CBD and drug interactions
Cannabidiol (CBD) is a non-hazardous, non-toxic and non-psychoactive substance that is extracted from hemp plants, also known as cannabis. As CBD use is often driven by the desire to get rid of certain symptoms (pain, inflammation, stress, acne, neurological disorders, etc.), individuals are often taking medication at the same time. But is combining CBD with your medication dangerous? This is the question we’re going to answer: find out everything you need to know about CBD and drug interactions.
Cannabidiol poses no risk to the human body
If many countries such as France legalise cannabidiol (with less than 0.2% THC), it is because many scientific studies agree that CBD poses no danger to the human body. This natural compound is not addictive: on the contrary, this plant extract is known to have therapeutic benefits. Therefore, it can be considered a natural remedy. The World Health Organization (WHO), which serves as a reference in the field, states that CBD is not harmful to health. It is not classified as a controlled substance (as drugs are). The only risks are a potential overdose, which constitutes taking more than 20,000 mg per day. However, this is a very difficult amount to reach for the average individual!
CBD and drug interactions: what are the risks?
The risks are low...
For most individuals and medications, the risk of serious interactions with cannabidiol is limited. The only issues associated with CBD and drug interactions stem from drug metabolism with enzymes found in the liver, including cytochrome P450. It also depends on the dosage of CBD consumed and the drug, as these two factors play an important role. In fact, when the same substance is mixed with CBD it can have different effects depending on the dosage. However, please bear in mind, that the risks are very low and you can consume CBD with the vast majority of medications. In addition, most studies on the subject concern doses of CBD in medical contexts (around 200 to 300 mg per day), a dosage much higher than average CBD consumption for individuals on a daily basis (between 20 to 60 mg per day).
... but there are interactions with certain drugs
A study conducted by the Penn State College of Medicine in Hershey has identified a list of 57 compounds that may be affected by CBD and THC. Interactions are considered "dangerous" for the following drugs included in the list:
● warfarin-based anticoagulants;
● antiarrhythmic drugs such as "amiodarone";
● thyroid hormones such as Levothyroxine;
● Clonazepam/Clobazam-based anticonvulsants.
If you are currently undergoing treatment with any of these medications, you should consult a healthcare professional before taking any form of CBD.
CYP450 enzymes
Drug metabolism in the liver
When we ingest a substance, our body takes metabolises it, or in other words, breaks it down. Drug metabolism occurs throughout the body, but it is your liver that does most of the work with a family of enzymes: cytochromes P450 (CYP450). This family converts exogenous substances so that they can eliminated from the body more easily. This is where drug interactions with CBD come into play: it is a substance that can slow down or speed up the metabolisation of drugs by affecting CYP450. This change in metabolic rate can alter the way your body processes your medication.
CBD and the CYP450 enzyme
The CYP450 family of enzymes is responsible for the metabolism of cannabinoids, including CBD. It interferes with CYP3A4, an important and active enzyme in the CYP450 family. CYP3A4 processes about half of the drugs metabolised by your body. As CBD inhibits CYP3A4, it is no longer able to function as effectively to break down medication. The reverse is also true: if the medication you are taking inhibits CYP3A4, then your body will not be able to process CBD as effectively. This can pose a risk to your health because if your body does not metabolise your medication quickly enough, you may end up with too much medication in your body leading to unwanted side effects.
The impact of CBD on other drug treatments
To give you a complete overview of CBD with and without drug interaction, here are the conclusions from existing studies on the subject:
- CBD with antidepressants, anxiolytics and sleeping pills: low and limited risk of interaction. As a precaution, take CBD 2 to 3 hours apart from these types of drugs so as not to disrupt their breakdown and metabolism.
- CBD with anticonvulsants: combining anti-epileptic drugs with CBD remains mostly safe (except for medication containing Clonazepam/Clobazam).
- CBD with thyroid hormones: there are potentially serious side effects associated with the use of CBD in combination with the drug Levothyroxine. Choose methods of administration that do not put strain on the liver and so that you may enjoy the benefits of CBD (e-liquids, patches, creams, etc.).
- CBD with corticosteroids, steroidal anti-inflammatory drugs: taking corticosteroids in combination with CBD could exacerbate the side effects as the CYP3A4 enzyme may be inhibited.
- CBD with antihistamines: there is a potential drug interaction between CBD and "Humex". Check the ingredients of your allergy or flu medication before taking cannabidiol, and spread out the doses of CBD.
- CBD with anticoagulants: in theory, it is dangerous for someone to consume CBD when they are taking anticoagulants as the blood dilution level would no longer be controlled, however, there are no studies to prove this. Speak to your doctor beforehand.
- CBD with opiate-based painkillers: there are no contraindications, it simply recommended that you adjust the dosage of opiates to prevent central nervous system depression.
- CBD with beta-blockers: there are no contraindications, but it is likely that the beta-blocker dosage will need to be adjusted.
- CBD with antihyperglycemic agents: check your blood sugar levels regularly if you are taking CBD at the same time, and take care.
Our tips for taking CBD with medicines
To ensure you take all precautions, whether you are concerned about a potential drug interaction with CBD or not, here are some tips:
- Always spread out doses of CBD and your medication by a few hours in order to give your liver enough time to do its job properly with each administration;
- Always speak to your doctor to determine the appropriate dose of CBD in relation to your medication;
- Choose quality products, for example, products approved by the French government which comply with very strict production and distribution protocol.
CBD and drug interactions: are there alternatives?
CBD products are available for both internal and external use: if you can’t or don’t want to take CBD at the same time as your medication, you can still enjoy the benefits of cannabidiol thanks to CBD cosmetics! These treatments are formulated as oils and creams for topical application to the body or face. After penetrating the skin, cannabidiol kicks in within 1 to 2 hours and provides effective and long-lasting relaxation. Apply a CBD cream before going to bed at night to allow you to sleep better, alleviate the stress of the day with a CBD oil massage, and take advantage of the antioxidant properties of these treatments to achieve beautiful skin as an added bonus! This ensures that you don’t take any risks.
CBD and drug interactions: myth or reality?
As you will probably have already realised, drugs and CBD can be combined without causing any harmful effects to the body (unlike alcohol, which should never be consumed with medication). Regarding potential drug interactions with CBD, the problem is one of overloading the liver: ingesting both substances at the same time may prevent the proper metabolisation of one of them. As mentioned above, however, bear in mind that studies are based on a dose of 200 mg - 400 mg CBD per day, which you will never reach by taking just a few drops of CBD oil per day!
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Comments
Atarax sommeil
Maya January 26th 2023Bonjour,
Prenant de l'atarax 25 pour dormir (un cachet le soir), et afin d'éviter les interactions entre atarax et cbd, peut on alterner la prise, soit un soir atarax seul et la nuit suivante un cbd seul?
Miranda E January 26th 2023
Huile de cbd
Sam August 13th 2022Je suis sous levothyrox car ablation totale de la thyroïde, je prends 15 à 20 gouttes par jour depuis 5 mois l'après-midi et le soir et je vais très bien ça soulagé mes douleurs et m'aide à dormir
Interaction cbd et médicaments.
Nicole Daumas. June 2nd 2022J'ai été tres intéressée par l'article que je viens de lire . Je suis sous Levothyrox et Aspirine protect.....Je me suis fracturée le col du fémur et j'ai toujours une petite douleur ,donc je prends cbd 20 pour cent ,et cela me fait du bien , je vais quand même en parler avec mon médecin .
J'ai des médicaments
Jérôme Rey June 2nd 2022Lecture rassurante et intéressante. À faire connaître aux médecins.