Post Transplant Patients Experience With CBD

[M Llama]

Looking to see if any transplant patients taking tacrolimus have had any drug interactions using marijuana specifically CBD only products or products with high CBD and low THC.

I received a kidney transplant 6 months ago and was recently diagnosed with fibromyalgia. My nephrologist and post transplant nurse thought CBD topicals and edibles were worth trying as an alternative treatment for fibro pain. I was looking more for relaxation effects and pain relief vs. the high. I recently started with marijuana CBD only edibles. After 7-10 days on edibles, my tacrolimus came back in the 20 range and retested 2 days later came back at 17. My prior labs were in the normal 7-10 range. The only new drug between the normal and toxic levels labs was the CBD. Has anyone had any interactions with CBD and tacro or other immunosuppressant drugs?

I was 100% sensitized when I received my transplant so I have to be especially careful with immunosuppressants.

My online research regarding tacrolimus and CBD - so far only one patient with significant drug-drug interaction.

Would love to hear about other post transplant recipients experiences regarding CBD products.

 

[AngryBird]

Hi,
I will call in some of the heavy crew on this one.
@SweetSue

 

[M Llama]

Found some more info regarding CBD:

Download Project CBD’s Primer on Cannabinoid-Drug Interactions. Link at the end of the article.

Project CBD Releases Educational Primer on Cannabinoid-Drug Interactions | Project CBD

The Download Lists info on CYP family specifics.

Tacrolimus is metabolized through CYP3A4/5. If I am reading correctly...that's a big IF... According to the download:

"CBD modulates CYP3A4 and 3A5. From preclinical research, it appears that low to moderate doses of CBD can inhibit both of these enzymes...THC and CBN at normal doses are unlikely to interact with 3A-metabolized drugs. Although THC and CBN are weak inhibitors of 3A4/5, CBD appears to activate 3A4 with respect to certain drugs (mephenytoin and indinavir) and to inhibit 3A4 with respect to others (e.g. cyclosporin, diltiazem)."

"◆ Ingested cannabinoids will have a greater effect on CYP3A-metabolized drugs, as they interact with CYP3A in both the intestines and liver. "

Cyclosporin is an immunosuppressant similar to tacrolimus, taken by transplant patients. So CBD likely inhibits tacro, (esp. ingested...ie: edibles) ...which can cause toxicity. Maybe why my tacro labs results were so high?

Does that mean THC and CBN products might not interfere with tacro?

Would appreciate any help interpreting the information.

Thanks in advance AngryBird and SweetSue.

 

[AngryBird]

I have informed her. She will answer as soon as she can.

 

[SweetSue]

Good job starting the thread M Llama.

Reading it over I’d say you’re right to be cautious about the CBD, but again, that suggests that the medical support team needs to keep a close eye and adjust the prescribed meds accordingly.

It mentions THC and CBN at normal doses. It’d be nice to know what they consider normal doses for THC to be. I’d figure something below 30 mg a day, but that’s just a best guess based on my study and research. The same probably applies for CBN.

We’re learning that a “normal” dose simply doesn’t exist in cannabis therapeutics, but the medical professionals seem to be most comfortable with limiting THC to a 10 mg dose, and with good cause. Most of us overmedicate, coming at our disease states with a THC hammer when the ECS prefers a feather’s touch.

 

[M Llama]

SweetSue, I think you just might be right! My nurse just told me that we will watch carefully and adjust my tacro, that I don't necessarily need to stop CBD!

Woo hoo!

 

[SweetSue]

SweetSue, I think you just might be right! My nurse just told me that we will watch carefully and adjust my tacro, that I don't necessarily need to stop CBD!

Woo hoo!

Ahhh..... it’s reassuring to get professional confirmation. Lol! I’m just a voracious student with a love of communication.

Now you can continue searching for that sweet spot.