Concomitant use of cannabis with other drugs may lead to cannabis–drug interactions, mainly due to the pharmacokinetic mechanism involving the family of CYP450 isoenzymes. This narrative systematic review aimed to systematize the available information regarding clinical relevance of cannabis–drug interactions. We utilized the PubMed/Medline database for this systematic review, using the terms drug interactions and cannabis, between June 2011 and June 2021. Articles with cannabis–drug interactions in humans, in English or Spanish, with full-text access were selected. Two researchers evaluated the article’s inclusion. The level of clinical relevance was determined according to the severity and probability of the interaction. Ninety-five articles were identified and twenty-six were included. Overall, 19 pairs of drug interactions with medicinal or recreational cannabis were identified in humans. According to severity and probability, 1, 2, 12, and 4 pairs of cannabis–drug interactions were classified at levels 1 (very high risk), 2 (high risk), 3 (medium risk), and 5 (without risk), respectively. Cannabis–warfarin was classified at level 1, and cannabis–buprenorphine and tacrolimus at level 2. This review provides evidence for both the low probability of the occurrence of clinically relevant drug interactions and the lack of evidence regarding cannabis–drug interactions.

Background: There is a need to explore pharmacological options for syndrome (FMS), such as medical cannabis. The aim of this systematic review was to synthesize and analyze the available information about the effectiveness/efficacy and safety of cannabis-based products for medical use (CBPMs) and cannabis-based medicines (CBMs), in patients with FMS. Methods: Interventional or observational studies, systematic reviews and meta-analysis regarding the effectiveness/efficacy and safety of CBPMs and CBMs in patients with FMS were retrieved from the PubMed/Medline database until April 2024. Then, the information was summarized in tables, with the type of CBPM and CBM, the method used in the study and the effective-ness/efficacy and safety outcomes. Results: 19 publications were selected from the search or form the relevant references. Different CBPM and CBM were used across the studies. Also, different instruments for measuring the effectiveness were used. In general, the use of CBPMs and CBM showed an important improvement in pain, quality of life, and sleep habits. There were no serious adverse events. Conclusions: The results show that CBMPs and CBMs could be effective and safe in patients with FMS; however, the evidence is limited and there is a need for high-quality clinical studies conducted with improved methodological design.

Background: A list of drugs that can induce takotsubo cardiomyopathy (TCM) was published in 2011 and 2016. The aim of the present review was to update this list. Methods: Similar to the 2011 and 2016 reviews, from April 2015 to May 2022 case reports of druginduced TCM were identified by a comprehensive search in Medline/PubMed database. The search terms were: takotsubo cardiomyopathy, tako-tsubo cardiomyopathy, stress cardiomyopathy, transientleft- ventricular ballooning syndrome, apical ballooning syndrome, ampulla cardiomyopathy OR broken heart syndrome; together with “iatrogenic”, “induced by” OR “drug-induced”. Registers published in English or Spanish, in humans, and with full texts were retrieved. Articles that recognized any drug associated with the development of TCM were selected. Results: Overall, 184 manuscripts were identified by the search. A total of 39 articles were included after an exhaustive revision. Eighteen drugs as possible triggers of TCM were identified in the current update. Of them, 3 (16.7%) have been previously identified, and 15 (83.3%) are different from the previous reports. Thus, the list of drugs as possible triggers of TCM updated in 2022 includes 72 drugs. Conclusion: There are new case reports that link drugs with the development of TCM. The current list is principally made up of drugs that generate sympathetic overstimulation. However, some of the listed drugs do not have a clear link with sympathetic activation.

Introducción: La disponibilidad de información estructurada de eventos adversos asociados al cannabis puede contribuir a la utilización adecuada del cannabis medicinal. Objetivo: Sintetizar y caracterizar los eventos adversos asociados a la utilización de cannabis. Método: Revisión estructurada de eventos adversos asociados a la utilización del cannabis en PubMed, utilizando términos Mesh (“Cannabis” And (“Drug-Related Side Effects or Adverse Reactions”), en humanos, publicados en inglés o español y acceso a texto completo, hasta noviembre 1 de 2024. Dos investigadores revisaron los artículos identificados y definieron su inclusión. Adicionalmente, se incluyeron referencias de artículos consideradas de interés. Resultados: Se identificaron 47 eventos adversos asociados al uso de cannabis, afectando principalmente el sistema nervioso central y cardiovascular, en especial desórdenes mentales, somnolencia y afecciones gastrointestinales. No se identificaron eventos adversos mortales relacionados al uso de cannabis. Conclusiones: La utilización de cannabis se asocia con la presentación de eventos adversos, en especial en los sistemas nervioso central y cardiovascular. Es necesario más estudios orientados a identificar y caracterizar eventos adversos asociados al cannabis.

Introducción: los indudables efectos nocivos que causa la radiación ultravioleta sobre la piel y la salud en general hacen necesario el uso diario de fotoprotectores. Estos se suelen seleccionar en función del factor de protección solar, que demuestra la fotoprotección frente a los rayos UVB, pero además es necesario determinar la protección en UVA a través de parámetros como el factor de protección UVA (FPUVA) y la longitud de onda crítica (λc). Sin embargo, diversos estudios han expuesto que el FPS de algunos productos es menor al etiquetado, lo que disminuye su eficacia contra la radiación, máxime si se considera que los usuarios no usan la cantidad adecuada. Objetivo: evaluar la capacidad de fotoprotección en el UVA-UVB de 14 fotoprotectores comerciales mediante la medición de los parámetros: FPS, FPUVA, longitud de onda crítica (λc) y relación UVA/UVB in vitro. Metodología: se siguió el método ISO 24443 usando placas de PMMA de 6μm y se aplicaron 1,3 mg/cm2 de producto, se llevaron a un espectrofotómetro de transmitancia difusa para medir la absorbancia del producto y se calculó cada uno de los índices de fotoprotección. Posteriormente, se evaluó la fotoestabilidad de las formulaciones por irradiación en un simulador solar. Resultados: se encontró que 6 de 14 fotoprotectores (43 %) tienen un FPS espectrofotométrico menor al etiquetado y que solo 9 fotoprotectores cumplen con los parámetros de longitud de onda crítica y relación FPUVA/ FPS para ser etiquetados como amplio espectro según la Unión Europea. Conclusiones: la medición del FPS in vitro sigue siendo un gran reto, debido a la variabilidad causada por diversos factores que influyen en el método. Sin embargo, sigue siendo una alternativa efectiva para la verificación del FPS y su correlación con el FPS in vivo, además de ser la metodología aceptada en Europa y Estados Unidos para proclamar fotoprotección en la UVA.