What Drugs Should Not Be Taken with CBD?

Hemp-derived CBD has gained notoriety for its ample range of medicinal uses and no side effects. But, does the lack of significant side effects mean CBD is entirely safe when taken with other medications?

Here’s all you need to know about CBD drug interactions:

The Cytochrome P450 System

To understand how CBD oil may interact with other substances in your system, you must first understand what the cytochrome P450 system is and the role it plays.

The cytochrome P450 system, found within the liver, consists of enzymes that process and eliminate potentially toxic compounds. The P450 enzyme system is responsible for metabolizing over 60% of all pharmaceuticals.

Can CBD Oil Interact with Medications I’m Taking?

Research shows that CBD may interfere with the P450 system’s ability to metabolize other drugs. When you consume CBD, it inhibits the system’s ability to metabolize compounds found in pharmaceutical, drugs meaning drugs can stay in your system longer. This can pose several risks especially if you are taking powerful painkillers like oxycodone and fentanyl.

CBD and CYP3A4 Enzyme

It’s important to note that CBD does not interact with every CYP450 enzyme. Most CBD interactions occur via a specific CYP enzyme called CYP3A4. The way CYP3A4 metabolizes CBD varies significantly from one person to another as a result of variations in our DNA makeup. In addition to CBD, drugs metabolized by CYP3A4 include:

  • Xanax
  • Lipitor
  • Claritin
  • Prednisone
  • Fentanyl
  • Viagra
  • Cialis
  • Ambien
  • Topamax

If you are taking any of these drugs, consult with a doctor before introducing CBD products to your daily regimen.

CBD and CYP2C19 Interactions

Research has shown that CBD inhibits CYP2C19 enzymes in the cytochrome P450 complex. This enzyme is responsible for metabolizing many proton pump inhibitors and antiepileptic drugs such as risperidone, pantoprazole, and clobazam.

Taking high doses of CBD can interfere with the degradation of these drugs leading to their increased bioavailability. This was shown in a two-month long clinical study where patients were treated for epilepsy with clobazam and CBD. The CBD interaction with CYP3A4 and CYP2C19 led to increased clobazam bioavailability. Researchers believe this same phenomenon can occur when taking other drugs that are metabolized by CYP2C19 enzymes. Again, if you are currently taking any medication, you should consult with a doctor first before beginning a CBD regimen.

CBD Oil and Blood Thinners

If you are taking CBD, you should pay particular attention to blood thinner medications like warfarin. Mixing CBD with blood thinners can make the blood thinner stay in your system for too long without being broken down, increasing the risk of potentially harmful side effects.

CBD and Adderall Interaction

Adderall is commonly prescribed for conditions like narcolepsy, attention deficit disorder (ADD) and attention deficit hyperactivity disorder (ADHD). The unregulated use of Adderall is also common among college students, who find Adderall helpful in improving their ability to concentrate and overall productivity. However, Adderall has side effects like fatigue, depression, and anxiety, especially as the impact of the drug begins to wear off.

Due to its calming effects, CBD can reduce the effects of Adderall, creating a more balanced feeling if the effects of the drug are too strong. However, using CBD during the comedown may cause excessive fatigue and feelings of relaxation.

CBD Interactions with Other Drugs

Any drug that is metabolized by the cytochrome p450 system may interact with CBD. These include:

  • Steroids
  • HMG CoA reductase inhibitors
  • Calcium channel blockers
  • Antihistamines
  • Prokinetics
  • HIV antivirals
  • Immune modulators
  • Benzodiazepines
  • Antiarrhythmics
  • Antibiotics
  • Anesthetics
  • Antipsychotics
  • Antidepressants
  • Anti-epileptics
  • Beta-blockers
  • PPIs
  • NSAIDs
  • Angiotensin II blockers
  • Oral hypoglycemic agents
  • Sulfonylureas

How to Dose CBD

One major factor determining how CBD may interact with other medications in your system is the potency of your daily dose. Stronger doses of CBD may stay in your body longer, thus interacting with the cytochrome P450 system for longer, as well. To ensure you are not taking a stronger dose than needed, start your CBD regimen with a relatively small dose and work your up slowly until you achieve the desired results.

Seek Professional Advice

For the most effective and safest CBD consumption practices, use pharmacist formulated CBD from a trusted CBD manufacturer and consult with your physician if you are taking any other medications. Using high-quality CBD with professional guidance will help you make the most of your CBD routine.

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