Evidence map›Paper›PMID 39292423›Full record

ArticleDrug safety2025

Pharmacovigilance in the Age of Legalized Cannabis: Using Social Media to Monitor Drug-Drug Interactions Between Immunosuppressants and Cannabis-Derived Products.

Matthew R Allen, Gwenyth Portillo Wightman, Zechariah Zhu, Adam Poliak, Davey M Smith, Mark Dredze, John W Ayers

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Drug safety, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Article
  3. Pharmacovigilance in the digital age: gaining insight from social media data.Experimental biology and medicine (Maywood, N.J.) · 2025
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Matthew R AllenSchool of Medicine, University of California San Diego, #333 CRSF 9500 Gilman Drive, La Jolla, CA, 92093, USA.ORCID 0009-0003-6372-9405
Gwenyth Portillo WightmanDepartment of Computer Science, Johns Hopkins University, Baltimore, MD, USA.
Zechariah ZhuAltman Clinical and Translational Research Institute, University of California San Diego, #333 CRSF 9500 Gilman Drive, La Jolla, CA, 92093, USA.
Adam PoliakDepartment of Computer Science, Bryn Mawr College, Bryn Mawr, PA, USA.
Davey M SmithAltman Clinical and Translational Research Institute, University of California San Diego, #333 CRSF 9500 Gilman Drive, La Jolla, CA, 92093, USA.
Mark DredzeDepartment of Computer Science, Johns Hopkins University, Baltimore, MD, USA.
John W AyersAltman Clinical and Translational Research Institute, University of California San Diego, #333 CRSF 9500 Gilman Drive, La Jolla, CA, 92093, USA. ayers.john.w@gmail.com.

Funding

UC San Diego Clinical and Translational Research InstituteUL1TR001442 · NCATS · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI FIRESTEIN, GARY S, HOGARTH, MICHAEL · 2015 to 2024
$88.3M
FDA HHS U01 FD005942NCATS NIH HHS UL1 TR001442NCATS NIH HHS UL1TR001442U.S. Food and Drug Administration InnovationU.S. Food and Drug Administration Johns Hopkins University Center of Excellence in Regulatory Science
6 · The paper itself

Abstract

introductionA clinical trial of Epidiolex

objectiveWe aimed to identify if similar drug-drug interactions (DDIs) are occurring among the consumer CDP market, even though they cannot be identified through trials.

methodsWe searched Reddit for subreddits related to CDPs or health, resulting in 63,561,233 posts. From these, we identified 190 posts discussing both immunosuppressants and CDPs. Two blinded investigators evaluated the following. (1) Was there a concern about a potential DDI between consumer CDPs and immunosuppressants? (2) Was there a unique adverse event attributed to a DDI between consumer CDPs and immunosuppressants?

resultsOf these, 66 posts (35%) expressed concern about a potential DDI, such as "Hey, my partner wants to try my edibles … she's on Prograf [tacrolimus] and wants to talk to a stoner who's had a heart transplant." Four posts (2%) reported a unique DDI, such as "I have clinical results that are semi-anecdotal, showing the coordination to my halting substance use … It's the CBD. Shot my prograf to 30 at like 4 mg." Two of the four reported DDIs are similar to those first reported for Epidiolex. The remaining two reported DDIs include a potential cannabidiol (CBD)/sirolimus or delta-9-tetrahydrocannabinol (THC)/sirolimus interaction and a THC/tacrolimus interaction, both resulting in drug toxicity.

conclusionThis case study is the first to report on DDIs involving consumer CDPs, including both CBD and THC products, as well as a broader class of immunosuppressants. This demonstrates the risks associated with using consumer CDPs alongside prescription medications while highlighting the need for development of increased surveillance to monitor consumer CDPs for drug safety signals, as well as comprehensive regulations that take into account the unique characteristics of the consumer marketplace.

Indexed as

Drug InteractionsImmunosuppressive AgentsPharmacovigilanceSocial MediaCannabisHumansUnited StatesImmunosuppressive Agents

Identifiers

PMID39292423
PMCPMC12829999

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.