Can CBD interact with other drugs?

CBD and other drugs.

A question we often hear, “Is CBD safe to take with other medications?” When taking multiple medications, there are always risks of drug interactions and it’s no different with cannabis.

Due to the nature of chemical compounds, almost every substance, including CBD, will interact with other substances. For instance, labels on a variety of prescription drugs will advise you to avoid grapefruit when taking the medication because it can significantly affect how the body metabolizes the drug.

CBD can deliver a variety of health benefits and is safe to take with many medications, however, CBD can illicit problematic interactions with certain drugs so if you are taking medications, it is highly recommended to consult with your physician.

WHEN INGESTED

There are differences between how THC and CBD are absorbed orally than when inhaled.

When CBD (cannabidiol) or THC (tetrahydrocannabinol) are ingested orally, any other medications that are also being taken can be enhanced or inhibited. This is specific to CBD when it is ingested, not vaporized. The way the circulation works with ingesting cannabis is going to go to the liver, it’s called the first pass effect. When ingested, THC and CBD pass through the liver and are metabolized by enzymes before entering the bloodstream.

Blood Thinners – CBD can have negative drug interactions with certain blood thinners. There is some concern that a person taking such medications “may inadvertently increase how thin their blood is, how anticoagulated they are.”

Studies have shown that CBD and other plant cannabinoids can increase the effects of drugs used for blood-thinning (e.g. warfarin) or drugs with a risk of blood-thinning (e.g. ibuprofen).

CBD preserves the medication’s durability and prolongs its presence in the body by slowing down how the body metabolizes these drugs. Effectively, CBD can increase and prolong the effects of drugs that increase the risk of bleeding and the usage of both simultaneously should be closely monitored by a medical professional.

Sedatives – When combined with sedatives, cannabinoids can increase the effects of the medication. The interaction between CBD and sedatives is not fully know but does not seem to have a directly negative effect on the user. To be safe, however, users should avoid combining CBD with sedatives.

Anti-seizure Medication – CBD can present problems under certain circumstances with anti-seizure medication. While CBD is widely known to be an effective treatment for epileptic seizures, it’s very important to consult with a medical professional in order to determine the proper dosage of CBD to effectively alleviate epileptic seizures.

Chemotherapy Drugs – While CBD has shown to alleviate cancer-related pain and slow the growth of cancer, if it is combined with chemotherapy treatment, the amount and type of cancer medication administered by your physician must account for the presence of CBD.

Grapefruit – Since both grapefruit juice and CBD can inhibit the metabolic process similarily, logically, any drug or medication that is advised to not be consumed with grapefruit juice, should also not be consumed with CBD.

For further reference, check out the list of some drugs that can interact with grapefruit juice that’s listed on Drugs.com:

• alprazolam
• amiodarone
• atorvastatin
• carbamazepine
• cilostazol
• clarithromycin
• colchicine
• dronedarone
• erythromycin
• felodipine
• fentanyl
• fentanyl transdermal system
• fexofenadine
• indinavir
• loratadine
• losartan

Please be advised that this list does not include all drugs that can interact with grapefruit or CBD, and it is highly recommended that you consult with your physician before taking Cannabidiol (CBD).

WHEN VAPORIZED

When it’s vaporized, the CBD bypasses the first pass effect of the liver so the effects on the blood thinners are relatively diminished. When smoked or vaporized, cannabinoids directly enter the bloodstream through the lungs.

WHEN USED TOPICALLY

Topical CBD products do not go through the bloodstream so there is less chance of them interacting with medications. CBD has become a popular treatment for pain and other conditions

WHEN USED WITH ALCOHOL

Since alcohol and CBD both relax you and lower your inhibitions, these effects could be especially strong and long-lasting when you mix the two substances. With CBD, you’re very chill, very lighthearted, mellow. The alcohol will make that more intense,

Different forms of cannabis can have different interactions as well.

Cannabis affects enzyme levels that in turn can speed up or slow down metabolism of other drugs.  Case studies have suggested that this can lead to adverse interactions with drugs like Antabuse and Prozac.

• Not every drug interaction has to be a bad thing.
• There are positive drug interactions as well.
• Cannabis can interact with other drugs like opioids. For example, people who are using opiates and then given cannabis, report an increased improvement with regards to pain control.  This means that the patient may not have to increase dosage of their opioids, and may even lead to de-escalation of overall usage.

Consult a Doctor Regarding CBD Drug Interactions

Please share this article with anyone you know who is considering taking CBD with another medication or drug.

• CBD can deliver a wide variety of benefits.
• Like any other substance, it can interact with other substances.
• It is extremely important to be aware of these CBD drug interactions.
• For your safety and health, always consult your physician if you are considering taking CBD in conjunction with any other prescribed medication.

If you have any questions, comments, or suggestions, please feel free to contact our office.