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Cannabidiol (CBD)

¿Qué es?

El cannabidiol (CBD) es una sustancia química de la planta Cannabis sativa, también conocida como cannabis o cáñamo. Una forma específica de CBD está aprobada como medicamento para las convulsiones en los EE. UU.

Se han encontrado más de 80 sustancias químicas, conocidas como cannabinoides, en la planta Cannabis sativa. Delta-9-tetrahidrocannabinol (THC) es el ingrediente más famoso del cannabis. Pero el CBD se obtiene del cáñamo, una forma de la planta Cannabis sativa que solo contiene pequeñas cantidades de THC. El CBD parece tener efectos sobre algunos químicos en el cerebro, pero estos son diferentes a los efectos del THC.

Se usa una forma recetada de CBD para el trastorno convulsivo (epilepsia). El CBD también se usa para la ansiedad, el dolor, un trastorno muscular llamado distonía, enfermedad de Parkinson, enfermedad de Crohn y muchas otras afecciones, pero no existe una buena evidencia científica que respalde estos usos.

Las leyes aprobadas en 2018 legalizaron la venta de cáñamo y productos de cáñamo en los EE. UU. Pero eso no significa que todos los productos de CBD elaborados con cáñamo sean legales. Dado que el CBD es un medicamento recetado aprobado, no puede incluirse legalmente en alimentos o suplementos dietéticos. El CBD solo se puede incluir en productos "cosméticos". Pero todavía hay productos de CBD en el mercado que están etiquetados como suplementos dietéticos. La cantidad de CBD contenida en estos productos no siempre es la misma que se indica en la etiqueta.

¿Qué tan efectivo es?

Natural Medicines Comprehensive Database (La Base Exhaustiva de Datos de Medicamentos Naturales) clasifica la eficacia, basada en evidencia científica, de acuerdo a la siguiente escala: Eficaz, Probablemente Eficaz, Posiblemente Eficaz, Posiblemente Ineficaz, Probablemente Ineficaz, Ineficaz, e Insuficiente Evidencia para Hacer una Determinación.

La clasificación de la eficacia para este producto es la siguiente:

Posiblemente eficaz para...

  • Trastorno convulsivo (epilepsia). La FDA de EE. UU. Aprueba un producto recetado específico (Epidiolex, GW Pharmaceuticals) para tratar las convulsiones causadas por el síndrome de Dravet, el síndrome de Lennox-Gastaut o el complejo de esclerosis tuberosa. No está claro si otras formas de CBD son útiles para las convulsiones. Por ahora, quédese con el producto recetado.
Existe interés en usar CBD para otros fines, pero no hay suficiente información confiable para decir si podría ser útil para estos usos.

¿Es seguro?

Cuando se toma por vía oral: Es posible que el CBD sea seguro en dosis adecuadas. Se han usado dosis de hasta 200 mg por día de manera segura durante un máximo de 13 semanas. Bajo la supervisión de un proveedor de la salud, se usó u producto de CBD específico recetado (Epidiolex) en dosis más alta y por tiempo prolongado.

El CBD puede causar algunos efectos secundarios, como sequedad de boca, presión arterial baja, aturdimiento y somnolencia. También se han informado signos de lesión hepática con dosis altas de la forma recetada de CBD, llamada Epidiolex.

Cuando se aplica a la piel: No hay suficiente información confiable para saber si el CBD es seguro o cuáles podrían ser los efectos secundarios.

Advertencias y precauciones especiales:

Embarazo y lactancia: puede que no sea seguro tomar CBD si está embarazada o amamantando. Los productos de CBD pueden estar contaminados con otros ingredientes que pueden ser dañinos para el feto o el bebé. Manténgase en el lado seguro y evite su uso.

Niños: Es posible que los niños tomen un producto de CBD recetado específico (Epidiolex) por vía oral en dosis de hasta 25 mg / kg al día. Este producto está aprobado para su uso en niños con ciertas afecciones que tienen al menos 1 año de edad. No está claro si otros productos de CBD son seguros para los niños.

Un grupo de trastornos oculares que pueden conducir a la pérdida de la visión (glaucoma): Algunas investigaciones iniciales sugieren que tomar CBD podría aumentar la presión en el ojo en algunas personas con glaucoma.

Enfermedad hepática: Las personas con enfermedad hepática pueden necesitar usar dosis más bajas de CBD.

Enfermedad de Parkinson: Algunas investigaciones preliminares sugieren que tomar altas dosis de CBD podría empeorar el movimiento muscular y los temblores en algunas personas con enfermedad de Parkinson.

¿Existen interacciones con medicamentos?

Moderadas
Tenga cuidado con esta combinación
Brivaracetam (Briviact)
El cuerpo modifica y degrada el brivaracetam. El CBD podría disminuir la rapidez con que el cuerpo descompone el brivaracetam. Esto podría aumentar los niveles de brivaracetam en el cuerpo.
Cafeína
La cafeína es modificada y descompuesta por el cuerpo. El CBD podría disminuir la velocidad con que el cuerpo descompone la cafeína. Esto podría aumentar los niveles de la cafeína en el cuerpo.
Carbamazepina (Tegretol)
La carbamazepina es modificada y degradada por el cuerpo. El CBD podría disminuir la rapidez con que el cuerpo descompone la carbamazepina. Esto podría aumentar los niveles de carbamazepina en el cuerpo y aumentar sus efectos secundarios.
Citalopram (Celexa)
La cafeína es modificada y descompuesta por el cuerpo. El CBD podría disminuir la velocidad con que el cuerpo descompone la cafeína. Esto podría aumentar los niveles del citalopram en el cuerpo.
Clobazam (Onfi)
El clobazam es modificado y degradado por el hígado. El CBD podría disminuir la rapidez con que el hígado descompone el clobazam. Esto podría aumentar los efectos y los efectos secundarios del clobazam.
Eslicarbazepina (Aptiom)
El cuerpo modifica y descompone la eslicarbazepina. El CBD podría disminuir la rapidez con que el cuerpo descompone la eslicarbazepina. Esto podría aumentar los niveles de eslicarbazepina en el cuerpo en una pequeña cantidad.
Estiripentol (Diacomit)
El cuerpo modifica y descompone el estiripentol. El CBD podría disminuir la rapidez con que el cuerpo descompone el estiripentol. Esto podría aumentar los niveles de estiripentol en el cuerpo y aumentar sus efectos secundarios.
Everolimus (Zostress)
Everolimus es modificado y degradado por el cuerpo. El CBD podría disminuir la rapidez con que el cuerpo descompone el everolimus. Esto podría aumentar los niveles de everolimus en el cuerpo.
Fluoxetina (Prozac)
El cuerpo cambia y descompone la fluoxetina. En algunas personas, el CBD podría disminuir la rapidez con la que el cuerpo descompone la fluoxetina. Esto podría aumentar los niveles de fluoxetina en el cuerpo.
Litio
Tomar dosis más altas de CBD podría aumentar los niveles de litio. Esto puede aumentar el riesgo de toxicidad por litio.
Medicamentos modificados por el hígado (medicamentos glucuronidados)
Algunos medicamentos son modificados y degradados por el hígado. El CBD podría cambiar la rapidez con que el hígado descompone estos medicamentos. Esto podría cambiar los efectos y los efectos secundarios de estos medicamentos.
Medicamentos modificados por el hígado (sustratos del citocromo P450 1A1 (CYP1A1))
Algunos medicamentos son modificados y degradados por el hígado. El CBD podría cambiar la rapidez con que el hígado descompone estos medicamentos. Esto podría cambiar los efectos y los efectos secundarios de estos medicamentos.
Medicamentos modificados por el hígado (sustratos del citocromo P450 1A2 (CYP1A2))
Algunos medicamentos son modificados y degradados por el hígado. El CBD podría cambiar la rapidez con que el hígado descompone estos medicamentos. Esto podría cambiar los efectos y los efectos secundarios de estos medicamentos.
Medicamentos modificados por el hígado (sustratos del citocromo P450 1B1 (CYP1B1))
Algunos medicamentos son modificados y degradados por el hígado. El CBD podría cambiar la rapidez con que el hígado descompone estos medicamentos. Esto podría cambiar los efectos y los efectos secundarios de estos medicamentos.
Medicamentos modificados por el hígado (sustratos del citocromo P450 2A6 (CYP2A6))
Algunos medicamentos son modificados y degradados por el hígado. El CBD podría cambiar la rapidez con que el hígado descompone estos medicamentos. Esto podría cambiar los efectos y los efectos secundarios de estos medicamentos.
Medicamentos modificados por el hígado (sustratos del citocromo P450 2B6 (CYP2B6))
Algunos medicamentos son modificados y degradados por el hígado. El CBD podría cambiar la rapidez con que el hígado descompone estos medicamentos. Esto podría cambiar los efectos y los efectos secundarios de estos medicamentos.
Medicamentos modificados por el hígado (sustratos del citocromo P450 2C19 (CYP2C19))
Algunos medicamentos son modificados y degradados por el hígado. El CBD podría cambiar la rapidez con que el hígado descompone estos medicamentos. Esto podría cambiar los efectos y los efectos secundarios de estos medicamentos.
Medicamentos modificados por el hígado (sustratos del citocromo P450 2C8 (CYP2C8))
Algunos medicamentos son modificados y degradados por el hígado. El CBD podría cambiar la rapidez con que el hígado descompone estos medicamentos. Esto podría cambiar los efectos y los efectos secundarios de estos medicamentos.
Medicamentos modificados por el hígado (sustratos del citocromo P450 2C9 (CYP2C9))
Algunos medicamentos son modificados y degradados por el hígado. El CBD podría cambiar la rapidez con que el hígado descompone estos medicamentos. Esto podría cambiar los efectos y los efectos secundarios de estos medicamentos.
Medicamentos modificados por el hígado (sustratos del citocromo P450 2D6 (CYP2D6))
Algunos medicamentos son modificados y degradados por el hígado. El CBD podría cambiar la rapidez con que el hígado descompone estos medicamentos. Esto podría cambiar los efectos y los efectos secundarios de estos medicamentos.
Medicamentos modificados por el hígado (sustratos del citocromo P450 2E1 (CYP2E1))
El hígado cambia y descompone algunos medicamentos. El CBD podría cambiar la rapidez con la que el hígado descompone estos medicamentos. Esto podría cambiar los efectos y efectos secundarios de estos medicamentos.
Medicamentos modificados por el hígado (sustratos del citocromo P450 3A4 (CYP3A4))
Algunos medicamentos son modificados y degradados por el hígado. El CBD podría cambiar la rapidez con que el hígado descompone estos medicamentos. Esto podría cambiar los efectos y los efectos secundarios de estos medicamentos.
Medicamentos que aumentan la descomposición de otros medicamentos en el hígado (inductores del citocromo P450 3A4 (CYP3A4))
El hígado modifica y descompone el CBD. Algunos medicamentos aumentan la rapidez con que el hígado cambia y descompone el CBD. Esto podría cambiar los efectos y los efectos secundarios del CBD.
Medicamentos que aumentan la descomposición de otros medicamentos por el hígado (inductores del citocromo P450 2C19 (CYP2C19))
El hígado modifica y descompone el CBD. Algunos medicamentos aumentan la rapidez con que el hígado cambia y descompone el CBD. Esto podría cambiar los efectos y los efectos secundarios del CBD.
Medicamentos que disminuyen la degradación de otros medicamentos en el hígado (inhibidores del citocromo P450 3A4 (CYP3A4))
El hígado modifica y descompone el CBD. Algunos medicamentos disminuyen la rapidez con que el hígado cambia y descompone el CBD. Esto podría cambiar los efectos y los efectos secundarios del CBD.
Medicamentos que disminuyen la degradación de otros medicamentos por el hígado (inhibidores del citocromo P450 2C19 (CYP2C19))
El hígado modifica y descompone el CBD. Algunos medicamentos disminuyen la rapidez con que el hígado cambia y descompone el CBD. Esto podría cambiar los efectos y los efectos secundarios del CBD.
Medicamentos sedantes (depresores del SNC)
El CBD puede causar somnolencia y respiración lenta. Algunos medicamentos, llamados sedantes, también pueden causar somnolencia y respiración lenta. Tomar CBD con medicamentos sedantes puede causar problemas respiratorios y / o demasiada somnolencia.
Metadona (Dolophine)
La metadona es degradada por el hígado. El CBD podría disminuir la rapidez con que el hígado descompone la metadona. La ingesta de cannabidiol junto con metadona podría aumentar los efectos y los efectos secundarios de la metadona.
Rufinamida (Banzel)
El cuerpo modifica y degrada la rufinamida. El CBD podría disminuir la rapidez con que el cuerpo descompone la rufinamida. Esto podría aumentar los niveles de rufinamida en el cuerpo en una pequeña cantidad.
Sirolimus (Rapamune)
El cuerpo modifica y degrada el sirolimus. El CBD podría disminuir la rapidez con que el cuerpo descompone el sirolimus. Esto podría aumentar los niveles de sirolimus en el cuerpo.
Tacrolimus (Prograf)
El tacrolimus es modificado y degradado por el cuerpo. El CBD podría disminuir la rapidez con que el cuerpo descompone el tacrolimus. Esto podría aumentar los niveles de tacrolimus en el cuerpo.
Tamoxifeno (Nolvadex)
El cuerpo modifica y descompone el tamoxifeno. El CBD podría afectar la rapidez con que el cuerpo descompone el tamoxifeno. Esto podría afectar los niveles de tamoxifeno en el cuerpo.
Topiramato (Topamax)
El topiramato es modificado y degradado por el cuerpo. El CBD podría disminuir la rapidez con que el cuerpo descompone el topiramato. Esto podría aumentar los niveles de topiramato en el cuerpo en una pequeña cantidad.
Valproato
El ácido valproico puede causar daño hepático. La ingesta de cannabidiol con ácido valproico podría aumentar la posibilidad de lesión hepática. Es posible que sea necesario suspender el CBD y / o el ácido valproico, o es posible que sea necesario reducir la dosis.
Warfarina
El CBD podría aumentar los niveles de warfarina, lo que puede aumentar el riesgo de hemorragia. Es posible que sea necesario suspender el CBD y / o la warfarina, o es posible que sea necesario reducir la dosis.
Zonisamida
El cuerpo modifica y degrada la zonisamida. El CBD podría disminuir la rapidez con que el cuerpo descompone la zonisamida. Esto podría aumentar los niveles de zonisamida en el cuerpo en una pequeña cantidad.

¿Existen interacciones con hierbas y suplementos?

Hierbas y suplementos con propiedades sedantes
El CBD puede causar somnolencia y respiración lenta. Tomarlo junto con otros suplementos con efectos similares puede causar demasiada somnolencia y / o respiración lenta en algunas personas. Ejemplos de suplementos con este efecto incluyen lúpulo, kava, L-triptófano, melatonina y valeriana.

¿Existen interacciones con alimentos?

No se conoce ninguna interacción con alimentos.

¿Como se usa normalmente?

El CBD ha sido utilizado con mayor frecuencia por adultos en dosis de 200 mg o menos por día. Hable con un proveedor de atención médica para averiguar qué dosis podría ser la mejor para una afección específica.

Para obtener información sobre el uso de CBD recetado, un producto llamado Epidiolex, hable con un proveedor de atención médica.

Otros nombres

2-[(1R,6R)-3-metil-6-prop-1-en-2-ilciclohex-2-en-1-il]-5-pentilbenceno-1,3-diol, CBD.

Metodología

Para saber más sobre cómo este artículo fue escrito, refiérase a la metodología de la Base exhaustiva de datos de medicamentos naturales.

Referencias

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Documento revisado - 09/30/2023