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Does CBD Interact with Medications?

Dale blog imageAuthor: Dale Hewett
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It’s no secret that CBD oil has become a household name, with many CBD products now sold online and in stores worldwide. Medical cannabis and cannabidiol CBD products are making waves among those looking for alternatives to over-the-counter medications. Does CBD interact with medications, though? What drugs should not be taken with CBD? Some are considering taking CBD right along with their prescription medications. However, is it safe to take CBD with prescription medications? Will it interact with other substances creating adverse reactions?

Let’s explore the possible interactions of cannabidiol (CBD) and other medications.

TL;DR – cannabidiol (CBD) can negatively interact with other medications. As a rule of thumb, if your prescriptions have the grapefruit warning on them, double check with your doctor before adding cannabidiol to your routine medicines.

Concerns About Mixing CBD Products and Medications

Cannabidiol (CBD) is claimed by many to have healing properties for several health conditions affecting the body and mind. In randomized clinical trials, it has been touted as helping ease the symptoms of insomnia, multiple sclerosis, chronic pain, anxiety, depression, and so much more!

Some researchers suggest that cannabidiol reduces intestinal inflammation, but there is a concern people have about mixing CBD with medications. While research is ongoing with many of the studies still in their infancy, many people are getting onboard the CBD train – and loving it.

The one main issue that needs to be addressed is the interaction that CBD seems to possess with certain drugs and medications. The main concern is regarding how certain substances are metabolized in the body.

Even though CBD is shown to be relatively safe, and the side effects are few, the potential for adverse interactions with other medications is worth noting.

Before you try CBD or take CBD with other medicines, it is best to talk to a doctor or healthcare professional who will let you know if CBD interacts with any other drugs you may be taking.

How CBD Interacts With Other Medications

The family of enzymes CYP450’s primary function is to help metabolize the several cannabidiol extracts of the cannabis Sativa plant. This includes CBD, THC, and many other minor cannabinoids. One specific enzyme in this family is, CYP3A4 which helps with metabolism.

However, any CBD may create an inhibitory effect during the metabolic process and interfere with CYP3A4’s function.

Nearly 60 percent of all clinically prescribed medications are processed by CYP3A4. And if there is any CBD present, the cannabidiol inhibits the breakdown of medications in this system. The flip side of this dilemma is if a person is taking any prescription medications and also attempts to take CBD, the effects of the CBD will be lessened and prevent the effectiveness of the CBD.

One thing to consider is that if your body already has a slow metabolism, you may have a build-up of medication in your system.

With that increased level of medication already present in your system, it may alter the effects of the CBD or possibly create unwanted or harmful side effects.

On the other hand, some substances may actually speed up the work that the CYP450 enzyme family has to do. Suppose you’re metabolizing a medication too quickly due to a foreign substance that is inducing the enzymes. In that case, the amount of medication in your system might not be enough to help treat your health condition.

CBD Metabolism and Cytochrome P450 Enzymes

When you take any approved prescription drug, supplement, or other substance, the body needs to metabolize it by breaking it down. Drug metabolism happens everywhere in the body, especially the gut and digestive systems.

However, the liver does most of the work to metabolize things like oral cannabidiol oil or prescription medication.

As the metabolism occurs, a family of enzymes (cytochrome P420 – or CYP450) does most of the work converting any unknown substance to be easily eliminated from the body. However, other drugs or medications may affect cytochrome P450 by altering the rate of metabolism.

This change in the rate may alter how the body processes medications like thyroid medication, over-the-counter medications like pain killers, cannabidiol oral capsules, and many more. This process is called “drug interactions.”

Is It Safe to Take CBD With Other Medications?

If you are considering taking CBD, medical marijuana (or medicinal cannabis) with one or multiple medications and wish to avoid a cannabis/drug interaction, talk to your doctor first.

Your doctor may be able to find a CBD product that is suitable to take with your medications.

They will know about any allergic reactions to ingredients, dosage, and if a cannabidiol initiation in your system will create any adverse effects on you or the effectiveness of the drugs. In certain situations, your doctor can monitor the cannabidiol exposure in your system by checking the blood plasma levels of the specific medications you are taking to see if they have been altered.

The bottom line is that you should avoid stopping any prescribed medications to switch to CBD as an alternative unless your doctor says so. This is especially important for chronic pain patients, cancer patients, or mental health concerns such as depression or anxiety disorders.

Can You Take CBD and Tylenol (Acetaminophen) Together?

Many people take over-the-counter pain medications like acetaminophen (Tylenol) on a regular basis, while also using cannabidiol (CBD) products for their potential therapeutic benefits. However, questions often arise around the safety and potential interactions of taking CBD oil, or other CBD products, alongside common OTC medications like Tylenol.

As both acetaminophen and CBD usage continue to increase, it’s important to understand whether they can be safely used together or if potential complications could arise from combining these substances.

Cannabidiol goes through your liver, which acts as the body’s filtration system (among other things). Taking CBD with acetaminophen may increase the risk of liver damage, but there are different school’s of thought here.

The likelihood that taking CBD with lower amounts of acetaminophen will cause issues is quite slim, but still possible.

What Medications Should Not Be Taken With CBD?

Not all medications within a specific category require grapefruit avoidance. Always check the information on your medication or ask your doctor.

Below are the types of medicines that will typically have a grapefruit warning:

  • Antibiotics, antimicrobials
  • Some anticancer medications
  • Antihistamines
  • (AEDs) or antiepileptic drugs
  • Blood pressure or blood-thinning medications
  • Cholesterol medications
  • Corticosteroids
  • Erectile dysfunction medications
  • Medications to treat GERD or nausea (GI medications)
  • Heart rhythm medications
  • Immunosuppressants (drugs that suppress the immune response)
  • Mood modification medications (drugs to help treat anxiety disorders, depression, or mood disorders)
  • Pain relief medications
  • Prostate medications

What Prescription Drugs Should Not Be Taken With CBD Oil?

One of the most critical warnings when taking premium CBD oil and any other substance is the “grapefruit warning.” Always avoid CBD if your medication or supplement has a grapefruit warning on the label.

Warning Label On Prescription

Although more research is needed to determine potential interactions of CBD with other medications, consuming grapefruit to grapefruit juice should be avoided entirely.

According to the FDA (Food and Drug Administration), web site consuming grapefruit, grapefruit juice, or products that contain grapefruit can elevate the concentration of the medication in the bloodstream. When this happens, it can create adverse side effects, and in some cases, an overdose can occur.

Check out this chart straight from the FDA for more information:

There are more than 85 known drugs that interact with grapefruit. And some other citrus fruits must also be considered potentially dangerous, like Seville oranges, tangelos, and pomelos. The potential dangers of grapefruits are related to chemicals found in the fruit called furanocoumarins.

These chemicals inhibit CYP3A4 the same way that CBD does. The result is the slower metabolism of medications and a potentially dangerous situation for patients taking specific drugs. You can find the grapefruit warning in several types of medications.

Grapefruit Warning Chart

Summary – CBD Interactions With Other Drugs

When adding any new supplement to your daily routine, it is best to talk to your doctor first, especially if you are thinking about taking CBD. Never stop taking prescribed medications without being told to do so by your doctor.

Conditions like depression, multiple sclerosis, chronic pain, and more can become potentially dangerous if prescribed medications are stopped or altered.

However, even with such warnings, your doctor will know if you can take such products while being closely monitored for any medication level changes in your system. This may be one way to continue your prescription while also experiencing the benefits of CBD.

Talk to your doctor or pharmacist today for recommendations on a quality CBD product that will suit your specific needs.

References

https://www.health.harvard.edu/blog/cbd-and-other-medications-proceed-with-caution-2021011121743
https://pubmed.ncbi.nlm.nih.gov/22163000/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5874292/

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About the Author - CBD Expert Dale Hewett

Dale Hewett Author
Dale Hewett

Dale Hewett is the owner and founder of New Phase Blends. He discovered his passion for CBD use after suffering from injuries sustained while on Active Duty in the US Army. His number one priority is introducing the same CBD products that he himself uses for relief to others who can benefit from them.

Dale holds a Master Degree of Science, and is the inventor of the popular, CBD-based sleep aid known as ‘Sleep.’ He’s given multiple lectures on CBD to institutions such as Cornell’s MBA student program, and Wharton’s School of Business.

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