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What Drugs Should Not Be Taken With CBD?

In this article we will be answering a few questions on CBD drug interactions and what drugs should not be taken while using CBD.

By Evelyn Valdez | Mar 22, 2019 in General Blog | 5 min read

What Drugs Should Not Be Taken With CBD?

CBD is a cannabinoid that is being researched for its various potential health benefits. It is now being heavily researched because of numerous anecdotal reports regarding CBD's magical therapeutic effects.

CBD oil has the potential to effectively help people with certain health issues. The majority of scientific research shows that it is safe to use and consume. However, it can have some unintended side-effects and pose risk when used incorrectly.

In this article we will be answering a few questions on drug interactions with CBD oil and what drugs should not be taken while using CBD. CBD hemp oil drug interactions are often overlooked and it's important to shed more light on this topic as the CBD industry takes another step forward.

What are Cannabinoids?

Cannabinoids are a group of compounds that are found in the cannabis sativa plant. There are over 100 cannabinoids found in the hemp plant that are being studied for their potential health benefits.

Cannabidiol (CBD) is one of the many cannabinoids that is now being widely studied for the potential health benefits they can provide.

Cannabinoids like CBG, CBN, CBDa, CBC, and CBD interact with certain body receptors such as the CB1 receptor to create a therapeutic synergy in the human body. When these cannabinoids work together, there is an amplified effect in the endocannabinoid system known as the entourage effect.

CBD and many other cannabinoids ultimately promote a healthier lifestyle.

CBD Oil Drug Interactions

It is not uncommon for over-the-counter drugs and prescription drugs to interact with other compounds. Prescription medication can have interactions with several things like caffeine, certain foods like grapefruit, alcohol, etc.

If a person is ingesting CBD oil, it's important to be aware of the potential CBD oil interactions may have with prescribed drugs.

Can cannabinoids, like CBD, interact with prescribed drugs? In short, yes they can. CBD interactions are not common and generally occur when hemp-derived CBD oil is used at high doses. Most potential interactions have also been identified to be relatively mild.

One of the interactions CBD can have with prescribed drugs is inhibiting the enzyme system in the human cytochrome P-450.

The Cytochrome P-450 System

The Cytochrome P450, also known as CYP450, is an enzyme family that can be found in the liver and is involved in metabolizing over 60% of drugs.

CYP450 is important because doctors determine the appropriate dosages of medications based on the processing times within the system. They make calculations using the average amount of time it takes for drugs and medications to be processed through the cytochrome P450 system.

If only one drug is being ingested and the P450 system is healthy, then these averages provide accurate dosage information. Certain substances or an unhealthy P450 system can affect the processing times by either making drugs metabolize slower or faster than they would on their own.

CBD and the Cytochrome P-450 System

Researchers have found through clinical trials that CBD inhibits the CYP3A4 and CYP2D6 enzymes which can alter the way your body processes drugs metabolized by those enzymes. If CBD inhibits a CYP enzyme then the prescribed drugs metabolism may be delayed.

If CBD induces a CYP enzyme then it will decrease the lifespan of the prescribed drug (metabolizes faster) due to more of that enzyme being made.

Discuss with your doctor whether the medication prescribed is affected by cannabidiol. If it is, then your doctor may consider adjusting the dosage on your medication.

The CYP450 is responsible for metabolizing over 60% of prescribed drugs. Cannabinoids like CBD can inhibit the CYP450 enzyme system. This can alter the way the body processes drugs metabolized by those enzymes.

What Drugs Should Not Be Taken With CBD?

The Indiana University Department of Medicine created a Drug Interactions Table which shows drugs that are metabolized by the CYP450 system. Clinical studies have shown drugs that interact with the CYP450 system may potentially interact with CBD.[1]

Below is a list of drugs that are known to use the CYP450 system:

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

This is a list of common drugs that are known to use the CYP450 system. It does not include all medication that can potentially be impacted by cannabidiol.

It’s hard to determine what exact prescribed medications may have an interaction with CBD. This is why you should consult with your doctor on whether the medication your taking is safe to consume while supplementing CBD.

How to Take CBD

There are various ways to consume and dose cannabidiol. If you're unsure if you should be taking higher doses or lower doses check out our CBD dosage calculator to find the correct dose of CBD for you.

Different ingestion methods affect the way CYP enzymes metabolizes CBD. The method you use to take CBD will vary depending on your lifestyle and preference. It also impacts how long it takes for CBD to work.

CBD Oils and CBD Tinctures

CBD oils and CBD tinctures are taken sublingually. CBD is absorbed by membranes under the tongue without swallowing.

Sublingual ingestion means CBD is absorbed into the bloodstream. The leftover amount that is swallowed is processed through ingestion.

CBD Vape


Vaping CBD or cannabidiol allows CBD to enter into the bloodstream directly through the lungs. It bypasses the digestive system therefore having a rapid effect.

Inhaling cannabinoids causes an interaction with CYP1 family of enzymes, so any potential cannabinoid-drug interactions will occur.

CBD Edibles

There are various ways to ingest CBD. Many companies offer CBD infused products in the form of gummies, soft gel capsules, dried fruits, water, etc.

Cannabinoids that are ingested are absorbed by the intestines, processed by the liver, and delivered throughout the body. Since there are multiple steps in this absorption method it takes longer to reach the bloodstream. It can take 2-4 hours for it to be absorbed into the bloodstream.

Cannabinoids taken through ingestion have a higher chance to have a drug interaction with drugs that are metabolized by CYP3A.

CBD Topical Creams

CBD creams and CBD lotions aren’t absorbed into the bloodstream, they are instead absorbed by the skin into joints. Therefore it will have cause no drug interactions.

Conclusion

CBD can provide several health benefits such as pain relief, anti-anxiety, anti-nausea, and in some cases used as an anti-inflammatory and anti-seizure supplement.

If you're already taking CBD and are prescribed medication be aware there are potential cannabinoid-drug interactions. It all depends on the prescribed drug, how it’s metabolized, and the form of CBD being taken. Check to see if CBD is legal in your state.

These statements have not been evaluated by the FDA. Consult with your medical professional on whether your prescribed medication will be affected by the CBD product you are using. They will adjust the dosage as needed or advise you on other medication or forms of taking CBD.

Resources

  1. https://drug-interactions.medicine.iu.edu/Main-Table.aspx

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