4 things you should know about combining CBD & medication

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Cannabidiol (CBD), especially in the form of CBD oil, is regarded by many as an (almost) miracle substance. It has shown very promising effects in a wide range of health conditions, but it should also be consumed with due diligence and care, like every other medicinal substance.

CBD can exert its effects on the human body because it’s a natural chemical that can interact with our own endocannabinoid system, but it can also interact with other important mechanisms, such as the pathways that allow for drug metabolization within the human body. For this reason, CBD can indeed change the way some substances interact with our organs and tissues, and that fact must be taken into account by everyone that uses or is considering using CBD oil or other CBD-containing substances.

Next, we present a list of the most important things you should know when taking CBD with other medication.

#1: CBD can change the way substances are used within the body

Many of the toxins, medications, and drugs that enter the human body are transformed by a specific family of proteins called cytochrome P450. These proteins (also known as enzymes) exist in the liver, kidneys, skin, lungs, gastrointestinal tract, and are capable of changing the structure of drugs, toxins, and medications, and allow them to be used (metabolized) by our bodies, therefore producing their effects in our health or being eliminated whenever needed.

You probably read somewhere that CBD can interfere with cytochrome P450 enzymes, and that is correct. But what does it mean, in practical terms?

It means that CBD can temporarily inhibit or slow down the activity of cytochrome P450 enzymes, thus changing the way certain drugs are metabolized within the body. This can have important effects on the body because it can slow down the effects of certain drugs and keep them longer within in blood and tissues since the body won’t be able to eliminate them properly and in a timely manner.

#2: Some medications’ effects are altered by CBD, others aren’t

Depending on the type of drugs, if they are metabolized by cytochrome P450 enzymes, and what their effects are, CBD can affect their actions.

Roughly speaking, what CBD does is slow down the transformation of the drugs, and therefore increasing the amount of time they spend in our bodies. With this increase, comes a series of consequences:

  • Medications can become more active;
  • Side effects may be increased;
  • The substances remain in the system for longer periods of time.

Based on this, there are a few interactions that everyone needs to know about.

According to a report released by the District of Columbia Department of Health, CBD may increase the blood concentration (and, most likely, also the effects and side effects) of the following list of medications and substances:

  • Macrolides;
  • Calcium channel blockers;
  • Benzodiazepines;
  • Anti-seizure medications (such as clobazam and norclobazam);
  • Cyclosporine;
  • Sildenafil (and other PDE5 inhibitors);
  • Antihistamines;
  • Haloperidol;
  • Antiretrovirals;
  • Some types of statins (atorvastatin and simvastatin);
  • SSRIs;
  • Tricyclic antidepressants;
  • Antipsychotics;
  • Beta-blockers;
  • Some opioids (for example, codeine and oxycodone);
  • Blood-thinners (warfarin, coumadin).

So, if you’re currently taking any of these substances, it’s advisable to take extra care when using CBD.

Since not many studies have yet been performed on this topic, the effects of CBD combined with many types of medication are still unknown or poorly understood. Therefore, we advise caution when taking CBD with other medication, and it is also advisable that you consult with a knowledgeable expert before starting CBD.

However, it’s also important to know that these effects do not occur with every single drug: only the substances that are metabolized by cytochrome P450 enzymes (it’s the majority, but not all) incur in these risks. For example, CBD can affect the action of atorvastatin and simvastatin, which are two types of statins, but not of other types of statins, such as pravastatin and rosuvastatin.

#3: Timing matters

Taking CBD and your other medications at different times of the day may be one step to reducing these conflicting effects, according to Yasmin Hurd, Ward-Coleman Chair of Translational Neuroscience and Director of the Addiction Institute at the Icahn School of Medicine at Mount Sinai.

“Spacing out doses helps reduce the workload on the liver”, Hurd states.

#4: CBD is not necessarily dangerous

Seeing that CBD can interfere with your medication may scare you a bit, but you know what else can interfere with it? Grapefruit juice.

This doesn’t make CBD a dangerous substance, it merely means that everyone should be aware of its effects and take the necessary precautions when consuming CBD products. And that happens with all medicinal substances, either natural or synthetic.

CBD is thought to be a helpful aid in many different conditions, and it can be used safely, as long as it’s in the appropriate dosage and all interactions with medications are closely monitored. Consult with an expert if you’re feeling uneasy, so that they may advise you in the best course of action for your particular case.

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