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Does CBD Interact with Other Medications?

Green Shoppers Written by Green Shoppers
Updated on April 18, 2019

There is a huge number of people in the United Kingdom now taking CBD to help with their general health. The reported health benefits far outweigh any side effects, of which there are very few. According to reports from reputable bodies including the World Health Organisation, CBD has very few side effects. Those that are experienced include a dry mouth, headaches, and drowsiness; most of these disappear after the first few uses.

CBD is able to interact with the endocannabinoid system (ECS), which is a system responsible for maintaining balance in the body. The ECS has an enormous responsibility to help keep us healthy. Its intricate connection with other biological systems means that the ECS has a vast influence.

When CBD is consumed, it indirectly encourages the ECS to work even better, keeping the body in optimal condition.

However, if you suffer from a particular ailment, you are probably already taking medication. CBD is a food supplement, not a medicine, and as a result it is not advisable to stop taking your medication at any point. As a result, you might be wondering whether it is safe to take CBD alongside your medicine and whether you will experience any negative effects.

That’s what we will be talking about in this post. But first, it’s necessary to understand a little bit about drug metabolism.

Liver Enzymes and Drug Metabolism

Whenever a new drug is released onto the market, doctors must calculate the appropriate dosage. To do this, they need to figure out how the drug is broken down by the body and how it is used.

Drugs are usually broken down in exactly the same way, in the liver. An enzyme called cytochrome P450 (CYP450) is responsible for metabolizing the drugs you consume. There are perhaps 50 enzymes that help to break down drugs, but CYP450 is by far the most important.

The body produces CYP450 in sufficient quantities for the body to function and metabolise the necessary substances. However, other substances can actually inhibit its production and prevent drugs from being broken down.

CBD and CYP450

You may have heard that CBD interacts with drugs, and you may also have heard that CBD is metabolised in the liver. These two assumptions are related. CBD is broken down in the liver when it is consumed orally, too, and so the CBD you consume will end up in the same place as the medications you take.

But CBD also inhibits the CYP450 enzyme. By doing this, it prevents drugs from being metabolized, leading to higher levels of the drug in your system. This may be dangerous, because the calculated dosage for you is no longer the amount you are taking. It could lead to unwanted side effects, or something even more severe.

There are a number of drugs that CBD interacts with, the most common of which are listed below. If in doubt, always consult a doctor.

CBD and Insulin

It has been reported that cannabis users have lower rates of obesity and diabetes than non-users. There is evidence to suggest that cannabis (and the CBD within it) may decrease insulin resistance and improve blood sugar control, which is the same thing that insulin injections do for those with diabetes.

Unfortunately, no direct studies have been done on CBD’s effect on blood sugar medication. But because we know that both could help to manage blood sugar levels, it’s possible that the two could work together well. That being said, your glucose levels could lower too much, so it’s important to keep an eye on them.

CBD and Blood Pressure Drugs

Many people are on drugs that alter their blood in some shape or form. Those with chronically high blood pressure may be taking medication to lower it. However, one of the reported side effects of CBD is also lowered blood pressure. The drop experienced after taking CBD is short-lived, but it is worth nothing.

If you need blood pressure medications, then make sure to keep an eye on your blood pressure if you decide to take CBD.

Warfarin and heparin are used for blood thinning and in conjunction lowering blood pressure. Be aware that THC may displace warfarin from protein binding sites – this is relevant if you are using combined CBD and THC products (which is illegal, by the way!).

CBD and Opioids

Medical marijuana has recently been proposed as a safer alternative to opioid medications. However, it is not legal to medicate using cannabis as of yet, and so CBD oils are the best we can get. Nevertheless, CBD topicals and oils have been recommended to use for pain, as CBD is able to reduce inflammation.

If you are suffering from severe and chronic pain, then trying CBD could be a safer alternative, as there are no side effects. With many patients prescribed opioids dying from addiction and overdose, CBD is clearly the better choice.

The only study we know of was conducted with regard to whole plant cannabis. Dr. Donald Abrams from San Francisco published a study from 2011 in which vaporized cannabis was tested in conjunction with opioids. There was no significant change in opioid blood concentrations after exposure to cannabis, but patients did report a 27% decrease in pain.

From this study, it looks as though taking CBD in conjunction with opioids could be safe and even beneficial. Nonetheless, you should remain alert and be very cautious if attempting to do so.

CBD and Sedatives

Recently, we wrote an article on whether CBD could help you to sleep. Many people use CBD oil as a sleep aid, or even apply CBD topicals with added lavender terpenes in order to help them drift off. So, we know that CBD can act as a sedative, but what about combining it with pharmaceuticals?

The additive effect of pharmaceuticals might cause an issue, as it might be a bit risky. While it is definitely worse to combine sedatives with alcohol, you might be best avoiding this combination altogether and just taking one or the other.

CBD and the Contraceptive Pill

If you are on the contraceptive pill, it is important to exercise caution with any cannabis product, including CBD. The interaction between CBD and liver enzymes is particularly negative for those using oestrogen-based pills, as they are more likely to be impacted by inhibited liver enzymes.

Furthermore, adding cigarettes, alcohol, or St. John’s Wort to your CBD and contraceptive pills will decrease their effectiveness even further.

As a result, if you are on the contraceptive pill, then be careful about using CBD. At the very least, take one in the morning and one in the evening. Better yet, use another form of contraception as well, such as condoms.

CBD and Alcohol

While alcohol is not medication, it’s worth talking about the interaction between it and CBD. Many of us drink alcohol on a regular basis, and that is why it’s important to understand how it may interact with CBD.

The available research is really up for debate. The jury is still out, and a lot of studies are quite biased. The fact that CBD beer exists suggests that combining the two is safe. But since CBD acts on a very individual basis, you should exercise caution at first and ensure that you are safe.

Last Word on CBD and Medications

CBD is known to be well-tolerated and have beneficial effects for a number of people. As a result, those who are ill might want to try CBD as an alternative medicine that has fewer side effects; but it could have negative interactions with your medication.

As a result, it is always best to consult your doctor. You cannot be punished for wanting to try CBD, and your health always come first. If your doctor adamantly advises against it, then it is best to take their word.