CBD has many great benefits for the human body and research to date shows that it is generally safe and has very few side effects. However, beware that CBD can have adverse interactions with certain medications and if you are taking any medications, it is advisable to first consult a doctor about the suitability of combining them with CBD. The interactions here are related to how the body metabolizes certain substances.
Drug metabolism and CBD
The drugs you take are always metabolised by your body in some way, this process takes place throughout the body, especially in the intestines and liver. The largest influence on drug metabolism is a large group of haemoprotein enzymes known as cytochrome P450 (or CYP450);
They have a significant effect on the transformation of foreign substances so that they can be easily eliminated from the body. However, some drugs and substances affect these enzymes so that drugs can be metabolized faster or slower. This change in the rate of metabolism changes the way your body processes the medication, so it is a drug-drug interaction;
According to research, the CYP450 family of enzymes is responsible for the metabolism of several cannabinoids, including CBD. Specifically, the CYP3A4 enzyme, which belongs to the CYP450 family, is responsible for CBD interfering with it during metabolism. The CYP3A4 enzyme is responsible for metabolizing roughly 60% of drugs, and if CBD inhibits this enzyme, it cannot function as efficiently to break down other drugs that have entered the body. It can also be the other way around, a number of drugs inhibit the enzyme and it cannot process CBD effectively. If the body metabolizes the drug too slowly, you can then have multiple drugs in your body at once, even if you are taking the correct doses. The increased levels of medication can then have various unwanted and harmful effects. Some substances can also speed up the work of enzymes and if your body metabolises medicines too quickly, you may have a deficiency of them in your body, which can also cause health problems;
How to safely use CBD while taking medication?
If you want to use CBD as a complementary therapy to relieve the symptoms of a particular condition, it is advisable to consult your doctor first, as he or she can determine a schedule and dosage that is safe for you. Your doctor may sometimes want to monitor the level of medication in your plasma. Do not stop taking your medication to try CBD unless your doctor tells you it is safe. Be aware that there are also CBD products that do not enter the bloodstream, so you don’t have to just take the products that are consumed, but use creams and ointments instead, for example;
Possible drug interactions
Beware of grapefruit and related citrus fruits. Research on CBD interactions with drugs is ongoing, so there is not yet a complete list of drugs with which interactions could occur. However, grapefruit has been shown to interact, so you should avoid it and all products that contain it, including juices. CBD and grapefruit have some similar properties, so you should avoid all medicines and products with grapefruit. Taking grapefruit can lead to higher blood levels of the drug and side effects, including overdose. More than 85 drugs react with grapefruit and similar citrus fruits such as Seville oranges, pomelos, etc. Chemicals in grapefruit known as furanocoumarins inhibit the CYP3A4 enzyme similar to CBD. As a result, the metabolism of drugs is slowed down, so taking CBD can lead to higher concentrations of the drugs in the body. If you see a warning on a medication against consuming grapefruit, it is not advisable to take it with CBD either;
Below we mention some drugs that may pose a potential danger when consuming grapefruit:
- antibiotics and antimicrobials
- anti-cancer drugs
- antihistamines
- antiepileptic drugs (AEDs)
- blood pressure medication
- blood thinners
- cholesterol medication
- corticosteroids
- drugs for erectile dysfunction
- medicines for nausea
- heart rhythm medication
- imunosuppressive
- Mood medicines, for example to treat anxiety, depression or mood disorders;
- painkillers
- drugs for prostate
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Research on interactions between CBD and drugs
Research on drug-CBD interactions is a work in progress and there is not enough research for all drugs yet. For example, in a study where 25 children with intractable epilepsy took clobazam and CBD, 13 of them showed higher levels of clobazam. Taking CBD and clobazam shouldn’t be downright dangerous, but it’s better to monitor drug levels. Another study looked at the effect of antiepileptic drugs such as clobazam and desmethylclobazam, with some people having levels outside the normal range. CBD can also disrupt the levels of medication in your system even when taking prescribed doses. But so far, there is a lack of research to determine which drugs are safe and which ones to watch out for.
You can take CBD and medication as long as you are under the supervision of a doctor who approves it. If necessary, your doctor should monitor your plasma medication levels and liver function. If you are taking CBD as well as certain medications, you should be especially careful of side effects such as drowsiness, nausea, fatigue, diarrhea, appetite, weight change, fatigue, or seizures;
