DDInter1055 DDInter284
Levofloxacin is a fluoroquinolone antibiotic and the optical S-(-) isomer of racemic [ofloxacin]. It reportedly carries 8 to 128-fold more activity against both gram-negative and gram-positive bacteria compared to R-(+)-ofloxacin and remains stereochemically stable following administration (i.e. it does not invert to the inactive isomer). Levofloxacin, along with other quinolones such as [gatifloxacin] and [moxifloxacin], is a member of the third generation of fluoroquinolones, colloquially referred to as the "respiratory quinolones" due to improved activity against gram-positive bacteria commonly implicated in respiratory infections.[A31453,A190756] Levofloxacin was first approved by the FDA in 1996, and was approved in Canada and several South American countries soon after.
Cannabidiol, or CBD, is one of at least 85 active cannabinoids identified within the Cannabis plant. It is a major phytocannabinoid, accounting for up to 40% of the Cannabis plant's extract, that binds to a wide variety of physiological targets of the endocannabinoid system within the body. Although the exact medical implications are currently being investigated, CBD has shown promise as a therapeutic and pharmaceutical drug target. In particular, CBD has shown promise as an analgesic, anticonvulsant, muscle relaxant, anxiolytic, antipsychotic and has shown neuroprotective, anti-inflammatory, and antioxidant activity, among other currently investigated uses [A32477, A32469]. CBD's exact place within medical practice is still currently hotly debated, however as the body of evidence grows and legislation changes to reflect its wide-spread use, public and medical opinion have changed significantly with regards to its usefulness in a number of medical conditions ranging from anxiety to epilepsy. From a pharmacological perspective, Cannabis' (and CBD's) diverse receptor profile explains its potential application for such a wide variety of medical conditions. Cannabis contains more than 400 different chemical compounds, of which 61 are considered cannabinoids, a class of compounds that act upon endogenous cannabinoid receptors of the body . Cannabinoid receptors are utilized endogenously by the body through the endocannabinoid system, which includes a group of lipid proteins, enzymes, and receptors that are involved in many physiological processes. Through its modulation of neurotransmitter release, the endocannabinoid system regulates cognition, pain sensation, appetite, memory, sleep, immune function, and mood among many other bodily systems. These effects are largely mediated through two members of the G-protein coupled receptor family, cannabinoid receptors 1 and 2 (CB1 and CB2)[A32585,A32824]. CB1 receptors are found in both the central and peripheral nervous systems, with the majority of receptors localized to the hippocampus and amygdala of the brain. Physiological effects of using cannabis make sense in the context of its receptor activity as the hippocampus and amygdala are primarily involved with regulation of memory, fear, and emotion. In contrast, CB2 receptors are mainly found peripherally in immune cells, lymphoid tissue, and peripheral nerve terminals . Tetrahydrocannabinol (THC) and cannabidiol (CBD) are two types of cannabinoids found naturally in the resin of the marijuana plant, both of which interact with the cannabinoid receptors that are found throughout the body. Although THC and CBD have been the most studied cannabinoids, there are many others identified to date including cannabinol (CBN), cannabigerol (CBG), (CBDV), and (THCV) that can be found within the medical cannabis . While both CBD and THC are used for medicinal purposes, they have different receptor activity, function, and physiological effects. If not provided in their activated form (such as through synthetic forms of THC like or ), THC and CBD are obtained through conversion from their precursors, tetrahydrocannabinolic acid-A (THCA-A) and cannabidiolic acid (CBDA), through decarboxylation reactions. This can be achieved through heating, smoking, vaporization, or baking of dried unfertilized female cannabis flowers. The primary psychoactive component of Cannabis, delta 9-tetrahydrocannabinol (Δ9-THC), demonstrates its effects through weak partial agonist activity at Cannabinoid-1 (CB1R) and Cannabinoid-2 (CB2R) receptors. This activity results in the well-known effects of smoking cannabis such as increased appetite, reduced pain, and changes in emotional and cognitive processes. In contrast to THC's weak agonist activity, CBD has been shown to act as a negative allosteric modulator of the cannabinoid CB1 receptor, the most abundant G-Protein Coupled Receptor (GPCR) in the body . Allosteric regulation is achieved through the modulation of receptor activity on a functionally distinct site from the agonist or antagonist binding site which is clinically significant as direct agonists (such as THC) are limited by their psychomimetic effects such as changes to mood, memory, and anxiety. In addition to the well-known activity on CB1 and CB2 receptors, there is further evidence that CBD also activates 5-HT1A/2A/3A serotonergic and TRPV1–2 vanilloid receptors, antagonizes alpha-1 adrenergic and µ-opioid receptors, inhibits synaptosomal uptake of noradrenaline, dopamine, serotonin and gamma-aminobutyric acid (GABA), and cellular uptake of anandamide, acts on mitochondria Ca2+ stores, blocks low-voltage-activated (T-type) Ca2+ channels, stimulates activity of the inhibitory glycine-receptor, and inhibits activity of fatty amide hydrolase (FAAH) [A31555, A31574]. CBD is currently available in Canada within a 1:1 formulation with tetrahydrocannbinol (THC) (as the formulation known as "nabiximols") as the brand name product Sativex. It is approved for use as adjunctive treatment for symptomatic relief of spasticity in adult patients with multiple sclerosis (MS). Sativex was also given a conditional Notice of Compliance (NOC/c) for use as adjunctive treatment for the symptomatic relief of neuropathic pain in adult patients with multiple sclerosis and as adjunctive analgesic treatment for moderate to severe pain in adult patients with advanced cancer . In April 2018, a Food and Drug Administration advisory panel unanimously recommended approval of Epidiolex (cannabidiol oral solution) for the treatment of two rare forms of epilepsy - Lennox-Gastaut syndrome and Dravet syndrome, which are among the two most difficult types of epilepsy to treat [L2721, L2719]. Epidiolex was granted Orphan Drug designation as well as Fast Track Approval from the FDA for further study in these hard to treat conditions. Notably, phase 3 clinical trials of Epidiolex have demonstrated clinically significant improvement in Lennox-Gastaut syndrome and Dravet syndrome . On June 25th, 2018, Epidiolex was approved by the FDA to be the first CBD-based product available on the US market.
Levofloxacin {u} (Compound) binds {v} (Gene) CYP1A2
CYP1A2 {u} (Gene) is bound by {v} (Compound) Aprepitant
Aprepitant {u} may cause a minor interaction that can limit clinical effects when taken with {v} Cannabidiol
Levofloxacin {u} (Compound) causes {v} (Side Effect) Myocardial infarction
Myocardial infarction {u} (Side Effect) is caused by {v} (Compound) Aprepitant
Aprepitant {u} may cause a minor interaction that can limit clinical effects when taken with {v} Cannabidiol
Levofloxacin {u} (Compound) binds {v} (Gene) CYP1A2
CYP1A2 {u} (Gene) is bound by {v} (Compound) Tamoxifen
Tamoxifen {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Cannabidiol
Levofloxacin {u} (Compound) causes {v} (Side Effect) Myocardial infarction
Myocardial infarction {u} (Side Effect) is caused by {v} (Compound) Tamoxifen
Tamoxifen {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Cannabidiol
Levofloxacin {u} (Compound) binds {v} (Gene) CYP1A2
CYP1A2 {u} (Gene) is bound by {v} (Compound) Leflunomide
Leflunomide {u} may lead to a major life threatening interaction when taken with {v} Cannabidiol
Levofloxacin {u} (Compound) causes {v} (Side Effect) Osteoarthritis
Osteoarthritis {u} (Side Effect) is caused by {v} (Compound) Leflunomide
Leflunomide {u} may lead to a major life threatening interaction when taken with {v} Cannabidiol
Levofloxacin {u} (Compound) upregulates {v} (Gene) FKBP14
FKBP14 {u} (Gene) is upregulated by {v} (Compound) Clarithromycin
Clarithromycin {u} may cause a minor interaction that can limit clinical effects when taken with {v} Cannabidiol
Levofloxacin {u} (Compound) downregulates {v} (Gene) HTATSF1
HTATSF1 {u} (Gene) is downregulated by {v} (Compound) Clarithromycin
Clarithromycin {u} may cause a minor interaction that can limit clinical effects when taken with {v} Cannabidiol
Levofloxacin {u} (Compound) upregulates {v} (Gene) FKBP14
FKBP14 {u} (Gene) is upregulated by {v} (Compound) Dextromethorphan
Dextromethorphan {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Cannabidiol
Levofloxacin {u} (Compound) resembles {v} (Compound) Gemifloxacin
Gemifloxacin {u} may cause a moderate interaction that could exacerbate diseases when taken with {v} Clarithromycin
Clarithromycin {u} may cause a minor interaction that can limit clinical effects when taken with {v} Cannabidiol
Levofloxacin (Compound) binds CYP1A2 (Gene) and CYP1A2 (Gene) is bound by Aprepitant (Compound) and Aprepitant may cause a minor interaction that can limit clinical effects when taken with Cannabidiol
Levofloxacin (Compound) causes Myocardial infarction (Side Effect) and Myocardial infarction (Side Effect) is caused by Aprepitant (Compound) and Aprepitant may cause a minor interaction that can limit clinical effects when taken with Cannabidiol
Levofloxacin (Compound) binds CYP1A2 (Gene) and CYP1A2 (Gene) is bound by Tamoxifen (Compound) and Tamoxifen may cause a moderate interaction that could exacerbate diseases when taken with Cannabidiol
Levofloxacin (Compound) causes Myocardial infarction (Side Effect) and Myocardial infarction (Side Effect) is caused by Tamoxifen (Compound) and Tamoxifen may cause a moderate interaction that could exacerbate diseases when taken with Cannabidiol
Levofloxacin (Compound) binds CYP1A2 (Gene) and CYP1A2 (Gene) is bound by Leflunomide (Compound) and Leflunomide may lead to a major life threatening interaction when taken with Cannabidiol
Levofloxacin (Compound) causes Osteoarthritis (Side Effect) and Osteoarthritis (Side Effect) is caused by Leflunomide (Compound) and Leflunomide may lead to a major life threatening interaction when taken with Cannabidiol
Levofloxacin (Compound) upregulates FKBP14 (Gene) and FKBP14 (Gene) is upregulated by Clarithromycin (Compound) and Clarithromycin may cause a minor interaction that can limit clinical effects when taken with Cannabidiol
Levofloxacin (Compound) downregulates HTATSF1 (Gene) and HTATSF1 (Gene) is downregulated by Clarithromycin (Compound) and Clarithromycin may cause a minor interaction that can limit clinical effects when taken with Cannabidiol
Levofloxacin (Compound) upregulates FKBP14 (Gene) and FKBP14 (Gene) is upregulated by Dextromethorphan (Compound) and Dextromethorphan may cause a moderate interaction that could exacerbate diseases when taken with Cannabidiol
Levofloxacin (Compound) resembles Gemifloxacin (Compound) and Gemifloxacin may cause a moderate interaction that could exacerbate diseases when taken with Clarithromycin and Clarithromycin may cause a minor interaction that can limit clinical effects when taken with Cannabidiol