Cannabidiol (CBD) interactions with prescription drugs are theoretically possible, but as of yet, they are largely under-researched and scientifically unproven. That said, CBD interaction with medicine still poses—as it should—a serious consideration for potential users. This is mostly because the cannabinoid gets metabolized by the same enzymes in the liver as many prescription drugs, which means that the latter's efficacy and potency can be affected. While uncommon, such CBD interactions can be dangerous, even fatal.
Below, we start with a list of red-alert prescription medicine—definitely consult with your doctor first before taking CBD concomitantly with these medicines.
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Also read on for some information on the specific enzymes involved in CBD metabolism, as well as more on CBD's safety profile and which side effects you may experience using CBD.
The Columbia Department of Health made available a document (Medical Cannabis Adverse Effects & Drug Interactions) discussing and listing the most prominent drugs that CBD and tetrahydrocannabinol (THC) can potentially interact with.
THC, the other best researched cannabinoid found in Cannabis sativa, gets mentioned here because many excellent CBD cannabis products contain both. They work well together and also with other compounds such as terpenes, etc.
The following was taken from the Columbia DoH's document. [1]
In theory, CBD may increase serum (blood) concentrations of:
In theory, THC can decrease blood concentrations of:
Again, it needs to be stressed that this THC and CBD interaction is mostly theoretical, as it is based on these cannabinoids' metabolic activity in the liver.
The above list is based on research that has shown THC to be a CYP1A2 enzyme inducer, while CBD appears to be a potent inhibitor of CYP3A4 and CYP2D6 enzymes. Both inhibit CYP2C9 enzyme activity. [5] [6]
But not all is theory.
Clinical research has shown CBD to increase serum levels of warfarin, a blood thinner—also topiramate and rufinamide, both anti-epileptics. It also increased desmethylclobazam—a metabolite of clobazam, another antiepileptic—in the blood. Yet paradoxically, it decreased clobazam serum levels. [2] [3]
Some research has furthermore shown THC to affect blood glucose levels, as well as theophylline, a bronchodilator. This doesn't seem to happen via the enzymatic pathway. [4]
Obviously, if you're taking any of the mentioned medications, it is imperative to visit your doctor before starting on CBD.
All cannabis use is contraindicated in the following conditions, except when supervised by a medical doctor. Most of these effects are dose-related.
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All of this may paint a scary picture and could put anyone off. Yet while caution is warranted, there's no reason not to explore CBD as a supplement to the mentioned medications. It may even be a good thing, as your doctor could titrate you down to a lower dose, especially of chronic prescription medicine. Lower doses could reduce the side effects these meds are most often associated with, which may even inspire your compliance with taking them. Again—always consult with your prescribing doctor first, as it will be crucial in some cases to monitor your serum drug levels.
Furthermore, CBD health benefits are numerous, and the cannabinoid has been shown to be safe for use in humans. It is not chemically addictive, and it doesn't alter the mind like THC in weed.
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Side effects are usually transient and self-correcting. They also tend to occur more when the CBD oil doses are very high and the user is cannabis-naive. These symptoms can include:
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CBD health effects are numerous, as research increasingly demonstrates. Don't let CBD drug interactions hold you back since the effects are usually dose-related and can be managed with the help of a medical doctor.
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CBD interactions with prescription drugs are theoretically possible, usually dose-related, largely under-researched, and scientifically unproven. Read more.
CBD interactions with prescription drugs are theoretically possible, usually dose-related, largely under-researched, and scientifically unproven. Read more.
CBD interactions with prescription drugs are theoretically possible, usually dose-related, largely under-researched, and scientifically unproven. Read more.