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首页> 外文期刊>Neuropediatrics >Cannabidiol Interacts Significantly with Everolimus-Report of a Patient with Tuberous Sclerosis Complex
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Cannabidiol Interacts Significantly with Everolimus-Report of a Patient with Tuberous Sclerosis Complex

机译：大麻肽与患有结核硬化复合物的患者的everolimus-eports相互作用

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A 6.5-year-old female patient with a TSC2 mutation had been given everolimus (EVE) for 3 years for pharmacoresistant focal epilepsy and for life-threatening, severe ventricular dysrhythmia. EVE had been started with daily dose of 0.15 mg/kg/day and was increased up to 0.6 mg/kg/day. Target blood trough levels of around 9 mu g/L had been documented. Although EVE therapy revealed no effect on seizure activity, cardiac rhythm normalized completely. Thus, EVE was reduced to a dose of 0.3 mg/kg/day leading to stable blood trough levels of 4 to 5 mu g/L. Due to refractory tonic seizures with a frequency of 1 to 4 per day, we initiated cannabidiol (CBD) treatment, raising it to a daily dose of 200 mg. After 6 weeks, the EVE blood trough levels rose to 12.0 mu g/L. Although we halved the EVE dose, her EVE blood trough level continued increasing up to 16.0 mu g/L. The CBD dose was increased to 500 mg/day (20.4 g/kg/day), but EEG parameters and seizures failed to respond. Serum concentrations of EVE were unstable under the co-medication with CBD. Depending on the CBD dose, they varied between 1.7 and 12.3 mu g/L, while EVE was always administered at the same dose. Although never before reported, CBD and EVE appear to interact, due to the metabolic pathway through CYP 450 3A4. Although we detected no side effects in our patient, we strongly recommend drug monitoring using the combination of CBD with EVE to prevent harmful overdosing.
机译：对于药物渗透局灶性癫痫和危及生命，严重的心室缺血性患有3年来，已给予6.5岁的女性患者，已为艾莫姆斯（前夕）给予3年。 Eve已经开始，每日剂量为0.15毫克/千克/天，增加至0.6mg / kg /天。记录了靶血槽水平约为9亩。虽然前夕治疗没有对癫痫发作活动的影响，心律节奏完全正常。因此，前夕减少到0.3mg / kg /天的剂量，导致稳定的血液槽水平为4至5μg/ l。由于每天频率为1至4的耐火功能紊乱，我们引发了大麻（CBD）处理，将其提高到每日剂量为200毫克。 6周后，EVE血槽水平升至12.0μmg/升。虽然我们减半剂量，但她的夏娃血槽水平持续增加高达16.0μg/升。 CBD剂量增加至500mg /天（20.4g / kg /天），但EEG参数和癫痫发作未能响应。在与CBD的共同用药下，肠道血清浓度不稳定。取决于CBD剂量，它们在1.7和12.3μg/ L之间变化，而Eve总是以相同剂量给药。虽然从未报告过，但由于通过CYP 450 3A4的代谢途径，CBD和EVE似乎相互作用。虽然我们在我们的患者中检测到没有副作用，但我们强烈建议使用CBD的组合强烈推荐药物监测，以防止有害过量。

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