In May, a report was published in Pediatrics describing a potential drug-drug interaction between cannabidiol (CBD) and methadone. The subject, a 13-year-old patient who for four months had been taking oral doses of methadone (7.5 mg b.i.d.) to treat chronic pain associated with metastatic cancer, noted a sudden increase in sleepiness and fatigue. Unbeknownst to the physicians, the patient's mother had been giving her daughter 5 mL of CBD three times per day orally, and had only recently increased her dosage to six times daily. As CBD inhibits CYP3A4 and CYP2C19, this suggests it affected the metabolism of methadone and exacerbated the drug's soporific effects.
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