CBD oil is often presented as a potential alternative for treating various health conditions, particularly those that may be related to anxiety, depression, and chronic pain. The hemp plant, especially hemp seeds, contains a large amount of nutrients that are known to be essential for human health, making it a superfood.
Yet, there is a long list of factors that people should take into consideration before adding cannabidiol to their diet. One of the most important is the potential for interactions between CBD and prescription drugs. CBD affects both your brain and your body, which can alter the way many medications work.
Below, we’ll take a closer look at what drugs should not be taken with CBD and why it is important to be careful when mixing certain drugs with CBD oil. Read on to learn more.
Word of Caution
You should never take CBD or any other hemp derivatives without consulting your healthcare provider first. Although the side effects of CBD taken in isolation are relatively mild, taking it with other medications can result in more severe and unexpected side effects.
Before mixing any drugs with cannabidiol, it’s important to speak with your doctor and see if they have any recommendations for you. They will help you avoid unwanted drug interactions and avoidable consequences.
Understanding Drug Metabolism
Before we dive into the list of drugs that should not be taken with CBD, it’s important to note that this is by no means an exhaustive list. The two main points of interaction for CBD are the liver and brain, so any medication that has an effect on these areas of the body is likely to be affected by CBD as well.
More precisely, it is known that CBD can interact with medications that are metabolized by the CYP450 enzyme found in the liver or those that act on CB1 receptors in the endocannabinoid system in the brain.
CYP450 and CBD
Cytochrome P450 (CYP450) refers to a system of liver enzymes in your liver that is responsible for metabolizing certain medications as well as detoxifying and excreting foreign substances in your body. It is estimated that these enzymes are involved in the metabolism of about 60% of all drugs on the market today.
CBD is a known inhibitor of CYP450, meaning that it binds to the areas of the liver responsible for metabolizing multiple medications and prevents CYP450 from inhibiting them in the intended way. Instead, depending on the amount of CBD and other internal factors, cannabidiol can either increase or decrease the effects of many prescription drugs.
It should be noted that CBD is not the only substance that can affect liver function. Grapefruit, for instance, also inhibits CYP450 – hence why there are grapefruit warnings on thyroid medication and other drugs.
Needless to say, this results in a wide range of potential interactions that range from minor to potentially life-threatening. Compromised liver function can also lead to other severe health problems.
Endocannabinoid System and CBD
The endocannabinoid system is a complex system of receptors and enzymes found throughout the body that play a role in many different physiological processes, including pain perception, appetite, mood, and memory.
CBD interacts with this system by preventing CB1 and CB2 receptors from breaking, allowing for better communication between the body and brain. This is why CBD shows much promise in the treatment of conditions like anxiety.
However, this exact mechanism of action can also result in interactions with other medications that target the endocannabinoid system or those that act on the same receptors as CBD.
What Medications Should Not Be Taken With CBD?
It is safe to say that any prescription medication that has the grapefruit warning on the label should not be taken with CBD. But the list of potential interactions goes well beyond that. The most common drug interactions with CBD include:
- Antidepressants – prescription medications such as Prozac (fluoxetine), Zoloft (sertraline), and Paxil (paroxetine) are typically dosed based on both your mental and physical condition and taking CBD alongside them can result in an increase in the breakdown speed of the antidepressants.
- Heart medications – there is a wide variety of heart medications that are known to interact with CBD, including blood thinners such as Eliquis (apixaban), calcium channel blockers such as Norvasc (amlodipine), and beta blockers such as Toprol (metoprolol). Although not every single one of them will interact with CBD, the benefit of taking cannabidiol may not be worth the risk.
- Painkillers – while a few studies showed that CBD has some painkilling properties, taking it with pain relief medications such as ibuprofen or naproxen can reduce their efficacy. This is primarily due to the way in which CBD works on the brain receptors.
- Thyroid medications – medications such as Synthroid (levothyroxine) specifically target CYP450 enzymes in the liver. CBD can inhibit their metabolism, resulting in hyperthyroidism which may lead to an increased heart rate, anxiety, and weight loss.
- Antibiotics – it is a broad category, with various medications aiming to kill different types of bacteria. Due to that, there isn’t one answer to whether CBD interacts with antibiotics or not. Some studies report that CBD use can actually increase the efficacy of certain antibiotics and support bactericidal action, but it is still best to avoid taking cannabidiol alongside them.
- ADHD medications – it should be mentioned that CBD may limit the absorption of some prescription medicaments while at the same time providing similar benefits. A few studies have shown that although CBD inhibits the absorption of ADHD medications such as Adderall (amphetamine), it can still provide some of the benefits of the drug, such as increased focus and concentration. Furthermore, medical cannabis is currently being studied as a potential treatment for ADHD.
- Over-the-counter medications – not every drug needs to be prescribed by a doctor. Some, like aforementioned painkillers, cold and flu medications, and sleeping pills are available over the counter. However, they rarely are tested for potential CBD-drug interactions with cannabis, so it is always best to consult with a healthcare professional anyway before taking them.
All in all, you should never experiment with taking CBD alongside other drugs on your own. Always consult with your healthcare provider and make sure the medications you’re taking won’t interact with CBD oil in a negative way.
Why Contact a Medical Professional
In view of the above, it is evident that taking cannabidiol with other medications, especially those that have a grapefruit warning on the label, can result in unwanted side effects and potentially dangerous consequences.
Therefore, it is important to consult with your healthcare provider before taking CBD oil or any other hemp derivatives. They will be able to properly assess your health condition and make sure that cannabidiol is safe for you to take.
On top of that, your healthcare provider will be able to accurately determine the right dosage of CBD oil for you to take, provided it will be allowed in your regimen, and inform you about any alternatives that may be available.
Frequently Asked Questions
When Should CBD Be Avoided?
CBD-only products are generally considered to be safe, with their non-intoxicating effects and lack of severe side effects, leaving drug interactions aside.
However, this doesn’t mean it’s completely safe for anyone. In fact, there are numerous groups of people who should avoid using CBD products – including medical cannabis – entirely, including:
- pregnant or breastfeeding women,
- children under the age of 18,
- people with liver disease,
- people with a history of substance abuse,
- people with certain medical conditions.
Before using the CBD product of your choice, it’s important to speak with wellness professionals and make sure it’s right for you.
What Should You Not Mix CBD With?
Apart from prescription and non-prescription medications, there are other things you should avoid mixing with CBD products. These include:
- Alcohol – needless to say, alcohol – a strong depressant – should not be mixed with CBD, as it can greatly increase the risk of adverse effects.
- Caffeine – CBD can already increase wakefulness and energy levels, so adding caffeine to the mix can result in unwanted side effects like anxiety and jitters.
- Nicotine – CBD can increase the effects of nicotine, which can be dangerous for people who are trying to quit smoking.
- Illegal drugs – CBD can potentially increase the effects of other substances, possibly putting you at risk of overdose.
Can I Take CBD and Drink Alcohol?
As mentioned above, mixing alcohol with CBD is not much different from any other drug interaction. While some people report that the two substances can actually cancel each other out, it’s not worth taking the risk.
There’s also the fact that CBD can increase blood alcohol levels, which can lead to intoxication even at lower doses. So, if you do decide to drink alcohol while taking CBD products or using medical marijuana, make sure you do so in moderation.
Can You Mix CBD With Other Medications?
In view of the article above, it is strongly advised not to mix CBD with other medications, especially those that are metabolized by the liver or those that act on the same brain receptors as CBD. This can lead to serious side effects, including liver damage and impaired cognition.
If you are taking any medications, it’s best to speak with your healthcare provider before using CBD or stop using it altogether.
Does CBD Affect Your Heart?
CBD does not interact with your heart directly. That is, its typical effects do not put you at risk of a heart attack or other cardiovascular problems. However, it can interact with your blood pressure medicine, which can lead to hypotension (low blood pressure).
Similarly, it may spike blood pressure if taken with other stimulants like caffeine. So, if you are taking any blood pressure medication, make sure to speak with your doctor before taking CBD.
Can CBD Unclog Arteries?
There is ongoing research on the effect of CBD on various heart-related diseases. A preliminary study showed that CBD could improve vasorelaxation, yet no concrete evidence regarding supporting artery health has been found, and more research is needed.
Is CBD Good for High Cholesterol?
It should be noted, however, that CBD can actually support healthy cholesterol levels. A study published in 2020 found that CBD was able to affect cholesterol metabolism, meaning it could help to keep cholesterol levels in check.
On top of that, the hemp plant itself contains a variety of nutrients that are essential for maintaining a healthy heart, including omega-3 fatty acids, magnesium, and fiber.
Does CBD Help With Arthritis?
As reported by Harvard Medical School, there is no evidence that CBD can help with arthritis – which seems to contradict what many people say about the oil. This is most probably caused by a little stretch and oversimplification.
While CBD may not be able to help with arthritis directly, it can help with the pain that comes as a result of this condition. This is because CBD shows promise in the treatment of various pains, often also associated with arthritis.
Is CBD Oil Safe for Seniors?
CBD is considered safe for seniors, provided that they do not have any underlying medical conditions that could be exacerbated by its use. However, it should be mentioned that seniors may be more sensitive to the effects of CBD, so it’s important to start with a lower dose than what’s typically recommended.
Is CBD Linked to Dementia?
Unfortunately, while CBD shows promise in the treatment of various conditions, there is no evidence that it can help with dementia. But, it can support the treatment of some of the symptoms often associated with this condition, such as agitation, pain, and nausea.
Why Do Doctors Not Prescribe CBD Oil?
There are a few reasons why doctors do not prescribe CBD, even though it’s legal in most states. First and foremost, there is a lack of scientific evidence to support its use for most medical conditions.
Secondly, CBD can interact with other drugs, but it is not always clear how or why this happens, which makes it difficult to assess potential drug interactions.
Finally, CBD is not regulated by the FDA in the same way as other medications. This means that its quality and safety can vary greatly from one product to another, and, more importantly, the legal status of prescription cannabinoid medications is unclear. Physicians, for instance, cannot prescribe CBD products to their patients.