If you take these medications, you should NOT use CBD
It is very important to realize that CBD does interact with some medications. You should always talk to a medical professional if you are currently on medication.
The way your body metabolizes CBD can interfere with how you normally metabolize other drugs you take. If those other drugs aren’t metabolized properly, they can stay in your system longer than you want. This can cause some negative side effects or possible complications.
One type of drug you should pay special attention to are blood thinners. Warfarin is an example. Taking CBD with warfarin can make the warfarin hang out in your system for too long without it being metabolized.
This doesn’t mean that CBD drug interactions are always bad. They can actually be a beneficial thing, if properly monitored. CBD can make other drugs more effective — so much so that you may be able to reduce the dosage of those other drugs, leading to fewer negative side effects from the pharmaceutical medication.
What causes the conflict with other medications?
The conflict is the result of a family of liver enzymes (Cytochrome P450) being inhibited by CBD and other phytocannabinoids. This important enzyme group metabolizes most of the pharmaceuticals we consume, including more than 60 percent of available medications.
Role of Cytochrome P450
CBD — at sufficient dosages — will temporarily deactivate Cytochrome P450 enzymes. Research shows that CBD can displace its chemical competitors which prevents Cytochrome P450 from metabolizing other compounds.
Low doses of Cannabidiol will have no noticeable effect on Cytochrome P450 activity. However, there is no clearly established dose, below which CBD won’t interact with other drugs.
CBD products can either decrease or increase the breakdown of other pharmaceuticals. It truly depends on the medication in question and the dosage of Cannabidiol used. Rather than eliminating the option of using CBD products for health concerns, you could talk with your doctor about adjusting the current dosage of your other medications so that you can use both products safely.
Interestingly, CBD oil is not alone in its effect on drug metabolism. Grapefruit, watercress, goldenseal, and St. John’s Wort all have a similar inhibiting action on Cytochrome P450.
If you are wary of talking to your doctor about Cannabidiol, you may be able to use the “grapefruit test” to determine if you can consume CBD.
Have you ever been told not to take your medication with grapefruit? This is because compounds in grapefruits can interfere with the metabolism of many medications.
CBD does the same thing. But as I said above, the effect is even stronger with CBD.
Do the grapefruit test with your doctor or pharmacist. Ask them: “Should I avoid eating grapefruit or drinking grapefruit juice with this medication?”
They will know exactly what you are talking about. If they say that you should avoid grapefruit with your medication, you now know you need to be careful about mixing CBD with those same medications as well. Talk to your doctor about CBD, and ask if they can adjust your medication to allow you to use CBD.
CBD and Caffeine
Caffeine is probably the world’s most commonly consumed “psychoactive drug.” Most people ingest at least a little bit here and there.
Since CBD oil is gaining popularity, many people want to know if they can consume both at the same time.
As it turns out, the two substances go together nicely!
For the sake of this manual, it is sufficient to say that both CBD and caffeine block adenosine (which is a compound produced in our bodies). Blocking adenosine results in vasodilation, which increases clarity and alertness.
However, CBD also reduces anxiety — due to its effects on other neurotransmitter systems — so the combination of CBD with caffeine can increase alertness and clarity while decreasing the jitters that can accompany caffeine.
It is worth noting that these effects depend on the dosage of CBD. High amounts of CBD tend to make you feel sleepy and sedated.
Caffeine is also metabolized by a Cytochrome P450 enzyme. Since Cannabidiol inhibits this enzyme system, caffeine will secrete more slowly. This can result in the stimulating effect being more prolonged and drawn out. This means it is not wise to take this combination close to bedtime!
CBD and Alcohol
There is some research that describes how CBD and alcohol interact, but for the sake of this manual, here is an overview of the benefits and effects of the interaction:
- Combining CBD and alcohol can result in significantly lower blood alcohol levels.
- CBD reduces the likelihood of alcohol relapse.
- CBD protects the liver from damage caused by binge-drinking alcohol.
- CBD prevents against neurodegeneration caused by alcohol consumption.
- CBD reduces the degree of liver steatosis, metabolic dysregulation, inflammation and neutrophil-mediated injury caused by consuming alcohol.
- Cannabinoids can affect nearly all enzymes responsible for metabolizing alcohol.
- Because CBD is a CB1 receptor antagonist, CBD can decrease the desire for alcohol.
- CBD inhibits the Cytochrome P450 enzyme system which plays a significant role in alcohol metabolism.
CBD vs Opioids
The DEA has declared that the country is in the midst of an opioid addiction crisis. In the United States, forty-four people die every day from prescription opioid overdose. If you include heroin in the equation, the number increases to 78 deaths every day.
Prescription opioid abuse and addiction is actually a substantially larger problem than heroin addiction in America. In 2014, for example, nineteen thousand people died from an opioid overdose and around eleven thousand died from a heroin overdose. In addition, many heroin users begin their addiction with prescription opioids. Nearly 7,000 people in the United States are treated in emergency rooms every day due to a misuse of a prescription opioid. In fact, one out of three prescriptions for opioids gets abused.
America consumes 80 percent of the world’s opioids while representing only 5 percent of the world’s population. Some countries even have trouble getting opioids for important medical needs like post-surgery and end-of-life treatment.
Based on research results from 2014, it is ironic to note that there is insufficient evidence to show that using opioids for an extended period is effective for improving chronic pain. In addition, the researchers did find an increased risk of serious harm associated with long-term opioid use. The risks include overdose, fractures, heart attacks, and sexual dysfunction.
In contrast, the American Academy of Neurology reported in the same year that an oral cannabis extract can be used to treat chronic neuropathic pain in multiple sclerosis with extremely good results. It has been shown through many research studies that cannabis oil extract can effectively treat chronic pain.
One other worthwhile point to note is that using cannabis in combination with a prescription medication for pain can decrease the amount of prescription medication needed, thereby making it safer for the patient. Obviously, you should consult with a medical professional if this is a route you want to take.