Does CBD interact with medications?

February 18, 2020
CBD
by cbdexqui_admin

There are some things in life you are unlikely to mix, like forks and power outlets or water and a computer keyboard. When it comes to food supplements and drugs, people usually do not care about their interaction. However, food, beverages and food supplements intake may alter a drug’s effect for the better or worse.

In this article, we will consider CBD benefits and CBD safety regarding other medications.

Why is CBD so popular?

Cannabidiol (CBD) is one of the most well-studied chemical compounds in the hemp plant. It has gained its popularity for its potential to alleviate a wide range of symptoms from anxiety and stress to chronic pain and neurological disorders. Studies confirm its therapeutic benefits and generally safe profile. CBD may interact with the receptors of the endocannabinoid systems, which is responsible for the homeostasis of the body and keeping the major physiological processes, such as appetite, sleep and immune functions.

Even though CBD is believed to be safe, it may cause minor side effects:

tiredness
diarrhoea
increased appetite or appetite loss
changes in weight

For a better experience, CBD comes in different forms, including CBD oils and tinctures, CBD topicals, capsules, and vapes. There might be even more unusual products such as CBD-infused chocolate and gummies, coffee and sweet drinks. Users may choose the most appropriate product and CBD dosage for their health condition.

What are drug interactions?

Remember the time when you swallowed a couple of different pills at the same time? Well, being combined, they might alter the medication’s effect on your body. That is not always the case, but the combination of prescription medications, over-the-counter medicines, herbs, vitamins, and supplements may increase or decrease their potency or cause undesirable side effects.

For example, a combination of diuretics, drugs that help the body to rid of excess water and salt, and some anti-inflammatory drugs may lower diuretic’s effectiveness.

So it is important that the doctor knows all of the prescription and non-prescription drugs, herbs, supplements, and vitamins an individual is using.

How may CBD interact with medications?

Cannabidiol has the potential to change the way the body metabolizes specific substances.

CBD may influence Cytochrome P450 enzymes, also known as CYP450, which are involved in metabolizing most of the pharmaceuticals and internal substances, such as toxins from cells. CYPs are spread mainly in the liver, but can also be found in the lungs and intestines.

Cannabinoids can inhibit or stimulate a CYP enzyme, altering the way the body processes metabolized drugs. This is a complex process, which differs depending on the drug. If cannabinoids, including CBD, inhibit a CYP enzyme, the metabolism of another medicament may slow down or be delayed. If the body metabolizes a medication too slowly, the concentration of medicines in the system may increase even with regular dosage. This may increase the medication’s effects and lead to unwanted or harmful side effects. On the contrary, if the cannabinoid stimulates a CYP enzyme, it may cut the lifetime of the second drug.

There may be the opposite situation. Some medications may inhibit CYP3A4, an important enzyme within the CYP450 family. So if taking CBD and other medications simultaneously, the body may not process CBD as effectively as needed.

There are more than 300 drugs, known to interact with cannabinoids. According to the Indiana University Department of Medicine, the main drug groups, affecting the CYP450 system include heart medications, antipsychotics, antibiotics, steroids, antidepressants, HIV antivirals, beta-blockers and many others. Check the link for the full list. There are also some medications, known as “prodrugs”. They need to get into the body and get metabolized to become an active drug. If it depends on CYP3A4, then inhibitors may weaken the active drug in the body and lower its therapeutic effect. On the contrary, not every medication may cause such an interaction.

Let’s consider the interaction between CBD and drugs in more detail:

CBD plus sedatives. Sedatives are used to suppress the central nervous system and are often prescribed to patients, suffering from stress, anxiety and loss of sleep. The interaction between sedatives and CBD is unknown, but high levels of cannabinoids may cause an additive effect. Therefore two of them should not be combined.
CBD plus opioids. Opioids contain chemicals that relax the body and can relieve severe pain. The studies suggest that there may be an interaction between the body’s opioids and the endocannabinoid system. However, the effect coming from such an interaction is unknown.
CBD plus anti-seizure medications. Such medicaments have initially been created to treat people with epilepsy. A 2015 study considers CBD benefits in the treatment of refractory epilepsy in patients receiving anticonvulsants. This is since both drugs are metabolized in cytochrome P450, which may enhance the medication’s effects. However, the dose adjustments of medicaments may be necessary.
CBD plus blood thinners. These medications help the blood to flow smoothly through veins and arteries, keeping blood clots from forming or getting more significant. Blood thinners may interact with CBD, that is likely to block the metabolism of these drugs in the liver. It may lead to an increased level of medications in the body and prolong their effect. It can be toxic or cause other problems, such as bleeding.
CBD plus chemotherapy treatment. Accurate dosage of chemotherapy drugs is a must when treating cancer. The faulty dose can make the treatment ineffective or harmful. Adding CBD to the treatment may inhibit the metabolism, resulting in higher drug concentration in the bloodstream. Even though CBD may alleviate cancer-related symptoms, if it is used in chemotherapy, the amount and type of cancer medication must be adjusted.

Why pay attention to Grapefruit warning?

The studies on the interaction between CBD and medications are still ongoing, so there is one rule that can be helpful in the meantime: avoid CBD products if your medicine has a grapefruit warning on the label.

In general, the warning specifies that people should avoid consuming grapefruit, grapefruit juice, and other citrus juices when taking the medication. Furanocoumarins, the chemicals in grapefruit, may disrupt the normal function of CYPs, similarly to CBD. This may lead to a higher level of the medication in the bloodstream, a slowed metabolization of medications, side effects or an overdose.

Such a warning is standard in some types of medications, but not all of them will require the avoidance of citrus fruit. It’s better to check the medication label or take advice from the doctor.

The bottom line

In conclusion, it is essential to mention that before trying CBD, you should talk to your doctor about all of the supplements and medications you are taking and their possible interaction. A medical specialist may help to define a CBD dosage, and the way it can be taken with other medications, for example, at a different time.

Keep in mind that there is a wide range of different CBD products that don’t usually enter the bloodstream. These are mainly topicals that do not interact with medications and may also be an option.