Botanical Empress

How CBD Interacts With Medications

With the resurgence of Cannabis Activism and the ever-increasing studies on the healing properties of CBD, more people are turning to this version of alternative medicine to help treat a host of symptoms. 

It’s a common misconception that since CBD does not get you high and has so many positive effects that it is 100% safe. 

CBD is not 100% safe. However, the benefits often outweigh the risks and CBD is usually a safer alternative to other more common medications. 

Before we get into the specifics of what to look out for when using CBD, let’s take a moment to go over what CBD is. 

What is CBD?

Cannabidiol, also known as CBD, is derived from the hemp plant which is a cousin of the marijuana plant. While CBD is a component of marijuana, by itself it does not cause a high because it does not activate the same regions in the brain as THC. 

How Does CBD Work?

CBD works by interacting with our body’s endocannabinoid system which is a regulatory system made up of naturally occurring cannabis-like molecules. These endocannabinoids work like neurotransmitters, sending messages through the body to help maintain homeostasis. CBD interacts with these receptors, triggering positive effects. 

CBD can do the following:

  • Relieve stress
  • Improve cardiovascular health
  • Help with insomnia
  • Help to increase your appetite
  • Relieve pain
  • Help improve your skin

Though usually well-tolerated, CBD can cause the following side effects:

  • Dry mouth
  • Diarrhea
  • Reduced appetite
  • Drowsiness/fatigue

More research is needed, but current medical studies show a lot of promise for a variety of ailments with little risk.

 According to the WHO organization, 

“In humans, CBD exhibits no effects indicative of any abuse or dependence potential…. To date, there is no evidence of public health related problems associated with the use of pure CBD.” (Organization, 2017)

What are the Different Types of CBD Oil available?

Currently, CBD is available in three forms:

Full-Spectrum CBD

Full-spectrum CBD retains all the different components of the cannabis plant and usually has a small amount of THC that is less than 0.3%. 

Broad-Spectrum CBD

Broad-spectrum CBD retains all the different components of the cannabis plant like full-spectrum CBD oil does, but it does not contain any THC. 

CBD Isolate

CBD isolate is the purest form of CBD. It contains only CBD and no other compounds from the cannabis plant. 

What Forms can CBD come in?

CBD can come in the following forms:

  • Oils 
  • Capsules
  • Topical Sprays
  • Vaping products
  • CBD infused food 
  • CBD infused products like lotions and soap. 
  • CBD infused drinks
  • Patches

Does CBD Interact with Other Medications?

Even though CBD does not get you high it still crosses the blood-brain barrier and affects the brain. It directly affects the central nervous system which can alter your mood and perception. 

CBD is also a known inhibitor of a certain group of liver enzymes called cytochrome P450 enzymes and as a result, creates an interaction that impairs drug metabolism

Drug metabolism is the process by which medicine is digested and used by the body. Most of this processing takes place in the liver.  Cystochrome P450 enzymes have a very important role where they maintain a healthy balance of life-sustaining molecules in all our cells. More importantly, regarding CBD, these enzymes break down the compounds found in prescription drugs. According to preclinical studies, CBD binds to the site where the enzyme activity occurs, competing with other compounds and thus preventing this system from breaking down other substances.

CBD is known to inhibit the production of this enzyme which means that with a lower amount of cytochrome enzymes in your system, prescription drugs hit harder and last longer because they aren’t broken down as quickly. 

About 2/3 of all prescription drug types can be affected by CBD in this manner. However, this negative interaction with the CYP450 enzymes depends on the dosage of CBD someone takes, their own physiology and the type of CBD used (full-spectrum, isolate, etc.)

Different Forms of CBD Bring Different Risks

Inhaled CBD gets into the blood faster which increases the risk of acute side effects. 

Edible CBD requires a longer time to be absorbed and is less likely to produce a dangerous concentration initially but could potentially reach toxicity as the body digests the edible. 

Topical CBD has a harder time of being absorbed fully through the skin and getting into the bloodstream making it the least likely form to cause an adverse interaction between other medications. 

Drugs That Interact With CBD

A study performed by researchers at Penn State College of Medicine identified 139 medications that may be affected by cannabinoids. From those numbers, 57 medications were found to have potentially dangerous altered concentration interactions. Not all the medication on this list is affected by CBD-only products. Some of them are only affected by THC compounds and are therefore safe to mix with CBD.

Medications that have potentially serious interactions with CBD are:

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

The following medicine can have adverse interactions with CBD:

  • Anesthetics
  • Angiotension II Blockers
  • Antiarrhythmics
  • Antibiotics
  • Anticonvulsants / Anti-Seizure Medications
  • Antidepressants
  • Antihistamines (Ex: Benadryl)
  • Antipsychotics
  • Antiretrovirals
  • Benzodiazepines
  • Beta Blockers (Ex: Metoprolol)
  • Calcium Channel Blockers
  • Cyclosporine
  • Haloperidol
  • HIV Antivirals
  • Immune Modulators
  • Macrolides
  • Non-Steroidal Anti-Inflammatory Drugs
  • Opioids (Ex: Codeine)
  • Oral Hypoglycemic Agents
  • Prokinetics
  • Proton-Pump Inhibitors (PPIs)
  • Sildenafil (and other PDES inhibitors)
  • Some Statins (Ex: atorvastatin and simvastatin but not pravastatin or rosuvastatin)
  • SSRIs
  • Steroids and Corticosteroids
  • Sulfonylureas
  • Tricyclic Antidepressants

Not everyone who is taking one of these medications and takes CBD will have adverse reactions. Studies have found that this has the potential to happen. Potential interactions may be dosage-dependent. 

As with any medication, you must weigh the risk against the benefits and decide if it’s a risk you are willing to take.  

As with any new product or medicine, it’s very important that you consult with your doctor and local pharmacists before taking it to make sure they feel it is safe for you to try given your current medications and medical conditions.

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