Different drugs interacting with each other is often seen in the elderly age where medications dealing with pain, diabetes, and high cholesterol. Geriatric population is now the fastest growing group of age in using medical cannabis. It displayed various effectiveness in relieving pain, and some phytocannabinoids are recommended in treating different kinds of metabolic conditions.

Hence, it is essential for both users and medical professionals to understand common pharmaceuticals, whether it is to prevent or predict negative interaction and if cannabis and pharmaceuticals can meet the requirements and result to a synergistic effect.

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The interactions of both drugs can work harmoniously and generate the desired effect with fewer side effects or do the opposite and cause danger and damage to the organs involved in the metabolism of the drug. Take, for example, a drug partnered with opiate can increase the potency of the painkilling effect which is highly possible to generate overdose. Another is a second analgesic could allow the dosage of an opiate to decrease its potency resulting to slow tolerance and decreasing other side effects.

There are many possible effects of drugs being taken and metabolized by the liver at the same time. However, users with very little knowledge or nothing at all about pharmaceutical will have a very hard time understanding the very detailed explanation of the process of drugs. By understanding the metabolic process between drugs is one method to estimate the possible drug interactions.

Cytochrome P450

Cytochrome P450 (CYP) is just one of the enzymes that metabolized half of all pharmaceuticals. It is a nonspecific enzyme that oxidizes a variety of molecules, letting the molecules more water-soluble and easier for the kidney to filter. This includes compounds like cannabinoids. Generally, interfering with CYPs activity in metabolizing a drug will increase the blood concentration. With very high blood concentration means high-risk cf efficacy and toxicity.

Prodrugs, on the other hand, are metabolized into the active compound. If the metabolism process is inhibited it decrease the desirable and adverse effects. Because of the complication of metabolizing drugs, it is easier to predict the outcome than guessing the exact effect.

Interaction of Cytochrome P450 and Cannabidiol

Cannabidiol (CBD) is a non-psychoactive compound that hinders CYP1A1, 2B6, 2C9, 2C19, 3A4 and 3A5 with submicromolar potency, and increases the activity of CYPs 2B10 and 2B13. The THC or Tetrahydrocannabinol that produce psychoactive effects is potent in the same manner of obstructing the effects of CYP2C9 and weakens the other CYPs. Determined by the dosage of CBD administered, it greatly affects drug metabolism.

Interaction of CBD of Pain Medications

Nonsteroidal anti-inflammatory drugs (NSAIDs) works mainly by hindering a certain enzyme in the body to reduce swelling. When NSAIDs and CBD are metabolized at the same time possible effects could result in the increase synaptic concentration of anandamide (major endocannabinoid). Which means it can give is highly possible to synergize the body with NSAIDs. It also potentially minimize the impact of gastric side effects.  

Opiates are one of the power pharmaceutical drugs that have a high risk of complications if used wrongly. This can lead to tolerance, drug dependence, and withdrawal syndrome if suddenly stopped. The studies about drug interaction of Opiates and CBD contains limited resource. Oral CBD with dosages of 400-800 mg given with intravenous fentanyl did no show any increase of adverse effects. Similar effects were shown for morphine when THC-rich cannabis is vaporized.  

Basically, Opiates and CBD regulates one another with the recent studies. Some study explains that it reduces the effects of opiates drugs and the other can possibly increase the addictive tendency. The most favorable opiate interaction of CBD and Opiates is through its modulation of dopamine and serotonin.

Although the research about CBD interaction with Pain medication is still in process. Most studies have shown positive feedbacks but more clinical trials need to done to prove CBD can go well with other medications.