Table 4 Hypothesized influence on THC metabolism

1

Fluconazole strong inhibition of CYP3A4 and weak inhibition of CYP2C9

CYP2C9 IM

In this patient, two CYP pathways for THC metabolism could be downregulated by fluconazole.

This patient, due to their CYP2C9 IM phenotype, has a genetic predisposition to reduced THC metabolism.

2,3

Diltiazem moderate inhibition of CYP3A4

CYP3A5 IM

In these two patients, one of the CYP pathways for THC metabolism could be downregulated by diltiazem.

These two patients, due to their CYP3A5 IM phenotype, have a genetic predisposition to increased THC metabolism.

4

Carbamazepine strong CYP3A4 induction

CYP2C9 IM-NM

In this patient, one of the CYP pathways for THC metabolism could be upregulated by carbamazepine.

This patient, due to their CYP2C9 IM-NM phenotype, has a genetic predisposition to reduced THC metabolism.

5

CYP2C9 PM

This patient, due to their CYP2C9 PM phenotype, has a genetic predisposition to reduced THC metabolism.

6–15

CYP2C9 IM

These patients, due to their CYP2C9 IM phenotype, have a genetic predisposition to reduced THC metabolism.

16–19

CYP3A4 IM-NM

These patients, due to their CYP3A4 IM-NM phenotype, have a genetic predisposition to reduced THC metabolism.

20

CYP2C9 IM-NM, CYP3A4 IM-NM, and CYP3A5 IM

This patient, due to their complex gene profile (CYP2C9 IM-NM, CYP3A4 IM-NM, and CYP3A5 IM), may have a genetic predisposition to altered THC metabolism. The net genetic impact on the metabolism is currently unknown.

21

CYP2C9 IM and CYP3A5 IM

This patient, due to their complex gene profile (CYP2C9 IM, and CYP3A5 IM), may have a genetic predisposition to altered THC metabolism. The net genetic impact on the metabolism is currently unknown.

22–34

CYP2C9 IM-NM

These patients, due to their CYP2C9 IM-NM phenotype, have a genetic predisposition to reduced THC metabolism.

35

CYP2C9 IM-NM and CYP3A4 IM-NM

This patient, due to their CYP2C9 IM-NM and CYP3A4 IM-NM phenotype, has a genetic predisposition to reduced THC metabolism.

36–42

CYP3A5 IM

These patients, due to their CYP3A5 IM phenotype, have a genetic predisposition to increased THC metabolism.

43

Diltiazem moderate inhibition of CYP3A4

In this patient, one of the CYP pathways for THC metabolism could be downregulated by diltiazem.

44–71

N/A

These patients had no medication or gene interactions that could alter THC metabolism.