Cannabis Has Drug-Drug Interaction Risks With Certain Chemotherapies

Cannabis use may impact the efficacy or side effect profile of patients undergoing active cancer treatment, according to research presented at the Society for Integrative Oncology 2024 Conference.

“Medical cannabis use is becoming more prevalent, and there is a risk for potential drug-drug interactions, including with medical cannabis. And so, we want to make sure that those patients, as well as healthcare providers out there, are aware of these potential risks for medication interactions,” Richard Lee, MD, Cherng Family Director's Chair, Center for Integrative Oncology, at City of Hope, said in an interview with Oncology Nursing News.

Lee and colleagues surveyed 313 patients undergoing cancer treatment at a National Cancer Institute (NCI)-designated cancer center. Among them, 61 (19.5%) reported being active cannabis users. The researchers then used Lexicomp and Natural Medicines Comprehensive Database to determine potential medication interactions (PMIs). Results showed that the most common cannabis-related PMIs were with acetaminophen (9.5%, moderate severity), dexamethasone (8%, moderate severity), and ondansetron (6.3%, moderate severity). The most common PMIs related specifically to chemotherapy treatment were with paclitaxel (4%, major severity) and doxorubicin (2%, major severity).

Transcript

To really assess and identify these risks, first, clinicians need to be asking patients what they're using, including over-the-counter [drugs], including cannabis, now that there are many different forms available over-the-counter and different states also allow medical cannabis use. So I think really the first step is understanding everything that a patient is using, not just prescription, but also nonprescription and over-the-counter types of medicines, including those that might be inhaled or ingested, even with liquids, gummies, and other forms.

Then it's important to think about using these medication interaction software. So you might want to use something Lexicomp, or in this case, we also use one that's very specific for herbs and supplements, called Natural Medicines interaction software, and this helped us identify many of the potential medication interactions with ongoing other medications that are using for as part of their treatment plan.

Reference

Kim E, Cullen J, Mendiratta P, et al. Prevalence of Cannabis Related Potential Medication Interactions (PMI) Among Patients with Cancer During Treatment. Presented at: Society for Integrative Oncology 2024 Conference. October 25-27, 2024. Costa Mesa, California.