CBD Drug Interactions: Safely Using CBD with Other Medications

Jul 29, 2021Posted by: brian sorel

CBD Drug Interactions: Safely Using CBD with Other Medications | iCBD

Cannabinol, popularly known as CBD, has taken the world by storm in recent years. CBD is the non-psychoactive ingredient in hemp and marijuana, and has been a proven aid in treating many ailments, such as insomnia, anxiety, arthritis, and more. With this natural remedy, there are many benefits users can experience without having to think about adding another pharmaceutical drug to their pill case. However, there is one thing to consider-  potential CBD drug interactions with the other pills in that case.  

While today’s research suggests CBD to be quite safe with minimal side effects, the one catch is that it can interact with some medications. While researchers are looking to uncover better understandings of CBD drug interactions, here’s what we know so far.

Prescription Medications

When it comes to CBD drug interactions, evidence in its relationship with prescription medications is the most established. Although we still have more to discover, the potential risks of combining CBD and prescriptions is something to consider (and talk to your doctor about).  

So far, we know that, yes, CBD does cause some drugs to work differently. The prescription drugs listed below are ones you should pay close attention to, as they have the most evidence stacked against them.

Medications that interact negatively with CBD:

  • Warfarin (blood thinner)
  • Amiodarone (heart rhythm medication)
  • Levothyroxine (thyroid medication)
  • Clobazam, Lamotrigine, Valproate (seizure medication)

All of these drugs treat serious illnesses and patients should not stop taking them in order to use CBD. There are alternative prescription medications available to treat these health issues that haven’t shown any adverse reactions when taken alongside CBD.

If you are adamant about trying CBD and are on one of the medications listed above, it’s important to find a healthcare professional who is able to walk you through proper treatment options.   

Over the Counter Medications and Supplements

There is currently no evidence that suggests CBD use interacts with common over the counter medications, like Tylenol or Ibuprofen. However, this doesn’t necessarily mean there is no future possibility of discovering adverse interactions. If you use over the counter medications regularly, we suggest speaking with your doctor first. 

Why Do These Interactions Occur?

When we take oral medications, it gets absorbed into our bloodstream and our bodies begin to process them so we can use its benefits. In order to process them, our blood travels through the stomach and into the small intestines. It then gets sent to the liver where it’s metabolized (broken down). 

In order to metabolize drug chemicals, the liver uses enzymes- specifically, cytochrome P-450 (CYP450) enzymes. Various foods and drugs can affect CYP450’s ability to break a drug down which can increase a drug’s effects (and side effects). The opposite is true as well, where if a substance increases the enzyme’s ability to break a drug down, it will decrease the effects of said drug.

What does this have to do with CBD, you ask? CBD is metabolized by CYP450 enzymes, as well as another enzyme in its family, CYP34A, which directly interacts with CBD. Additionally, CYP3A4 is responsible for metabolizing 60% of pharmaceutical drugs. This dual interference can increase or decrease the effectiveness of other medications to not work as well or to work too much. These relationships can also affect how CBD is processed and used in our bodies. 

The main concern with these CBD drug interactions is the hindrance to the intended performance of a medication. If a prescribed medication you are taking helps treat a serious health disorder, you want your medication to be working properly. Otherwise, it could create more serious health issues without you realizing it. 

While we work to understand these relationships better, researchers at Penn State have recently released a list of 57 medications that could potentially interact with CBD. On this list, you can see which enzymes play a part in specific drug metabolization, with many mentioning CYP3A4.

Note: Some medications on this list only interact with THC, the psychoactive ingredient found in marijuana.

What do CBD and Grapefruits have in Common?

Interestingly enough, grapefruit has been found to interact with certain medications, so much so that their prescription bottles come with a warning.

This is because, through research, grapefruit has proven to interact with the CYP450 enzymes. Yep, those same enzymes the liver uses to break down medications in our bodies. And that warning label really is no joke as its interaction with some medications can be quite risky.

Data on CBD drug interactions have yet to pull the same significant results grapefruit interactions have. But some research does suggest it, and considering that the same enzymes are at play, you can never be too careful. That’s why it’s always important to talk to your doctor when deciding to add any new remedies (supplements too) to existing prescriptions.  

CBD Liver Safety 

With all this talk about the liver, you may be wondering if any research suggests the safety of CBD use on the liver. While there is currently no research that suggests CBD has any damaging effects on the liver when taken properly, it is always important to stay within recommended dosing limits to be sure. 

Other CBD Products to Consider

You can still obtain the benefits of CBD without having to take oral remedies- like oils, edibles, drinks, or vapes. Consider using something topical, like a lotion or a roll-on gel. Since these types of products are applied to the outer layer of skin, they aren’t designed to enter the bloodstream, meaning they won’t interact with any medications. 

In Conclusion

 While research is breaking ground in understanding CBD drug interactions, further studies need to be conducted to draw more precise findings. With what we do know, some prescriptions do react negatively with CBD (and grapefruit). There is no current research that points to any risks with using CBD and over the counter medications.

And once again, it’s always important to consult a healthcare professional before trying CBD. They will not only help you figure out any potential CBD drug interactions, but they can also aid in determining the best dose of CBD for you.

Lastly, since the FDA currently does not regulate CBD products it’s important to make sure the products you use are safe and don’t include poor quality ingredients. By researching the quality of your CBD products, it will further limit the potential of unknown drug interactions from occurring.  

Written by Alyssa Motheral