Cannabidiol (CBD) is one of the fastest-selling products to come along in years. It seems like everyone you know is using it to help with one medical condition or another. Many swear by its effectiveness to help with anxiety, inflammation, pain, and many other physical and mental issues. For many that have not tried CBD yet, they want to know if it’s safe to use if you are on other medications?
CBD is still being studied by many researchers. We know many positive things about CBD, but we also know it has some undesirable effects too. It is thought by some researchers to be safe to use CBD while taking some medications. However, the consequences of using CBD with so many other medicines are still not clear. There are some scientists and doctors that believe CBD does interfere with some prescription medications.
What Is CBD?
CBD is a cannabinoid that can be found in the cousin plants marijuana and hemp.
Growing hemp and CBD products derived from hemp is legal nationwide as long as the THC content does not exceed 0.3%. The legality of hemp CBD nationwide was made federal law with the 2018 Farm Bill. The Food and Drug Administration (FDA) regulates CBD products. The Department of Agriculture (DOA) regulates hemp growing.
Even though hemp was removed from the Schedule I Controlled Substance list in the US, its cousin marijuana remains on the list. Marijuana can cause intoxication. However, so far, 11 states have chosen to legalize marijuana for recreational and medical purposes. CBD derived from marijuana is legal in those US states. Over 30 other states have medical marijuana programs that allow marijuana and CBD from marijuana to be obtained at state dispensaries as long as you have been approved for the program.
Can CBD Have Side Effects?
CBD products are thought to be safe to use, according to most researchers. However, it can cause side-effects in some people. CBD is usually well tolerated but could cause things like dry mouth, diarrhea, drowsiness, fatigue, and loss of appetite, according to the Mayo Clinic.
Some side-effects of using CBD were discovered during research of CBD and seizures in some rare forms of epilepsy. To date, the FDA has only approved one CBD-based drug called Epidiolex because it was proven effective in reducing or eliminating some seizures. The research revealed that one downside of CBD could be side effects when taken with other medications.
Can CBD Interfere With Drug Effectiveness?
Only a small number of people report any harsh side effects from using CBD. However, some studies do show it can have unintended interactions with some prescription medications, over-the-counter medicines, and herbal products.
One concern of using CBD while taking other medications or supplements is that it could cause the medicines to not work correctly. Some drugs are broken down by enzymes in the liver. It is thought by some researchers that CBD may interfere with or compete with these enzymes. This could cause too much or not enough of the drug in the body. This is referred to as altered concentration. If altered concentration occurs, it might lead to medications not working correctly or lead to worse problems.
What Medicines Could CBD Interfere With?
When it comes to using other herbs and supplements while taking CBD, excessive sleepiness may occur. CBD has been shown to cause drowsiness, so taking it with other herbs and supplements that also cause drowsiness is not recommended. You may want to avoid using catnip, California poppy, kava, Jamaican dogwood, L-tryptophan, melatonin, sage, St. John’s wort, skullcap, and others.
You can likely eliminate using other herbs and supplements while using CBD products, but avoiding prescription and necessary over-the-counter medications might not be possible. In fact, some medication you already take may be vital to your health and well-being.
Warfarin is a drug used to prevent dangerous blood clots in those that have already had them or people that may be susceptible to them. Using cannabinoids like THC and CBD could increase the risk of bleeding in people that take Warfarin. Warfarin is known to have a low theraputic window. Even minor changes to the anticoagulant’s effect may cause bleeding or thrombosis. This is because CBD and THC can inhibit metabolic activity of an enzyme known as CYP2C9.
Theophylline is a bronchodilator drug. It is used to treat lung condition symptoms caused by asthma, bronchitis, and lung diseases like emphysema. Marijuana smoking could hasten the metabolic clearance of theophylline. Using marijuana in other forms besides smoking may not. It has been shown that tobacco smoking can cause a similar effect. However, it’s not clear whether it’s marijuana specifically that causes a metabolic clearance or smoking in general. So, this connection to CBD use is still questionable for now.
A drug prescribed to treat some epileptic seizures is valproate. It may also be used to treat manic episodes of bipolar disorder and migraine headaches. If you take valproate and CBD together, it could raise liver enzymes that could cause liver damage. One clinical trial showed 21% of epileptic patients taking valproate with the CBD-based drug Epidiolex, displayed an elevated level of transaminase. This was more than 3 times what is normal. Epidiolex is the first CBD-based drug approved by the FDA to help with seizures associated with Lennox-Gastaut syndrome and Dravet syndrome.
Clobazam, a benzodiazepine, is also used to treat seizures caused by Lennox-Gastaut syndrome in adults and children. Since Epidiolex is derived from CBD, it can increase the effects and side-effects of clobazam when used together. CBD is a potent CYP2C19 inhibitor. When it is used with clobazam, the interaction between the two adds to clobazam’s efficacy. One problem with using the two drugs together is their sedation effects. Both clobazam and CBD have them. Clinicians may be advised to lower the clobazam dosage when used along with CBD.
Tacrolimus is an immunosuppressive medication. It is given to patients with organ transplants like heart, kidney, or liver. CBD can interfere with the metabolism of tacrolimus according to research conducted by Dr. Alloway. Dr. Alloway is a specialist in post-transplant immunosuppression. Preventing rejection of transplanted organs is a top priority and the medication given to patients to stop it is an absolute necessity.
Even though alcohol is not a prescription drug, it is still considered a drug and causes intoxication. Researchers have discovered that alcohol can increase THC levels right after smoking. Even CBD derived from hemp contains small amounts of THC. The effect does appear to diminish soon afterward.
These are just some of the medications that can be affected by using CBD at the same time. The only way to know if it’s safe to use CBD products while taking other medications is to consult with your doctor before you begin using CBD. You should never stop taking a prescribed medication just so you can use CBD without consulting your doctor first.
Most doctors today have at least some knowledge of CBD. Getting a recommendation for using CBD from your doctor is more reliable than conducting your own research. This is especially true if the medication is something that may be helping to keep you alive. Blood pressure medication, pain medications and many others may not work as they should when combined with CBD. Although CBD has been shown to help with come medical and mental conditions, there is still plenty of research to be concluded.