CBD and Drug Interactions: What You Need to Know

Are you wondering what drugs to avoid when you are taking CBD? Are you interested in the adverse effects when taking CBD with your current medication?

If you are taking prescription drugs and you are keen on adding CBD into your routine, then this page is for you. CBD and drug interactions are not the same in every medication.

In this article, we will cover the interaction between CBD oil and other drugs and give you an overview of the potential side effects, so let’s get started!

Can CBD Oil Interact with Medications

According to Peter Grinspoon. M.D., an instructor in medicine at Harvard Medical School, CBD have hypothetical drug interactions because CBD inhibits two main enzyme systems. The only question is if it’s clinically important or not.

One system is the same one that grapefruit inhibits – the CYP34A enzyme system. This is just like grapefruit juice because it can cause your body to have higher doses of benzodiazepines [anti-anxiety medications] or certain antipsychotic medications.

CBD also inhibits the system that metabolizes a lot of serotonin reuptake inhibitors (SSRIs)., tricyclic antidepressants and antipsychotics as well. Taking CBD products while on psychiatric medications could hypothetically interfere with how the medications are metabolized.

This can also slow down the system that the body uses to process toxins, the cytochrome P-450 enzyme system. This system is made up of liver enzymes that break down certain medications into smaller parts so your body can process them more easily.

When this system is inhibited by a compound like CBD, the medications will stay longer in the system than desired. As a result, you will experience the side effects of that unprocessed medication.

CBD drug interactions are not always bad. CBD can also make other drugs more effective, so you can reduce the dosage and experience less negative side effects to deal with.

“Certainly, if someone is on a very delicately balanced medical regiment, CBD could knock that out of whack because of the two different enzyme systems it inhabits. In terms of actual clinical practice, I haven’t heard any stories of people having clinical decompensation because of adding CBD to their regime,” Grinspoon said.

He added that the potential interactions should be regarded as “hypothetical than real” and the side-effect of CBD is “very minimal.”

So, is it okay to take CBD oil with other medications? Yes and no because depending on your case adding CBD on your medication may or may not do good. In general, this depends on CBD drug interactions with medications.

For instance, CBD interacts differently with antidepressants, blood thinners or antibiotics. In the next sections, I will discuss these in detail. So, continue reading.

What Drugs Should Not be Taken with CBD

Some medicines are contraindicated to be used in conjunction with CBD. Here are some of the medicines you need to avoid and why you should do so.

Blood Thinners (Warfarin/Coumadin) – CBD could block the metabolism of these drugs causing them to remain in higher concentrations and be more active which could become toxic or may cause other complications.

Benzodiazepines (Xanax/Ativan) – CBD can potentially increase the side effects. Thus, you will likely feel more sedated and drowsy. There are cases when medicine becomes toxic and interfere with the respiratory system.

Here is a list of medicines that use the CYP450 system and may interact with CBD.

• Steroids
• HMG CoA reductase inhibitors
• Calcium channel blockers
• Antihistamines
• Prokinetics
• HIV antivirals
• Immune modulators
• Benzodiazepines
• Antiarrythmics
• Antibiotics
• Anesthetics
• Antipsychotics
• Antidepressants
• Anti-epileptics
• Beta blockers
• PPIs
• NSAIDs
• Angiotension II blockers
• Oral hypoglycemic agents
• Sulfonylureas

CBD and Drug Interactions Potential Side Effects

CBD is generally safe to take. However, you should still take this with caution because there are some adverse effects reported.

As mentioned, CBD can either increase or decrease the effectiveness of a drug.

Here is a list of what you should observe when you are combining your current medication with CBD oil.

🌿 Increased or new medication side effects
– Drowsiness
– Sedation
– Nausea

🌿 Decrease in medication effectiveness
– Breakthrough seizures

🌿 Common CBD side effects or changes
– Fatigue
– Diarrhea
– Changes in weight
– Changes in appetite


CBD Interaction with Antidepressants

Can you take CBD with antidepressants? I’ve heard this question from several individuals with depression who wish to try this and the answer will surely please you because you can do so.

A small study evaluated the use of CBD in patients with anxiety before a public speaking test.

The results showed that those who used CBD before their speech experienced less anxiety and discomfort. Thus, CBD oil can benefit people who need to reduce anxiety before an event.

In general, you can safely use CBD supplements when you are taking antidepressants whether its Prozac, fluoxetine, sertraline or Zoloft. However, Grinspoon warned about potential concerns.

For him, among the things that you should consider is the fact that CBD isn’t regulated by the FDA. You should make sure that you are getting your CBD oil from a reliable supplier. Also, you should look out for the labels because some are inaccurately labeled and other formulations include THC.

🌿 You shouldn’t worry too much when it comes to the potential interactions between CBD and antidepressants whether its Prozac, Lexapro, sertraline, Zoloft or fluoxetine because the side effects profile of CBD is “very minimal.”

However, it is still best if you consult your doctor before using CBD supplements while on antidepressants.


CBD Interaction with Blood Thinners

Blood thinners prevent blood clots and beta-blockers and cannabis have a reputation for working well together.

Beta-blockers lower blood pressure by reducing the heart rate, the heart’s workload and the heart’s output of blood.

They also signal the blood vessels to open up to improve blood flow and lower adrenaline. Meanwhile, cannabis can increase heart rate and make the heart pump harder.

CBD interacts with blood thinners and all the pharmaceuticals are processed by the cytochrome P-450 enzyme system. However, you should note that CBD interacts with most medications, but not every medication within that category. So, it might work well in some brands but not in others.

For instance, you might need to take care when combining CBD oil and Warfarin. However, those who are using Heparin, another anticoagulant with CBD face fewer risks.

This table also shows that taking CBD with Heparin (Various), Edoxaban(Lixiana) and Dabigatran (Pradaxa) is safe as there is no known interaction. Meanwhile, CBD interaction with Warfarin (Coumadin, Jantoven) or Apixaban (Eliquis) is a bit different.

When taking these medications with CBD oil, you have to be careful because they can remain in the system longer and you are likely to experience the side effects.

It’s still important that you consult with your doctor before using CBD oil and blood-thinning medications together. In this way, your doctor can make adjustments to your medications while taking into account any changes that CBD oil may have in its processing time.


CBD Interaction with Beta Blockers

CBD oils lower blood pressure and improve health in patients whose heart is under strain due to lifestyle factors, medical complications or both. CBD also helps reduce anxiety where doctors prescribed beta-blockers.

Some even prefer this because it delivers the same results with very few unintended effects. However, due to the inhibition of the cytochrome P-450 enzyme system in the liver, it should be used cautiously if you combine it with different medications that use the same pathway as the beta-blockers.

Beta-blockers reduce blood pressure and slow the heart rate. They are often prescribed to treat individuals with anxiety, high blood pressure, and other heart conditions.

When the P-450 pathway is occupied with CBD, it could take your body longer to process medication. CBD can affect the metabolization of these drugs and the blood pressure may drop too much if they are taken together. Your heart rate may slow further and you might experience side effects.

Common side effects when taking beta-blockers and CBD oil together include dropping your blood pressure. CBD can lower blood pressure and amplify the effects of beta-blockers.

However, when your blood pressure is too low you will feel tired, lethargic, dizzy and weak. In extreme cases, you could risk fainting or go into a shock, which is considered a medical emergency.

🌿 Thus, combining beta-blockers and CBD oil could result in a higher amount of beta-blockers’ active ingredient present and unmetabolized your body for a longer period and an increase in the likelihood that you’d experience the side effects.

Also, if you are taking two compounds, you have to adjust the dosage and find the right balance for both the beta-blockers and CBD oil.


CBD Interaction with Antibiotics

CBD is among the things that are known to interact with antibiotics. CBD works with our endocannabinoid system to improve the production of natural cannabinoids.

Due to this, it is natural to assume that CBD may interact with antibiotics as well as other medications in some way.

CBD has been shown to inhibit the Cytochrome P-450 system,which can alter the way the system metabolizes certain drugs. In the case of combining antibiotics and CBD, you are at risk of taking less or more than required which could be dangerous as it could lead to an overdose.

While it’s true that CBD can have a potentially negative impact in the case of antibiotics, it is also true that the compound can have a range of positive interactions with other medications, which has led to many patients requiring a lower dosage.

Many patients have been able to reduce their prescription meds or even stop taking them altogether after taking CBD.


CBD Interaction with Blood Pressure

There is a wide range of pharmaceuticals prescribed for lowering blood pressure. If you are taking one of the more common medications for hypertension like valsartan, metoprolol beta-blocker, lisinopril, amlodipine besylate, or hydrochlorothiazide you should consider the potential risks.

One study shows that a single dose of CBD reduces resting blood pressure and the blood pressure response to stress, particularly cold stress, especially in the post-test periods. This may reflect the anxiolytic and analgesic effects of CBD as well as the potential direct cardiovascular effects.

Considering the use of CBD as a medicinal product, this should be considered for people taking CBD. However, further research is required to establish whether CBD has any role in the treatment of cardiovascular disorders such as hypertension.

CBD oil is a natural method of reducing blood pressure and controlling hypertension. If you take this for blood pressure, make sure to monitor your blood pressure. You can also supplement it with other lifestyle changes to avoid harmful effects.


CBD Interaction with Alcohol

CBD and alcohol may amplify each other’s effects. When taking both together in high doses, it may cause sleepiness and sedation.

However, several animal and human studies show that CBD protects against alcohol-induced cell damage and reduces blood alcohol concentration and addiction.

Alcohol is known for its ability to reduce inhibitions and promote feelings of relaxation. CBD has the same effects on your body. When taken together, they amplify each other’s effects which may result in changes in mood and behavior.

Seventy-two people showed that 25-75 mg of CBD daily for just one month reduced anxiety  and improved sleep quality.

Also, according to Healthline, CBD protects you from alcohol’s side effects may reduce some of the alcohol’s side effects. It can also protect you from alcohol’s side effects.

Here are some of the things CBD can do when taken with alcohol.

• Prevents cell damage and disease
• Reduces blood alcohol levels
• Therapeutic for alcohol addiction

🌿 However, one should still take these two with caution because there is a study showing that combining alcohol and CBD can cause significant impairments in motor performance and alterations in the perception of time.

So, if you are driving or operating a machine, it’s best if you do not take CBD and alcohol together.


Conclusion

Overall, CBD oil is safe to ingest. However, you have to take it with caution when you combine this with your other medications because it might result in some adverse effects. CBD can either increase or decrease the effectiveness of a drug depending on the interaction.

It is highly recommended that you consult with your doctor if you are considering CBD as alternative medicine or an addition to your current medication for your safety. Also, by doing this you will be properly guided on the dosage and the other important factors that you have to consider especially if there are contraindications.

 

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