Sweet Annie - Epidiolex (Cannabidiol (prescription drug)) Interaction
Herbal: Sweet Annie
Also Known As: Artemisia annua, Absinthe Sauvage, Ajenjo Silvestre, Annual Wormwood, Artemisinin, Chinese Wormwood, Ching-hao, Herba Artemisiae Annuae, Herbe aux Cent Goûts, Huang Hua Guo, Qing Hao, Qinghao, Sweet Sagewort, Sweet Wormwood
Drug: Cannabidiol (prescription drug)
Brand names:
Epidiolex
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Jul 22, 2023
Interaction Details
Cannabidiol (prescription drug) is classified as belonging to the following category: Hepatotoxic Drugs
Theoretically, concomitant use might have additive adverse hepatotoxic effects.
There is some concern that Sweet Annie can adversely affect the liver.
Interaction Rating
Likelihood of Occurrence
PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists
References
- Centers for Disease Control and Prevention (CDC). Hepatitis temporally associated with an herbal supplement containing artemisinin-Washington, 2008. MMWR Morb Mortal Wkly Rep 2009;58:854-8.
- Savage RL, Hill GR, Barnes J, Kenyon SH, Tatley MV. Suspected hepatotoxicity with a supercritical carbon dioxide extract of Artemisia annua in grapeseed oil used in New Zealand. Front Pharmacol. 2019;10:1448.
- Ruperti-Repilado FJ, Haefliger S, Rehm S, et al. Danger of herbal tea: a case of acute cholestatic hepatitis due to Artemisia annua tea. Front Med (Lausanne). 2019;6:221.
Interaction Details
Cannabidiol (prescription drug) is classified as belonging to the following category: Cytochrome P450 3A4 (Cyp3A4) Substrates
Sweet Annie may alter plasma levels and clinical effects of drugs metabolized by CYP3A4.
In vitro research shows that the Sweet Annie constituent artemisinin induces CYP3A4, possibly increasing CYP3A4 activity by 1.9-fold. However, Sweet Annie extract seems to inhibit the activity of CYP3A4 in vitro, suggesting that other constituents of Sweet Annie play a role in its effects on the overall activity of this enzyme. More information is needed to determine whether taking Sweet Annie extract affects the metabolism of CYP3A4 substrates.
Interaction Rating
Likelihood of Occurrence
PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists
References
- Xing J, Kirby BJ, Whittington D, et al. Evaluation of P450 inhibition and induction by artemisinin antimalarials in human liver microsomes and primary human hepatocytes. Drug Metabl Dispos 2012;40(9):1757-64.
- Kane NF, Kiani BH, Desrosiers MR, Towler MJ, Weathers PJ. Artemisia extracts differ from artemisinin effects on human hepatic CYP450s 2B6 and 3A4 in vitro. J Ethnopharmacol 2022.
Sweet Annie Overview
Sweet Annie (Artemisia annua) is a plant native to Asia and a member of the daisy family. It is commonly known as 'sweet wormwood'.
Sweet Annie has a long history of use in traditional medicine, particularly in China, where it is known as "qinghao." One of the primary constituents of Sweet Annie is 'artemisinin', which is often used as a sole ingredient in dietary supplements. Some studies have suggested that it may have potential health benefits, including the ability to reduce fever and inflammation and to kill certain types of bacteria and viruses.
Sweet Annie is also used in some traditional and folk remedies for its insect-repellent properties and its purported ability to treat malaria.
Cannabidiol (prescription drug) Overview
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Cannabidiol is used to control seizures in adults and children 1 year of age and older with Lennox-Gastaut syndrome (a disorder that begins in early childhood and causes seizures, developmental delays, and behavioral issues), Dravet syndrome (a disorder that begins in early childhood and causes seizures and later may lead to developmental delays and changes in eating, balance, and walking), or tuberous sclerosis complex (TSC; a genetic condition that causes tumors to grow in many organs). Cannabidiol is in a class of medications called cannabinoids. It is not known exactly how cannabidiol works to prevent seizure activity.
Sweet Annie - More Interactions
Sweet Annie interacts with 833 drugs
Interaction Rating Key
These severity listings are for informational use only. Never start, stop or otherwise change your therapy before speaking with your provider.
| Major | The combined use of these agents is strongly discouraged as serious side effects or other negative outcomes could occur. |
| Moderate | Use cautiously under the care of a healthcare professional or avoid this combination. A significant interaction or negative outcome could occur. |
| Minor | Be aware that there is a chance of an interaction. Watch for warning signs of a potential interaction. |
| Unknown | No interactions have been reported or no interaction data is currently available. |
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Parts of this content are provided by the Therapeutic Research Center, LLC.
DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
© 2021 Therapeutic Research Center, LLC
Drug descriptions are provided by MedlinePlus.
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Dr. Brian Staiger, PharmD
In addition to being a clinical pharmacist specializing in pharmacotherapy, Dr. Brian Staiger is a registered herbalist through the American Herbalist Guild. He has combined his passion for pharmacy practice with the study of medical ethnobotany to improve patient care. Feel free to reach out about any of your herbal or medication questions!
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