Does CBD Interact with Other Medications?

Pill pack Does CBD interact with other medications

Major questions when it comes to CBD include: how will it effect my body? And will CBD interact with other medications I’m taking?

The good news is, the side effects of consuming CBD are generally mild. And, not all people who take CBD experience them. CBD’s reported side effects include:

  • Drowsiness
  • Upset stomach when large amounts of CBD are consumed
  • Diarrhea
  • Changes in appetite or weight loss

Again, these side effects don’t always occur, and are usually mild. And for many people who report that CBD has relieved them of chronic pain, anxiety, or trouble sleeping, the benefits of taking CBD far outweigh the occasional mild side effects.

Prescription medications, on the other hand, can often have multiple, major side effects. You can suffer through the side effects or are prescribed another medication to offset them. This is one reason a product like CBD holds such appeal. If it can relieve symptoms with minimal side effects, why not try it?

But, while CBD may have minimal side effects on its own, if you are taking certain other medications there can be cause for concern.

While it’s always best to speak with your doctor before adding a supplement like CBD to your routine, here’s what we know so far about CBD’s interactions with other medications.

Metabolization, CBD, and the P-450 Enzyme System

Everything that we consume is metabolized by the liver. This includes both CBD and prescription medications. And CBD interacts with enzymes in the liver in a potentially problematic way.

The cytochrome P-450 enzyme system, which is concentrated in the liver, is responsible for breaking down many of the substances that enter our bodies. It separates them into simpler materials that are easier for the body to process. In fact, P-450 enzymes process close to 90% of the medications we consume.

This makes P-450’s role critical to the proper processing of many of the most common medications. If you’ve even been warned to avoid grapefruit when taking certain medications, it’s due to the way that certain compounds in grapefruit interfere with the functioning of P-450. Similarly, when a large amount of CBD is consumed, it can cause the P-450 enzymes to temporarily stop working.

Cut grapefruit on a pink dish
Grapefruit can inhibit processing by the liver in the same way as CBD.

When this system is offline, it can alter the effectiveness of medications that are consumed. They are not being processed and released into the body at the rate and level they were prescribed for. This can mean that too much of the medication remains in your system at one time.

As mentioned, grapefruit juice interacts with the P-450 enzymes in the same way as CBD. More medications have been studied for their interactions with grapefruit juice than with CBD. To get a sense of what drugs may interact with CBD, you can look at a list of drugs affected by grapefruit.

Common Medications Affected by CBD

Open bottle of pills

It’s often hard for doctors to determine the effects CBD might have on a patient taking certain medications, because CBD servings vary. Below are some common types of medication that CBD has been found to interact with:

Blood Thinners

A study published in 2017 found that CBD affected the processing of Warfarin, a commonly prescribed blood thinner. Essentially, CBD can prolong the effects of Warfarin in the body, requiring a decreased dose of Warfarin to be administered.

Sedatives

Medications like Benzodiazepines, which are commonly prescribed for patients diagnosed with anxiety disorders, can also interact with CBD. Since both are reported to produce calming, sedative effects, combined they can cause increased sedation, at levels that may be unsafe. And, if someone is taking a product that contains THC, that compound can also increase anxiety symptoms, inversely affecting the effectiveness of the prescribed sedatives.

Antidepressants & Mood Stabilizers

While limited studies show that CBD can improve symptoms of depression and bipolar disorder, there is a risk that any medications prescribed for these conditions may not work properly when combined with CBD.

Antiseizure Medications

CBD has shown significant promise in limiting seizures. The only prescription medication currently approved by the FDA, Epidiolex, is used to reduce seizures in patients with severe forms of epilepsy. However, a small study at Massachusetts General Hospital found that CBD can interact with other anti-seizure medications. The P-450 process is again at play here. Children in the study were taking both CBD and clobazam, an anti-convulsant. CBD was found to increase the blood concentrations of the clobazam, requiring a reduced dosage to be prescribed to the majority of the patients in the study.

Chemotherapy Drugs

CBD is popular as a pain reliever, and initial studies show it may be effective at slowing tumor growth. However, chemotherapy treatments rely on precise dosages of the drugs to be administered. While it appears that CBD can be taken in conjunction with these drugs, it’s critical to let doctors know what you are taken, so they can adjust the level of the chemotherapy drugs accordingly.

One tip if you’re looking to take CBD but have medication concerns: try vaping. The vaping process brings CBD directly to the lungs, where it enters capillaries and passes into the arteries. In this case, the CBD doesn’t need to pass through the liver, so it won’t interact with the P-450 enzymes. Because of this, vaping is also considered the fastest way for CBD to enter our systems and begin working.

Though CBD research is increasing, formal study results are still limited. We may be in for some surprising discoveries regarding CBD to be released in the coming years, including the ways it can support or inhibit other medications and supplements. If you have any concerns about taking CBD or how it may affect conditions you have or medications you are taking, it’s important to discuss them with your doctor before you try CBD in any form.

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