Evidence of a Clinically Significant Drug-Drug Interaction between Cannabidiol and Tacrolimus.

Cannabidiol (CBD), a major purified non-psychoactive component of cannabis with anticonvulsant properties, was approved by the Food and Drug Administration in June 2018 as an adjuvant treatment for refractory epilepsy (Epidiolex; GW Pharmaceuticals). CBD is metabolized by CYP3A4 and CYP2C19 with a growing body of evidence suggesting it is also a potent inhibitor of these pathways. We report for the first time a significant drug-drug interaction between the purified CBD product and tacrolimus. A participant in a CBD clinical trial for epilepsy who was also receiving tacrolimus showed an approximately 3-fold increase in dose normalized tacrolimus concentrations while receiving 2000-2900 mg/day of CBD. Our report delineates an important concern for the transplant community with the increasing legalization of cannabis and advent of a FDA approved CBD product. Larger studies are needed to better understand the impact of this drug-drug interaction in solid organ transplant recipients. This article is protected by copyright. All rights reserved.

This article is protected by copyright. All rights reserved.