易获取含有大麻二酚（CBD）的产品。据报道，CBD能抑制药物代谢的蛋白质，包括细胞色素P450（CYP）3A4/5、CYP2C9、CYP2B6、CYP2D6、CYP2E1、CYP1A2、CYP2C19、羧酯酶1（CES1）、葡萄糖醛酸酯转移酶（UGT）1A9、UGT2B7、糖蛋白P（P-gp）和乳腺癌耐药蛋白（BCRP）。CBD与药物的相互作用的相关性目前大部分尚不清楚。本研究旨在确定可能与口服CBD产生相互作用的药物，评估是否已经报告了CBD与药物的相互作用，并评估DMP的底物是否是常用药物。共确定了403种药物为DMP的底物。已报道了53/403种底物在人体（n = 25）、体内（n = 13）或体外（n = 15）的CBD与药物相互作用。在53种底物中，31种底物的水平由于CBD而增加，1种底物下降，4种底物无变化。对于5种底物，结果存在争议，并且有12种底物的水平未报告。在德国最常使用的30种药物中，有67%为DMP的底物，在美国最常使用的50种药物中，有68%为DMP的底物。急需进行关于CBD与药物相互作用的药理学研究。应向患者提供有关潜在风险的教育，并提高医生的意识水平。监管机构应意识到这个问题，并在国际层面上发起一项倡议，增加CBD的安全性。版权所有©2023年欧洲内科联盟。由Elsevier B.V.出版。保留所有权利。

Products containing cannabidiol(CBD) are easily accessible. CBD is reported to inhibit the drug-metabolizing proteins(DMP) Cytochrome P450(CYP)3A4/5, CYP2C9, CYP2B6, CYP2D6, CYP2E1, CYP1A2, CYP2C19, carboxylesterase 1(CES1), uridine 5'diphospho-glucoronosyltransferase(UGT)1A9, UGT2B7, P-glycoprotein(P-gp) and Breast Cancer Resistance Protein(BCRP). The relevance of CBD-drug interactions is largely unknown. Aim of the study was to identify drugs, potentially interacting with orally ingested CBD, to assess whether CBD-drug interactions have been reported, and if substrates of DMP are frequently prescribed drugs.Identified were 403 drugs as substrates of DMP. CBD-drug interactions were reported for 53/403 substrates in humans (n = 25), in vivo (n = 13) or in vitro (n = 15). In 31/53 substrates, CBD induced an increase, in 1/53 a decrease, in 4/53 no change in the substrate level. For 5/53 substrates, the results were controversial, and in 12/53 no substrate levels were reported. Among the 30 most frequently prescribed drugs in Germany were 67% substrates of DMP and among the 50 most frequently prescribed drugs in the USA 68%.There is an urgent need for pharmacologic studies on CBD-drug interactions. Patients should be educated on the potential risk and awareness should be increased among physicians. Regulatory authorities should become aware of the problem and start an initiative on an international level to increase the safety of CBD.Copyright © 2023 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.