The Scary Truth Of Drug Interactions With CBD (Cannabidiol)

With Cannabidiol (CBD) popping up everywhere, consumers are increasingly starting to understand the undeniable benefits CBD has to offer. While it’s true that  CBD is a non-toxic substance that’s safe and well tolerated among its users, concerns arise when combining prescription drugs and CBD together (1). 

Within the liver there are a group of enzymes known as the Cytochrome (CYP 450) that are responsible for breaking down drugs and ridding the body of toxins. However, when CBD is ingested, it inhibits the CYP 450 enzymes by increasing or decreasing how other drugs are metabolized and filtered (2). 

CBD interactions with medications

There are three medications that CBD can negatively interact with: 

  • Clobazam – an anti-epileptic drug, used in treating epilepsy.
  • Warfarin –  an anticoagulant (blood thinner) used in treating or preventing blood clots. 
  • Valproate (Valproic Acid) – an anticonvulsant drug used in preventing migraines, and treating various types of seizures and bipolar disorder (manic depression). It’s often used with other seizure medications (3,4,5). 

Studies have proven CBD to be a powerful antiepileptic molecule in reducing seizures in rare forms of epilepsy. However, combining CBD with Clobazam increases sedation more significantly in adults than when CBD is taken alone. This is problematic for the liver and it may even cause more threatening seizures (6). 

Adverse effects are also produced with the combination of CBD and Warfarin. Because CBD inhibits the CYP 450 enzymes, combining CBD with Warfarin actually prevents Warfarin from fully metabolizing, thus causing excessive bleeding (7).  

Combining Clobazam and Warfarin with CBD has shown to create adverse effects on the body, specifically the liver. Perhaps, however, the most damaging combination is Valproate (Valproic acid) and CBD. Valproic acid alone causes detrimental liver injury, but when CBD is added to the mix, it can dramatically increase liver injury (8). 

CBD interactions with other meds

Unfortunately, there’s a lack of evidence surrounding the interactions of CBD with other medications. However, some studies suggest that CBD can either reduce or enhance the potency of certain medications, thus reducing the dosage of certain prescription drugs. Antidepressants and opioids are just two examples of how CBD can positively affect the reduction, dependency, and side effects of these types of prescribed medications. With that said, it’s important to inform your doctor anytime two substances are combined (9,10).  

Doctors will often monitor organ function and blood levels when new substances are added to pre-existing medications. Be sure to consult with your doctor when considering taking CBD. If you feel consulting with your doctor about CBD will be an issue, consider taking CBD several hours before or after your prescribed medications. And try consuming CBD sublingually or through inhalation to avoid CBD from filtering through the liver. Remember to always start slow and with low doses when considering CBD.



Sources:

  1. https://www.who.int/medicines/access/controlled-substances/CannabidiolCriticalReview.pdf
  2. https://www.projectcbd.org/science/cannabis-pharmacology/cbd-drug-interactions-role-cytochrome-p450
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4933812/
  4. https://www.ncbi.nlm.nih.gov/books/NBK470313/
  5. https://medlineplus.gov/druginfo/meds/a682412.html
  6. https://echoconnection.org/new-study-finds-cbd-interacts-antiepileptic-drugs/ 
  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5789126/
  8. https://medlineplus.gov/druginfo/meds/a682412.html
  9. https://www.consciouslifestylemag.com/cbd-health-benefits/
  10. https://www.leafly.com/news/health/cannabis-cannabinoids-drug-interactions


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