycompa (perampanel)." Eisai Inc
  4. (2015) "Product Information. Rexulti (brexpiprazole)." Otsuka American Pharmaceuticals Inc
View all 4 references

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Moderate

aminophylline food

Applies to: aminophylline / guaifenesin

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.

See also

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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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