Cannabis (Cannabis sativa)
Warfarin dose adjustment required after cannabidiol initiation and titration
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A case of a possible interaction between cannabidiol and warfarin is presented along with a brief overview of cytochrome enzymes involved in these drugs' metabolism.
Case Report DIPS
| Question | ||
|---|---|---|
| 1. Are there previous credible reports in humans? | Yes | Yes |
| 2. Is the interaction consistent with known interactive properties of the precipitant drug? | Yes | Yes |
| 3. Is the interaction consistent with known interactive properties of the object drug? | Yes | Yes |
| 4. Is the event consistent with the known or reasonable time course of the interaction (onset and/or offset)? | Yes | Yes |
| 5. Did the interaction remit upon de-challenge of the precipitant drug with no change in the object drug? | NA | NA |
| 6. Did the interaction reappear when the precipitant drug was re-administered with continued use of object drug? | Skipped | Skipped |
| 7. Are there reasonable alternative causes? | Yes | Yes |
| 8. Was the object drug detected in the blood or other fluids in concentrations consistent with the interaction? | No | Unk/NA |
| 9. Was the drug interaction confirmed by objective evidence consistent with the effects on the object drug (other than from question 8)? | No | NA |
| 10. Was the interaction greater when the precipitant drug dose was increased or less when the precipitant drug dose was decreased? | Yes | Yes |
| (>8 = Highly Probable; 5-8 = Probable; 2-4 = Possible; <2 = Doubtful) |