What Drugs Should Not Be Taken with CBD
In recent years, global interest in the hemp plant and its possible applications has increased, partly due to the potential health benefits of one of its primary cannabinoid: Cannabidiol or CBD. Research done on CBD isolate suggests that it may be an effective treatment for a range of conditions and ailments, including chronic pain, inflammation, anxiety, epilepsy, and depression, among others.
Although this research is still in its relative infancy, studies have shown CBD to be safe to use and consume regularly and in high doses – and the only side-effects are minimal and mild, such as nausea and drowsiness.
However, like every compound, CBD has the ability to interact with other substances to produce stronger adverse side-effects – and it can even pose serious risk when mixed with certain prescription drugs. Although it’s always best to consult a medical professional before starting a course of any new supplements or drugs, this article will explain the basics of when CBD should not be consumed.
It’s Down to the Cytochrome P450
The cytochrome P450, also known as CYP450, is a group of liver enzymes that are involved in the metabolizing process of more than 60% of drugs and toxins inside the body. Medical professionals use the CYP450 to determine the appropriate dosages of medications, which are based on the metabolizing times within the body.
Calculations are made using the average amount of time it takes for a medication to be processed by the CYP450. They provide accurate information regarding dosage, but only if one medication is being consumed and the CYP450 system is healthy and functioning optimally.
However, certain substances can interact with the CYP450 system and affect the metabolizing process, making it either slower or faster. This can have adverse – and sometimes serious – effects on the body.
CBD and the CYP450 system
By inhibiting the CYP450 system – specifically, CYP3A4 and CYP2D6 enzymes – CBD can temporarily deactivate its activity, thereby altering the way in which other compounds are metabolized by the liver. This may have the effect of delaying the metabolizing process of certain medications that also use the CYP450 system, causing them to stay in your system longer – and sometimes causing their effects to be stronger and longer-lasting.
Drugs that are known to use the CYP450 system include, but are not limited to:
- Steroids
- HMG CoA reductase inhibitors
- Calcium channel blockers
- Antihistamines
- Prokinetics
- HIV antivirals
- Immune modulators
- Benzodiazepines
- Antiarryhthmics
- Antibiotics
- Anesthetics
- Antipsychotics
- Antidepressants
- Anti-epileptics
- Beta-blockers
- PPIs
- NSAIDs
- Angiotensin II blockers
- Oral hypoglycemic agents
- Sulfonylureas
Caution should therefore be exercised when considering CBD as a supplement or treatment if you are already taking any of these medications. Although much more research is required in this area in order to gain a fully comprehensive understanding, we’ve outlined the evidence we currently have below.
CBD and Sedatives
CBD is often used as a treatment for insomnia due to its sedative effects that occur as a result of interaction with the endocannabinoid system’s CB receptors located throughout the central nervous system. Therefore, when combined with sedative medication, CBD can increase the overall effect – which can be an unpleasant and unwanted experience for the consumer.
CBD and Drugs that Increase the Risk of Bleeding
One study by the NCBI evidenced that CBD can increase the effects of medication used specifically for thinning the blood (for example, warfarin) or drugs with a risk of blood-thinning (for example, ibuprofen).
This is because CBD increases the durability of the medication, thereby prolonging the metabolizing process and, therefore, its presence in the body. This can increase and prolong the effects of the medication and, in turn, increase the overall risk of bleeding.
CBD and Anti-Seizure Medication
CBD’s potential use in the treatment of epilepsy is currently perhaps the most researched aspect of the cannabinoid. While it has proven to be extremely effective in relatively high doses, in some circumstances, it can sometimes cause adverse effects when a small dose is taken in conjunction with certain anti-seizure medication.
A study way back in 1992 found that a low dosage of CBD will not deliver anti-seizure benefits, but it will still inhibit the CPY450 system. This resulted in prolonged concentrations of clobazam (an anti-epileptic drug) and norclobazam (the metabolite of clobazam) in the body, which can actually cause more aggressive seizures.
Therefore, it’s extremely important that a medical professional determines the correct dosage of CBD when used for its anti-seizure properties in conjunction with other medication.
The Grapefruit Trick
Just like CBD, grapefruit interacts with the CPY450 system by inhibiting certain enzymes. Unlike CBD, however, grapefruit is commonly listed on medication packaging as something to avoid consuming.
Therefore, any medication that should not be consumed with grapefruit should also not be consumed with CBD.
Always Consult a Medical Professional
As previously mentioned, research into CBD and its interaction with certain types of medication is relatively limited, so these findings are by no means conclusive. The quality, purity, and type of CBD can potentially have an effect on its interaction with any substance, so it’s always highly recommended to consult a certified medical professional before consuming CBD alongside any medication – whether it’s prescribed or not.