. Author manuscript; available in PMC: 2021 Mar 19.

Published in final edited form as: J Am Coll Cardiol. 2020 Jan 28;75(3):320–332. doi: 10.1016/j.jacc.2019.11.025

Table 4.

Medications affected by cannabinoids

Mechanism	Cannabinoid involved	Key Therapy Affected	Anticipated Change in Drug Level
CYP3A4 Inhibition	CBD, THC, CBN, SCB	Anti-Arrhythmic [Amiodarone, Quinidine, Lidocaine]	↑
		Calcium Channel Blockers [Dihydropyridine + Non- Dihydropyridine]	↑
		Isosorbide dinitrate/mononitrate	↑
		HMG-CoA Reductase inhibitors [Atorvastatin, Lovastatin, Simvastatin]	↑
CYP2C9 Inhibition	CBD, THC, CBN, SCB	Warfarin	↑
		HMG-CoA Reductase inhibitors [Rosuvastatin, Fluvastatin]	↑
		Non-steroidal anti-inflammatory drugs [Celecoxib, Ibuprofen, Naproxen]	↑
CYP2D6 Inhibition	CBD, THC, CBN	Beta Blockers [carvedilol, metoprolol]	↑
CYP2D6 Inhibition	CBD, THC, CBN	Anti-arrhythmic [flecainide, mexiletine, propafenone]	↑
CYP1A Inhibition/Induction	CBD, CBN, SCB	Theophylline, Caffeine	Inhibition: ↑ Induction: ↓

CBD: cannabidiol; CBN: Cannabinol; SCB: Synthetic Cannabinoids; THC: Tetrahydrocannabinol