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What Drugs Should Not Be Taken With CBD?

July 04, 2019 6 min read

What Drugs Should Not Be Taken With CBD?

CBD, or cannabidiol, is a chemical compound just like any other substance on our beautiful planet. Just like any other compound, it has the potential to interact with other compounds, such as medications that metabolize in the same part of the body. There are a whopping 98 identified drug interactions just for caffeine, some of which stop the other drug from working completely. Even grapefruit can’t be eaten if you’re on certain prescription medications – which means it’s no surprise that CBD and some drugs just shouldn’t mix. 

Fortunately, unlike caffeine and grapefruit, most of the potential interactions with CBD and other drugs have been identified as harmless or mild. In some cases, other drugs and CBD can work in combination with each other favorably instead of having adverse side effects. We always recommend speaking with a certified health professional or physician prior to taking CBD oil or adding it into your daily routine, especially if you are currently on or plan on taking prescription medications. Today, though, we’re going to cover some of the drugs that have been shown to interact with CBD in some way to look at which drugs should not be taken with CBD.


How CBD Might Interact with Other Drugs

We see a range of ways for how CBD interacts with other drugs, medications, and chemical compounds. Cannabidiol may potentially reduce the metabolism of other drugs that compete for the same enzyme as itdoes. Metabolized by the cytochrome enzymes CYP2C19 and CYP3A4 in the body, this can raise the blood levels of other medications that metabolize the same way, which would require your doctor to do a downward adjustment on your doses. It can inhibit CYP2D6, the enzyme targeted by risperidone and omeprazole medications. Likewise, it could reduce the metabolization of diclofenac and warfarin by inhibiting the hepatic enzyme, CYP2C9. 

It was found to increase the bioavailability of Hexobarbital, a barbiturate derivative with sedative and hypnotic effects that’s often sold in both sodium salt and acid forms like Tobinal, Evipan, and Citopan. While cannabis may increase the potency or effectiveness of other drugs, close monitoring by your physician or a medical professional is important. Your dosage may need to be adjusted even if the drug interact is beneficial, so make sure you’re staying honest with your doctor if you’re interested in using CBD.

The CYP450 Enzyme

CBD interacts with more than one cytochrome enzyme, including one located primarily in the liver and brain that’s involved in helping the body process about 60% of the pharmaceuticals on the market right now.

In short, cannabidiol has the potential to interact with a lot of medications just from this enzyme alone. 

In fact, here are some of the drugs that have been shown to use the CYP450 enzyme system in our bodies:

·       Sulfonylureas

·       Oral hypoglycemic agents

·       Steroids

·       Antihistamines

·       Antidepressants

·       Anti-epileptics

·       PPIs

·       Calcium channel blockers

·       Prokinetics

·       HIV antivirals

·       Benzodiazepines

·       Antibiotics

·       Antipsychotics

·       And more

By interacting or saturating this enzyme system, CBD could potentially prevent other drugs from accessing the same enzyme. This causes those medications to build up in the bloodstream instead, which simply makes the drug more potentHowever, it could also prevent medication from having a timely effect or releasing into the bloodstream when it’s expected to. On the bright side, just using CBD oil or another CBD product doesn’t mean that your CYP450 enzyme system is affected. Those results came from observing consistently high doses of CBD. 


The lower dosages that come in a CBD oil tincture bottle will likely not cause the same extreme effects. We still need more research before we can find the exact dose of CBD required to make any significant difference for a drug interaction. As a rule of thumb, it’s safe to assume that the risk of drug interaction increases the more CBD you take in a daily sitting.

Serum Concentration Increase

CBD may cause an increase the amount of medication in your blood, otherwise known as serum concentrations, according to the District of Columbia’s Department of HealthJust like grapefruit, this means it may interact with beta blockers, calcium channel blockers, antiretrovirals, antihistamines, and antidepressants. Allergy pills, blood pressure medication, and even cholesterol drugs may absorb differently due to CBD blocking the liver enzyme it’s trying to metabolize through. 

Again, this is only found in very high doses of CBD, some of which are stronger than an entire standard bottle of a CBD oil tincture. Low amounts of CBD such as standard serving sizes throughout the day don’t appear to affect how your body is processing other medicine (though a doctor’s second opinion is always recommended).

Timing Might be Everything

While you need to discuss with your physician the schedule for taking your drugs, some research suggests that the timing of when you take other medications and CBD might play a huge role in CBD’s interaction with those drugs. The goal is to reduce the workload of the liver. Medication that metabolizes in the liver enzymes are already causing the liver to perform its bodily function. However, all drugs have a half-life, and it doesn’t stay in your liver once it has been metabolized. You just have to wait long enough for the enzymes in your liver to regain a sufficient level of their function before using CBD oil. Drug interactions between CBD and other liver enzyme metabolizing medications may diminish after waiting a couple hours between taking your prescription medication and taking the cannabidiol. Your chances of a drug interaction could be lower by trying CBD throughout different times of the day.

Everyone processes CBD and other drugs differently, so you may experience different interactions than others or have little to no reaction even when you take medication in combination with cannabidiol. Heavily influenced by our body size, age, genetics, and sensitivity to chemical compounds, the effect medication will have and how our bodies will process it can vary greatly. This is just one of the reasons you want to speak with a certified health professional if you’re taking other medication to make sure it doesn’t interfere with a daily serving or more of cannabidiol.

The CBD Product You Choose Matters

There are a tremendous variety of CBD products available now – from CBD oil tinctures, to soft chews, to topicals, we see new products released every day for the industry. The way you decide to use CBD will contribute greatly to how it interacts with any medication you’re on. How much cannabidiol gets into the bloodstream varies from method to method.

For example, applying a topical CBD cream to a target area on the body, or maybe over a muscle spasm, means that the cannabidiol is only interacting with the CB receptors on the skin. The amount of CBD absorbed into the bloodstream topically is likely negligible, making it one of the safest options if you want to use CBD but don’t want it to interact with a more important prescription medication you’re taking. You can also ingest the cannabidiol directly through a CBD oil tincture, soft chew, or other edible product. 

This reduces how much and how fast the CBD hits the bloodstream, taking the long route through the gastrointestinal system before heading to the liver to reach those important liver enzymes we keep talking about. Using this method to consume your CBD, you still lessen some of the CBD that’s absorbed into the enzymes in the liver. CBD oil sublingually is the second-best way to get the most effective dose possible. Swishing it around in your mouth, through your teeth, and substantially under your tongue will allow it to hit the highest surface count of capillaries. This is a direct route to your bloodstream, so you can expect the effects to hit the fastest and most effectively, lasting around the same amount of time as an edible might. While this is one of the best ways to get the most out of a CBD oil bottle, it also runs the chance of causing the CBD to interact most severely with any other medication.

The most direct route, an IV is the only way to get the CBD anymore directly into your bloodstream. However, you can also vape or smoke the product; some CBD oil formulas can even be used for both vaping and sublingual doses.

Be Smart

Don’t mix substances without receiving medical advice from a doctor first. We love seeing how many people have found the effectiveness of CBD daily, but your health is the most important factor. We use CBD to promote general wellness, so we want to be upfront about anything that substance might interact with. 

Whether you’re taking your prescribed medications or you’re new to cannabidiol, speak with a certified health professional before you take your first serving. Alternatively, you can also check out our lab reports to feel more confident about the lack of contaminants and pollutants and accuracy of the cannabinoid content level we report. You can also check out the FAQ section for any other CBD related answers you are looking for. 

In the meantime, we hope this answers any questions you had about how cannabidiol metabolizes in the body, how CBD interacts with other medications or prescription drugs, and, ultimately, which drugs should not be taken with CBD.


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