Case report: Medical cannabis—warfarin drug-drug interaction
Abstract Aim A case of an 85-year-old patient with concurrent use of warfarin and medical cannabis containing delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) is described. Warfarin continues to be a cornerstone of anticoagulation treatment despite the recent addition of FDA-approved anticoa...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-01-01
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| Series: | Journal of Cannabis Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s42238-021-00112-x |
| _version_ | 1798026545692934144 |
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| author | Tyan F. Thomas Evdokia S. Metaxas Thu Nguyen Whitni Bennett Kathryn V. Skiendzielewski Diane H. Quinn Alice L. Scaletta |
| author_facet | Tyan F. Thomas Evdokia S. Metaxas Thu Nguyen Whitni Bennett Kathryn V. Skiendzielewski Diane H. Quinn Alice L. Scaletta |
| author_sort | Tyan F. Thomas |
| collection | DOAJ |
| description | Abstract Aim A case of an 85-year-old patient with concurrent use of warfarin and medical cannabis containing delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) is described. Warfarin continues to be a cornerstone of anticoagulation treatment despite the recent addition of FDA-approved anticoagulant agents. It is well known that warfarin has numerous drug interactions; however, much remains unknown about its interaction with THC and CBD. A literature review was conducted to identify documented cases of possible interactions between cannabis and warfarin. The case reports we identified noted that cannabis may potentially increase warfarin’s effect. Therefore, we aimed to determine why an effect was not seen on our patient’s warfarin dose despite daily use of medical cannabis. Case This case report describes an 85-year-old patient who despite starting an oromucosal medical cannabis regimen of THC and CBD (which provided 0.3 mg of THC and 5.3 mg CBD once daily and an additional 0.625 mg of THC and 0.625 mg CBD once daily as needed) had minimal INR fluctuations from October 2018 to September 2019. Conclusion Despite the introduction and use of medical cannabis therapy, with both THC and CBD components, an elderly patient with concurrent warfarin use did not see major INR fluctuations, in contrast to published literature. The potential for warfarin and THC/CBD interactions may be dependent on route of administration and dose of the cannabis product. |
| first_indexed | 2024-04-11T18:37:05Z |
| format | Article |
| id | doaj.art-ff32b328e4a34d769c8cfa9141d44d0d |
| institution | Directory Open Access Journal |
| issn | 2522-5782 |
| language | English |
| last_indexed | 2024-04-11T18:37:05Z |
| publishDate | 2022-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cannabis Research |
| spelling | doaj.art-ff32b328e4a34d769c8cfa9141d44d0d2022-12-22T04:09:14ZengBMCJournal of Cannabis Research2522-57822022-01-01411610.1186/s42238-021-00112-xCase report: Medical cannabis—warfarin drug-drug interactionTyan F. Thomas0Evdokia S. Metaxas1Thu Nguyen2Whitni Bennett3Kathryn V. Skiendzielewski4Diane H. Quinn5Alice L. Scaletta6Philadelphia College of Pharmacy, University of the SciencesCorporal Michael J. Crescenz VA Medical CenterCorporal Michael J. Crescenz VA Medical CenterCorporal Michael J. Crescenz VA Medical CenterCorporal Michael J. Crescenz VA Medical CenterDepartment of Pharmacy Practice and Pharmacy Administration, Philadelphia College of Pharmacy (PCP) at University of the Sciences (USciences)University of the Sciences, Philadelphia College of PharmacyAbstract Aim A case of an 85-year-old patient with concurrent use of warfarin and medical cannabis containing delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) is described. Warfarin continues to be a cornerstone of anticoagulation treatment despite the recent addition of FDA-approved anticoagulant agents. It is well known that warfarin has numerous drug interactions; however, much remains unknown about its interaction with THC and CBD. A literature review was conducted to identify documented cases of possible interactions between cannabis and warfarin. The case reports we identified noted that cannabis may potentially increase warfarin’s effect. Therefore, we aimed to determine why an effect was not seen on our patient’s warfarin dose despite daily use of medical cannabis. Case This case report describes an 85-year-old patient who despite starting an oromucosal medical cannabis regimen of THC and CBD (which provided 0.3 mg of THC and 5.3 mg CBD once daily and an additional 0.625 mg of THC and 0.625 mg CBD once daily as needed) had minimal INR fluctuations from October 2018 to September 2019. Conclusion Despite the introduction and use of medical cannabis therapy, with both THC and CBD components, an elderly patient with concurrent warfarin use did not see major INR fluctuations, in contrast to published literature. The potential for warfarin and THC/CBD interactions may be dependent on route of administration and dose of the cannabis product.https://doi.org/10.1186/s42238-021-00112-xWarfarinMedical cannabisAnticoagulationDrug-drug interaction |
| spellingShingle | Tyan F. Thomas Evdokia S. Metaxas Thu Nguyen Whitni Bennett Kathryn V. Skiendzielewski Diane H. Quinn Alice L. Scaletta Case report: Medical cannabis—warfarin drug-drug interaction Journal of Cannabis Research Warfarin Medical cannabis Anticoagulation Drug-drug interaction |
| title | Case report: Medical cannabis—warfarin drug-drug interaction |
| title_full | Case report: Medical cannabis—warfarin drug-drug interaction |
| title_fullStr | Case report: Medical cannabis—warfarin drug-drug interaction |
| title_full_unstemmed | Case report: Medical cannabis—warfarin drug-drug interaction |
| title_short | Case report: Medical cannabis—warfarin drug-drug interaction |
| title_sort | case report medical cannabis warfarin drug drug interaction |
| topic | Warfarin Medical cannabis Anticoagulation Drug-drug interaction |
| url | https://doi.org/10.1186/s42238-021-00112-x |
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