Does CBD Interact With Other Medications?
Is CBD-drug interaction something you’re concerned about?
CBD (cannabidiol)’s therapeutic properties have fuelled its popularity in recent years. As a natural compound, this substance relieves a variety of symptoms, allowing for safer and more effective management of different health conditions.
CBD is non-intoxicating, unlike THC (tetrahydrocannabinol).
As a treatment for anxiety disorders, depression, inflammation, pain, neurodegeneration, seizure disorders, sleep deprivation, metabolic conditions, neuropathy, migraines, inflammatory bowel disease, and more, CBD has many benefits.
Due to CBD’s many potential benefits, you may wonder whether it can interact with certain medications used to treat the same symptoms – and whether you should take them together.
Here are the dos and don’ts of using CBD with medications.
What Drugs Should Not Be Taken with CBD
CBD should not be taken with pharmaceutical drugs and medications, according to a study from the Indiana University Department of Medicine.
Below is a list of all groups of drugs that can negatively interact with CBD oil.
Angiotensin II Blockers
Antiarrhythmics
Antibiotics
Antidepressants
Anticonvulsants / Anti-Seizure Medications
Antihistamines
Antipsychotics
Anaesthetics
Beta-Blockers
Benzodiazepines
Calcium Channel Blockers
HIV Antivirals
HMG CoA Reductase Inhibitors (Statins)
Immune Modulators
Non-Steroidal Anti-Inflammatory Drugs
Oral Hypoglycemic Agents
Proton-Pump Inhibitors (PPIs)
Prokinetics
Steroids and Corticosteroids
Sulfonylureas
A group of drugs called “prodrugs” must be processed into their therapeutic compounds before they can be used as therapeutic compounds. Consuming the inactive compound turns it into the active compound once it reaches the body.
A drug interaction may result in insufficient concentrations of the therapeutic agent in the bloodstream, thereby reducing its potency if the mechanism is dependant on the CYP450 system (more on that later).
CBD Interaction with Drugs & Medications
In the following section, we discuss the most common interactions between CBD and medications. If you are taking any of the following substances, consult your doctor before purchasing CBD oil.
CBD and Ibuprofen Interaction
As a non-steroidal anti-inflammatory drug (NSAID), Ibuprofen works similarly to CBD in terms of inflammation and pain relief. There are concerns about possible negative interactions between CBD oil and NSAIDs.
According to a study in the Journal of Neurology Research, CBD and ibuprofen have not been reported to interact, but it doesn’t mean they don’t exist. Health experts say potential interactions may depend on the dosage. If a certain dosage threshold is crossed with CBD and NSAIDs like Ibuprofen, nerve damage can result.
CBD and Adderall Interaction
CBD products with a higher concentration were associated with lower ADHD scores. CBD can interfere with ADHD medications, decreasing their effectiveness while providing more pronounced benefits. CBD and Adderall interactions may result in decreased appetite as a side effect.
CBD and Lamictal Interaction
The combination of medical cannabis and Lamictal may increase side effects such as dizziness, confusion, drowsiness, and difficulty concentrating. Judgement impairment may also be experienced by elderly consumers. Despite this, CBD use itself did not cause any of these side effects. CBD can affect Lamictal’s effectiveness, depending on the dosage, when it comes to interactions with CBD.
CBD Oil and Antibiotics
CBD does not interact with antibiotics, although this may happen if an antibiotic is metabolised through the cytochrome P450 enzyme system. Researchers have found that taking CBD and antibiotics together may enhance their effects without causing any negative side effects. To confirm these findings on a larger scale, more research is needed.
CBD Oil and Omeprazole
Proton Pump Inhibitors (PPIs) such as omeprazole and CBD can inhibit the enzymes that are targeted by these drugs. Some heartburn medications can increase the risk of diarrhoea when CBD is taken with them.
CBD and Thyroid Medications
CBD oil can cause mild nausea in some people when taken with thyroid medications. Taking CBD together with a thyroid medication may cause hyperthyroidism since more thyroxine would be secreted than the body could metabolise, because both substances are processed by the CYP450 enzyme system.
CBD and Lisinopril
Taking CBD along with medications like Lisinopril may lower blood pressure even further, causing you to feel lethargic and weak. If you take antihypertensive medications, consult your doctor before adding CBD to your routine.
CBD and Prednisone
As both CBD and corticosteroids inhibit the CYP450 enzyme system, concomitant use may increase the risk of systemic side effects from corticosteroid use. CBD should never be taken with corticosteroids such as prednisolone and hydrocortisone.
How Drugs Interact: Understanding Drug Metabolism
In the body, metabolism refers to how energy is used, or how drugs are metabolised.
At rest, a person’s basal metabolic rate is the number of calories he or she needs to maintain healthy body functions.
This is very different from the basal metabolic rate. As a general rule, drug metabolism refers to how a substance is processed and used by the body. The liver is responsible for the majority of this processing.
The ‘first-pass effect’ or ‘first-pass metabolism’ is what scientists call it.
The liver breaks down a medication into its active compounds so that the body can use them when you take it. Drugs are broken down into their individual components, just as carbohydrates are broken down into sugars, fats into triglycerides, and proteins into amino acids.
These compounds are then converted into metabolites by enzymes. A metabolite influences a variety of bodily processes, and once used up, it is flushed with urine.
How Is CBD Metabolised?
The body’s drug metabolism determines how fast medications and other therapeutic compounds are processed into their individual metabolites and how long they last.
Oils, capsules, and gummies containing CBD must pass through your gut before they enter your bloodstream. Then, they travel through the bloodstream to the liver, where they are absorbed through the hepatic portal. By breaking down CBD into its metabolites, the liver allows it to circulate in the bloodstream again throughout the body.
What Is the Cytochrome P450 System?
In addition to breaking down compounds into metabolites, the liver detoxifies and excretes foreign substances. Cytochrome P450 (CYP450) is a system of enzymes that allows this to happen. Heme is a cofactor in these enzymes that converts cannabinoids into more water-soluble molecules, increasing their absorption and effectiveness.
Researchers estimate that 60% of drugs are metabolised by the CYP450 system. In addition, doctors and pharmacists use this system to analyse, evaluate, and predict the benefits and side effects of drugs.
However, certain compounds can negatively affect the metabolism of certain medications by impairing the CYP system’s functioning. It is possible for drugs to be metabolised faster or slower as a result of these interactions.
CBD And the Cytochrome P450 System
There is evidence that CBD interacts directly with the liver’s CYP450 system, as mentioned earlier. CBD binds to the enzyme site, competing with other compounds and preventing the enzyme from breaking down other substances, according to preclinical studies.
CBD’s inhibitory effect on the CYP450 enzymes is mainly determined by how much CBD a person takes, their physiology, and the type of CBD they use (e.g., whole-spectrum CBD vs. CBD isolate). Depending on the dosage, CBD binds to the enzymes’ active sites more or less strongly. The tighter the bond, the greater the competitive inhibition.
Contraindications for Taking CBD with Medications
Regardless of its biological inertness, CBD has many health benefits. CBD’s pharmacokinetics and pharmacodynamics are complex, just like any other medication. As a result, certain medications may be compromised by it.
CBD can potentially affect any therapeutic substance that relies on the CYP450 system. A grapefruit warning on your medication’s bottle is a common indicator of an interaction. If you are taking the two compounds together, you should always consult your doctor and pharmacist first.
A Doctor’s Consultation Is Always Recommended
Our list of drugs above is not exhaustive and does not include all pharmaceutical substances that may interact with CBD. As with antibiotics and Ibuprofen, not all medications from these categories will cause an interaction.
You can avoid potentially negative interactions with your medications and supplements by consulting with a doctor experienced in CBD and cannabis use. Your doctor can help you maximise the effects of your CBD treatment by prescribing compounds that work synergistically with CBD.
You can also get advice from your doctor on finding the right dosage for you.
Key Takeaways on CBD Drug Interactions
CBD’s safety profile has been acknowledged by major health agencies, such as the World Health Organisation (WHO), demonstrating that it’s well-tolerated by animals and humans.
CBD affects a variety of systems, which explains its therapeutic versatility. Due to its versatility, CBD interacts with a wide range of prescription medications and over-the-counter products.
A consultation with a health professional will not harm you if you’re unsure whether CBD will interact with medication you’re taking – unlike attempting to figure out these interactions yourself.