May 17, 2019 5 min read

CBD is quickly becoming known for its myriad of benefits for the mind, body,skin, and more. However, as consumers advance into the world of cannabidiol, more and more questions arise. One very important matter of discussion for many CBD users is it's potential to interact with any prescription or over-the-counter medications. Since CBD might be useful for managing a variety of symptoms, including some associated with various chronic illnesses, many potential CBD users are concerned about the possibility of drug interactions.

The idea isn't far fetched since even certain foods can disrupt some medications interactions in the body. In this article, we hope to answer any questions you may have related to CBD and your medications. Can CBD interact with medications? If so, which ones? Is cannabidiol safe to take with my medication? Keep reading to find out.


Is it Possible for CBD to Have Drug Interactions?

When you think of the way CBD interacts in the body, you should realize that any chemical compound has the potential to react with any number of the compounds around it all the time. One common example of this is when you eat salty foods and it causes you to retain water and feel bloated. Similarly, all medications, supplements, and other compounds that are taken into the body can potentially cause a reaction, either with your body’s natural compounds or with each other. The same can be said for CBD, and some evidence exists to help us understand exactly how CBD may interact in the body and with common medications. In fact, there are some medications that we know shouldn’t be taken alongside CBD at all.

One of the main complications that cause CBD drug interactions is cannabidiol’s impact on liver enzymes. CBD inhibitscytochrome P450 activity that is necessary to metabolize many medications and other compounds. Some medications that utilize the CYP450 pathway include:

  • Steroids
  • Immune modulators
  • Benzodiazepines
  • Anesthetics
  • HMG CoA reductase inhibitors
  • Calcium channel blockers
  • Prokinetics
  • HIV antivirals
  • Antiarrythmics
  • Antidepressants
  • Antihistamines
  • Anti-epileptics
  • Beta blockers
  • PPIs
  • NSAIDs
  • Angiotension II blockers
  • Oral hypoglycemic agents
  • Antibiotics
  • Antipsychotics
  • Sulfonylureas

Other common substances have been found to affect this group of liver enzymes as well, which is why many medication labels read “Don’t take this medication with grapefruit juice.” Just like with the grapefruit conundrum, it really depends when the CBD is taken. A grapefruit that is eaten hours before a medication dose is less likely to impact the medication than if it were eaten alongside the dose. That means that you may be able to take CBD alongside other medications if the doses are properly spaced, but still, research suggests that there are a few medications that may interact with CBD in other ways.


Medications that May Interact With CBD

Research about CBD drug interactions is still limited, and it is important that you work closely with your doctor when planning to use CBD alongside your regular prescription routine. However, there are a few medications that may interact with CBD that have already been researched. The following medications may interact with cannabidiol, and you may not be able to take cannabidiol alongside them. Some medications can still be taken with CBD, but should be closely monitored. If you’re taking any of these medications, talk to your doctor before starting cannabidiol.


CBD Interaction with Blood Thinners

Studies have shown that there are certain interactions between CBD molecules and medications that are known to thin the blood. One study shows a directinteraction between CBD and warfarin, a blood thinning medication used to prevent or treat blood clots. CBD may affect the way that these medications are metabolized, causing them to stay in the body longer or have increased effects, which can increase the risk of bleeding and other side effects already related to most blood thinning medications. However, the two medications can be used together, and in some cases may be beneficial, but should always be approved and monitored by a doctor.


CBD Interaction with Seizure Medications

While many people have heard stories of the seizure-stopping power of cannabidiol, it’s important to note that it can interact with certain medications that may be prescribed for managing epileptic seizures.Studies have shown that CBD inhibits cytochrome P450 enzymes resulting in higher concentrations of medications like clobazam and norclobazam for extended periods of time. This build-up of these medications may actually result in stronger, more aggressive seizures. Not all medications used to treat seizures are alike, however, and some may have no interaction with CBD at all. Either way, you should definitely consult your doctor before taking CBD alongside your normal seizure medications.


CBD and Chemotherapy Medications

Many people also are turning to CBD to help with the side effects related to chemotherapy. However, using CBD alongside any cancer therapy should be closely monitored by a doctor. Chemotherapy medications often require precise dosing to ensure safety and efficacy. When the medication is designed, it accounts for the body’s normal metabolic rate. CBD may slow down the metabolic process and cause more of the medicine to reach the bloodstream than intended. For this reason, chemotherapy medication must be measured after considering the CBD dose, and CBD and chemotherapy should only be combined with a doctor’s guidance.


CBD Interaction with Sedatives

Cannabinoids interact with certain neuroreceptors to directly impact brain activity. Because of these interactions, CBD has been linked to certain sedative effects, which is why many people are using it to combat anxiety, promote relaxation, andeven help them sleep. CBD may interact with certain sedative, too, to increase their effects. This increased effect, called an additive effect, doesn't alter the effects of the medication but multiplies it instead. For this reason. CBD and sedatives can often be used together, but the dosing needs to be adjusted accordingly and overseen by a doctor.


CBD and Prodrugs

Some medications, called “prodrugs” are actually inactive compounds that are activated by the body during the metabolic process. Many of these medications utilizeCYP3A4 pathways, which are an extension of the CYP450 liver enzyme system. Therefore, these medications may experience the same inhibited metabolic process as others, causing them not to “activate.” Therefore, many of these prodrugs can be made ineffective by cannabidiol. Some popular medications that fall in this category include codeine, Vyvanse, and Concerta.


Avoiding and Reporting CBD Drug Interactions

CBD’s interaction with medications is still mostly misunderstood, and there is very little clinical evidence to explain how CBD will react with the majority of medications. However, many people use CBD alongside their regular wellness routine and other medications with great results. The best way to ensure that you avoid any adverse drug interactions is to consult your doctor before using CBD. Be sure he or she is aware of any medications or other supplements you are taking. If you take CBD alongside other medications, start with one small dose of CBD and monitor the effects. If you notice any adverse reaction after you start taking cannabidiol, whether you are taking prescription medications or not, talk to your doctor before continuing. For more information about potential CBD side effects, you may be interested in reading “Common CBD Oil Side Effects and How to Avoid Them.”

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