CBD and Medications: Understanding the Risks

Products containing cannabidiol (CBD) are increasingly popular, promising relief from insomnia, hot flashes, chronic pain, and seizures. While some claims are supported by research, others are simply hype. However, trying CBD isn’t without risks. CBD is a biologically active compound, which means it can have unintended consequences, including interactions with supplements, herbal products, over-the-counter (OTC) medications, and prescription drugs.

The Nature of CBD: More Than Just a Harmless Supplement

Cannabidiol, or CBD, is a biologically active compound derived from the cannabis plant. Unlike its cousin THC, CBD doesn’t produce a “high,” but it does interact with the body in significant ways. While generally considered safe, CBD can cause side effects and interact with various medications, supplements, and herbal products.

CBD and Drug Interactions: A Complex Relationship

When taken alongside other medications, CBD can potentially alter their effects or increase the risk of side effects. Here’s what you need to know:

1. Amplifying Side Effects

CBD may intensify the effects of drugs that cause drowsiness. This includes:

• Opioids
• Benzodiazepines (e.g., Xanax, Ativan)
• Antipsychotics
• Antidepressants
• Antihistamines (e.g., Benadryl)
• Alcohol

Combining CBD with these substances could increase the risk of sedation, fatigue, and potentially lead to accidents¹.

2. Altering Drug Metabolism

CBD can interfere with enzymes in the liver responsible for breaking down many medications. This interference can lead to:

• Too much of a drug remaining in the system, increasing the risk of side effects
• Not enough of a drug in the system, potentially reducing its effectiveness

A study from Penn State College of Medicine identified 57 medications that could be dangerously affected by cannabinoids like CBD. Some notable examples include²:

• Warfarin (a blood thinner)
• Amiodarone (for heart rhythm)
• Levothyroxine (thyroid medication)
• Several anti-seizure medications (clobazam, lamotrigine, valproate)

The Importance of Drug Formulation

The way CBD is consumed can affect its interaction with other drugs:

1. Inhaled CBD: Enters the bloodstream quickly, potentially increasing the risk of acute side effects and interactions.
2. Edible CBD: Takes longer to absorb but may eventually reach levels that could interact with medications.
3. Topical CBD: Generally less likely to cause systemic interactions, but research in this area is limited³.

It’s important to note that CBD products are not regulated for purity, concentration, or safety, adding another layer of complexity to potential interactions.

Navigating CBD Use Safely

If you’re considering using CBD, especially alongside other medications, keep these points in mind:

1. Consult Your Healthcare Provider: Always inform your doctor or pharmacist about your CBD use, particularly if you have underlying health conditions or take other medications.
2. Be Especially Cautious If You:
   • Take multiple medications
   • Are an older adult
   • Have liver or kidney disease
   • Have epilepsy
   • Have heart issues
   • Have a weakened immune system
   • Are on medications that affect the immune system
3. Start Low and Go Slow: If approved by your healthcare provider, start with a low dose of CBD and gradually increase as needed while monitoring for side effects.
4. Choose Quality Products: Look for CBD products that have been third-party tested and come with a Certificate of Analysis (COA).
5. Be Aware of Potential Interactions: Pay attention to any changes in how you feel or how your medications seem to be working after starting CBD.

The Bottom Line: Caution and Communication are Key

While CBD shows promise for various health conditions, it’s not without risks. The potential for drug interactions means that CBD should be approached with caution, especially when combined with other medications or supplements.

Remember, natural doesn’t always mean safe. CBD is a potent compound that can significantly impact your body’s systems. Open communication with healthcare providers is essential to ensure that CBD use is safe and effective for your individual health situation.

As research on CBD continues to evolve, staying informed about the latest findings will help you make the best decisions for your health. Always prioritize safety and consult with healthcare professionals before incorporating CBD into your wellness routine, especially if you’re taking other medications.