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CBD Drug Interactions: How CBD Interacts With Medications

CBD drug interactions are an important thing to be aware of if you are thinking about introducing CBD into your health regimen. People use CBD as part of an arsenal to fight against ongoing pain and inflammation, as well as anxiety.

There's no disputing that CBD, also known as cannabidiol, has been the hottest health trend in recent years and isn't showing any signs of slowing down. CBD was (and is) found in everything from edibles and tinctures to bath and beauty items. 

You may be asking if you can take CBD and certain medications together. CBD is regarded as a natural, holistic, and safe method to handle many health conditions. However, it is regarded as quite a powerful health supplement. It could be likely that your CBD dose may affect the efficacy of certain medications, including antidepressants.

How is CBD broken down in your body?

The same wide family of liver enzymes known as CYP450 breaks down a large number of medicines, including CBD. Some enzymes in this family are inhibited by CBD. This causes patients to break down certain pharmaceuticals more slowly, increasing the risk of side effects unless your doctor lowers the amount. CBD, on the other hand, can activate other enzymes in this family, speeding up the breakdown of some medications, making them potentially less effective unless the dose is raised.

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Examples of what medications combined with CBD can have negative effects?

  • Some antidepressants (such as fluoxetine, or Prozac)
  • Medications that can make you drowsy (antipsychotics, benzodiazepines)
  • Antibiotics containing macrolides (erythromycin, clarithromycin)
  • Medication for the heart (some calcium channel blockers)

Experts say a lot of questions remain concerning how CBD interacts with the body's drug-metabolising enzymes. We know that CBD affects some drug-metabolising enzymes, but not others. So much information and monitoring still needs to be done, there are a lot of unknowns about how CBD interacts with different medications and on different people.

Should I be taking CBD along with antidepressants?

So, what can happen if you combine CBD oil with antidepressants? Unfortunately, there are only a few studies from which to draw. CBD may have speculative medication interactions; the question is whether or not these interactions are clinically significant. The mechanism that metabolises a lot of serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, and antipsychotics is likewise inhibited by CBD. Taking CBD supplements while taking these psychiatric drugs could potentially interfere with how they are metabolised.

The majority of people on antidepressants or other psychiatric meds aren't concerned about this. Certainly, because CBD inhibits two different enzyme systems. If someone is on a very precisely balanced medicinal regimen, CBD might throw things out of whack, however. In terms of clinical practice, there hasn’t been much evidence of patients experiencing clinical decompensation as a result of including CBD into their regimen.

What exactly do we know about CBD's interactions with other medications?

Studies on Epidiolex, the only FDA-approved CBD medicine, which is intended to treat uncommon kinds of epilepsy, provide the most direct information. Epidiolex has been observed to cause a 30% increase in blood levels of the blood thinner warfarin, increasing the risk of bleeding. It can also interfere with other epilepsy drugs.

Is it possible for CBD to interfere with the drugs I'm taking for arthritis?

Given what we currently know about how CBD is metabolised, experts don’t expect substantial drug-drug interactions with typical arthritis medications like methotrexate or most nonsteroidal anti-inflammatory treatments (NSAIDs). However, caution with one NSAID, diclofenac, should be encouraged. Rheumatologists are also continually on the lookout for liver issues that might be caused by arthritis drugs, such as CBD, NSAIDs, and methotrexate.

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Are elderly persons more susceptible to CBD medication interactions?

Yes, for a variety of reasons. As we become older, our livers and kidneys may have a harder time removing medications from our bodies. Furthermore, elderly patients and those with chronic health conditions are more likely to take many drugs, which raises the danger of drug interactions. Side effects or interactions that cause dizziness and raise the risk of falls in the elderly are something to watch out for. Combining the antidepressant fluoxetine with cannabis products, for example, can cause dizziness and sleepiness.

cbd medicine interactions

Should some people avoid CBD?

If you have known liver impairment, you should take caution. The amount of CBD used to prevent mice from seizures was found to cause liver damage in a study published earlier this year. Other animal research suggests that CBD may raise liver enzyme levels, raising concerns about liver toxicity in methotrexate patients.

If people using Epidiolex for epilepsy also take valproic acid to control seizures, they are more likely to have abnormal liver enzymes, as well as tiredness and other symptoms. This is crucial for people with arthritis to know, since valproic acid is sometimes used for pain that isn't controlled by other medications.

Do CBD creams reduce the danger of drug interactions?

Because very little, if any, of a topical product is likely to be absorbed into your system, this is most likely the case. “Unfortunately, we don't have good data on how much of a topical CBD product is absorbed,” says the author. “The inactive chemicals in the product, where it's placed on the body, and whether you wear a bandage over the area after applying it can all influence this,” explains Dr. Bemben.

While topical CBD products may not be absorbed deeply enough to cause drug interactions, they may not be as beneficial for arthritic pain. A topical would be appropriate if you only have one joint that hurts, and it's close to the surface, it's less likely to treat a hip or other deep joint.

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What type of doctors need to know  I'm experimenting with CBD?

Tell your rheumatologist and anybody else who treats you with medicine, even a pharmacist. If you need surgery and are using CBD, your anaesthesiologist may pick a different dose or kind of anaesthesia.

Can I see if certain drugs might interact with CBD using an online resource?

Online databases can assist health practitioners in evaluating potential drug-drug interactions. Freely available materials are less credible, therefore it's critical to discuss all of your drugs, including CBD, with your doctor and pharmacist.

Patients can use drugs.com to look for cannabidiol (which will give you the FDA-approved oral medicine Epidiolex) or cannabis (which will give you both THC and CBD) and see if there are any potential conflicts with other medications they're taking.

Can there be life-threatening CBD medication interaction?

No significant drug-drug interactions have been reported with over-the-counter CBD medications. However, because these items are new, it can take some time for reports to be published. Experts still can’t say for certain how much over-the-counter CBD medicines and how they mix with other medications.

In Summary

When it comes down to it, the possible interactions between CBD and many prescription drugs are more theoretical than real. It's also true to note that CBD has a very low risk of negative effects.

Of course, it's always a good idea to talk to your doctor about potential interactions and to tell him or her about any prescription or over-the-counter medications or supplements you're taking. At the end of the day, whether or not to use CBD supplements while taking antidepressants is a personal decision, but it's critical to be well-informed.

You may also like to read: Will Consuming Cannabidiol Make You Fail Drug Tests?

Josephine Gibney

Josephine Gibney is a freelance writer from Waterford. She has worked as a lifestyle reporter, a creative copywriter and a communications specialist over the last ten years. Her short fiction was longlisted for the 2020 Sean O’Faolain Prize and she is currently working on her first novel.

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