Drug & supplement interaction

Cannabinol (cbn) + Zafirlukast

Zafirlukast brand name: Accolate.

Moderate Interaction
The bottom line Moderate

Zafirlukast falls into 3 drug categories that Cannabinol (cbn) can interact with; the most serious is rated moderate. Theoretically, CYP3A4 inhibitors might increase the levels and clinical effects of cannabinol.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions3
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Cannabinol (cbn) and Zafirlukast

These two interact in 3 distinct ways. Each one is explained separately below.

Why Are There 3 Interactions?

Cannabinol (cbn) interacts with whole categories of medication. Zafirlukast falls into 3 of those categories, so it can interact with Cannabinol (cbn) in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 3A4 (CYP3A4) INHIBITORS

1 of 3

Why this applies to Zafirlukast

Zafirlukast falls under CYTOCHROME P450 3A4 (CYP3A4) INHIBITORS — the group Cannabinol (cbn) interacts with.

Theoretically, CYP3A4 inhibitors might increase the levels and clinical effects of cannabinol.
In vitro research shows that CYP3A4 enzymes are involved in the 8-hydroxylation of cannabinol. So far, this interaction has not been reported in humans.
Severity Moderate Likelihood Possible Evidence D

Interaction 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.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the key thing to know: in this pairing, it's the CBN that may be affected, not your zafirlukast. Zafirlukast can mildly slow down an enzyme in your liver called CYP3A4, and lab studies suggest that same enzyme helps break down cannabinol. So in theory, taking them together could let CBN build up a bit, which might make you feel more of its effects, like extra drowsiness or grogginess.

I want to be honest about how soft this evidence is. It comes from test-tube research only, and nothing like this has actually been reported in people. So it's more of a 'good to be aware of' than a real alarm. Zafirlukast itself isn't a prodrug, so its asthma protection shouldn't change. Still, run any CBN product by your pharmacist or doctor first.

References
  1. Watanabe K, Yamaori S, Funahashi T, Kimura T, Yamamoto I. Cytochrome P450 enzymes involved in the metabolism of tetrahydrocannabinols and cannabinol by human hepatic microsomes. Life Sci. 2007;80(15):1415-9. PubMed
Moderate

CYTOCHROME P450 2C9 (CYP2C9) INHIBITORS

2 of 3

Zafirlukast also falls under CYTOCHROME P450 2C9 (CYP2C9) INHIBITORS.

Theoretically, CYP2C9 inhibitors might increase the levels and clinical effects of cannabinol.
In vitro research shows that CYP2C9 enzymes are involved in the 11-hydroxylation of cannabinol. So far, this interaction has not been reported in humans.
Severity Moderate Likelihood Possible Evidence D

Interaction 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.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist: zafirlukast (Accolate) can act as a mild blocker of a liver enzyme called CYP2C9. Lab studies suggest your body uses that same enzyme to help break down CBN. So in theory, taking them together could slow how fast you clear CBN, letting a bit more build up. That points toward stronger CBN effects, think extra drowsiness, grogginess, or lightheadedness, rather than any change in how your asthma medicine works.

Keep this in perspective. This is based only on test-tube research, not real people, and it hasn't actually been reported in patients. CBN products also vary a lot in quality and dose. Still, it's worth a quick chat with your pharmacist or doctor before pairing them, especially if you already feel sleepy.

References
  1. Watanabe K, Yamaori S, Funahashi T, Kimura T, Yamamoto I. Cytochrome P450 enzymes involved in the metabolism of tetrahydrocannabinols and cannabinol by human hepatic microsomes. Life Sci. 2007;80(15):1415-9. PubMed
Moderate

CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES

3 of 3

Zafirlukast also falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES.

Theoretically, cannabinol might increase the levels and clinical effects of CYP2C9 substrates.
In vitro research shows that cannabinol potently inhibits CYP2C9 enzymes. So far, this interaction has not been reported in humans.
Severity Moderate Likelihood Possible Evidence D

Interaction 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.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist with zafirlukast (Accolate). Your liver uses an enzyme called CYP2C9 to help clear this asthma medicine. Lab studies suggest CBN can block that same enzyme, which in theory could let zafirlukast build up a bit higher in your system. Since zafirlukast works as-is (it isn't a prodrug that needs activating), more of it could mean a stronger effect and a higher chance of side effects like headache, nausea, stomach upset, or, rarely, signs of liver irritation.

I want to be honest though: this is only seen in test-tube research, not in real people, so we don't truly know if it matters. Still, please run it past your pharmacist or doctor before pairing them.

References
  1. Nasrin S, Watson CJW, Perez-Paramo YX, Lazarus P. Cannabinoid Metabolites as Inhibitors of Major Hepatic CYP450 Enzymes, with Implications for Cannabis-Drug Interactions. Drug Metab Dispos 2021;49(12):1070-1080. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • 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.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Cannabinol (cbn) Also Interacts With Other Medications

Cannabinol (cbn) has 388 moderate known drug interactions in our database — the Zafirlukast one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Cannabinol (cbn)

Covers the 2,830 medications we’ve checked against Cannabinol (cbn). Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Zafirlukast

This page covers Cannabinol (cbn) only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Zafirlukast page lists 88 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Adrafinil (moderate), African Wild Potato (moderate), Bacopa (moderate) and Berberine (moderate).

By severity: 1 major · 64 moderate · 23 minor.

Open the Zafirlukast interaction page

How much people look this up

Where Cannabinol (cbn) and Zafirlukast Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Cannabinol (cbn)
Top half

#544 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Zafirlukast
Steady interest

#2,231 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Cannabinol (cbn)

What is Cannabinol (cbn)?

  • Sleep support
  • Relaxation
  • Pain or discomfort
  • Appetite-related concerns

Cannabinol (CBN) is a minor cannabinoid found in the cannabis plant, often marketed as a 'sleep' aid, but solid human research is very limited. Because it comes from cannabis and product quality varies widely, talk with your pharmacist or doctor before trying it, and avoid it during pregnancy and breastfeeding.

Read the full Cannabinol (cbn) monograph & all interactions
Medication

About Zafirlukast

What Is Zafirlukast Used For?

Brand name: Accolate

Zafirlukast tablets are used for the prophylaxis (prevention) and chronic treatment of asthma in adults and children 5 years of age and older. It is taken daily to help control ongoing asthma symptoms — not to relieve a sudden asthma attack.

It is available under the brand names Accolate and Zafirlukast as an oral tablet.

See full Zafirlukast drug information
Keep checking

Other Drugs & Cannabinol (cbn)

Browse every other medication we’ve checked against Cannabinol (cbn) — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
388Moderate
0Minor
2,441No known interaction
Moderate

388 interactions

Showing 60 of 388 moderate interactions — see all 388 on the Cannabinol (cbn) page.

No interaction 2,441 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

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

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Pharmacist Counseling Corner

Taking Cannabinol (cbn) and Zafirlukast Together: Common Questions

Can you take Cannabinol (cbn) with Zafirlukast?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 3 interactions listed for Cannabinol (cbn) and Zafirlukast?
Zafirlukast belongs to more than one drug category, and Cannabinol (cbn) interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Cannabinol (cbn) and Zafirlukast interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.