Interactions of cannabinoids and anti-COVID-19 treatments – 1/21
For anyone using hemp products.
The majority of candidate drugs under examination for COVID-19 treatment could have DDIs with THC and/or CBD. Although, to our knowledge, there are no case reports on such DDIs, physicians treating patients with COVID-19 and/or those patients enrolled in clinical trials of candidate drugs should assess for cannabis/cannabinoid use and monitor physiological responses to COVID-19 that could be influenced by cannabis/cannabinoid use (e.g., potentiation of side effects, changes in exposure of candidate drugs, and/or levels of cytokines).
Although concomitant binding of THC/CBD and candidate drugs for COVID-19 to plasma proteins, transporters, or metabolism do not necessarily produce a clinical effect, the importance of cannabinoid screening is highlighted by the common use of cannabis/cannabinoids for conditions that may function as risk factors for COVID-19 complications or mortality (e.g., human immunodeficiency virus and autoimmune disorders such as multiple sclerosis).
The importance of closely monitoring physiological responses to COVID-19 (e.g., cytokines) is supported by research that has identified increased infection potential and immunosuppressive effects associated with CBD; concomitant administration of immunosuppressants may further reduce levels of their intended cytokine target(s).
Although more research is needed, these additive effects could result in primary and/or secondary infections. In addition, a recent in vitro study demonstrated that CBD can antagonize some dexamethasone effects, overriding the anti-inflammatory potential of steroids when used in combination.
Until a priori research determines whether (and to what extent) successful COVID-19 treatments interact with cannabis/cannabinoids, it seems prudent to assess current cannabis/cannabinoid use among suspected or confirmed COVID-19 patients and consider additional monitoring in the event that modified treatment approaches are needed to avoid unwanted DDIs.