CBD can change the way your body processes certain drugs
Cannabidiol (CBD) has potential for relieving symptoms such as insomnia, anxiety, chronic pain, and a number of other health problems.
And while the studies on the effectiveness of CBD are still ongoing, many people are trying it out.
In previous research shows that CBD is generally safe with few, if any, side effects. There is one major caveat, however: CBD can interact with some medications. This has to do with how the body metabolizes certain substances.
Before trying CBD, it is important to speak to your doctor about all of the vitamins, supplements, prescription and over-the-counter drugs that you are taking. Here's why this conversation is important.
Drug metabolism and CYP450 enzymes
Whenever you take a drug or other substance, your body has to metabolize or break it down. The metabolism of drugs takes place throughout the body, for example in the intestines, but the liver also makes a major contribution.
A family of enzymes called cytochrome P450 (CYP450) does the important job of converting foreign substances so that they can be easily eliminated from the body.
However, some drugs or substances affect CYP450 by slowing or speeding up drug metabolism. This change in metabolic rate can change the way your body processes the drugs or supplements you take - creating an interaction with it.
Why is CYP450 important when it comes to CBD and medication?
Research has shown that the CYP450 family of enzymes is responsible for the metabolism of various cannabinoids, including CBD. Specifically, CYP3A4, an important enzyme within the CYP450 family, takes on this task. But during this process, CBD also interferes with CYP3A4.
The CYP3A4 enzyme is responsible for metabolizing about 60 percent of clinically prescribed drugs. However, when CBD blocks CYP3A4, it can no longer break down the drugs in your body as effectively.
The reverse can also happen. Many drugs inhibit CYP3A4. Then, if you take CBD while taking these medications, your body will no longer be able to process the CBD as effectively.
If your body metabolizes a drug too slowly, you may suddenly have more drugs in your body than intended - even if you stick to your normal dose. An increased level of a drug in your body could increase its effects, including unwanted or harmful side effects.
Some substances also speed up the work of the CYP450 family of enzymes. If your body metabolizes a drug too quickly because another substance is stimulating the enzymes, you may not have enough of the drug in your body at once to treat a health problem.
Trying out CBD safely while taking medication
If you'd like to try CBD as an adjunct therapy to relieve symptoms of a specific medical condition, talk to your doctor about it first.
He can help you determine a CBD product, dosage, and schedule that will be compatible with your medication. In certain situations, your doctor may monitor the blood plasma levels of certain medications you are taking.
Don't stop taking any of your medications to try CBD unless your doctor says it's safe.
Remember that using CBD in the form of lotions, creams, and ointments can also be an option. Unlike oils, edibles, and vaping solutions, topical products typically don't go into the bloodstream - provided it's not a transdermal solution that is designed to do so.
Possible drug interactions
Look out for the grapefruit warning
Although studies are still ongoing to identify possible interactions between CBD and certain drugs, there is one rule of thumb that can help consumers in the meantime: Avoid CBD if your drugs have a grapefruit warning on the label.
This warning states that people taking the drug should avoid consuming grapefruit or grapefruit juice.
According to the Food and Drug Administration, consuming grapefruit while taking any of these drugs can lead to a higher concentration of the drug in the bloodstream and cause undesirable side effects or even an overdose.
More than 85 drugs interact with grapefruit and some closely related citrus juices - such as Seville oranges, grapefruits, and tangelos. That's because chemicals in grapefruit known as furocoumarins inhibit CYP3A4 in a similar way to CBD. The result is a slower metabolism of drugs.
Grapefruit warnings are common with various medications, but not all medications in a category require grapefruit not to be used. Check the leaflet that came with your medication or ask your doctor.
Current research on interactions between CBD and drugs
The researchers are working to determine the specific interactions between CBD and various drugs. Animal studies have been conducted for certain drugs, but in many cases scientists are still in the process of determining how these results can be applied to humans.
Some small clinical studies have already been carried out. In a study of 25 children with difficult-to-treat epilepsy, 13 children were given both clobazam and CBD. The researchers found elevated levels of clobazam in these children. They report that taking CBD and clobazam together is safe, but recommend monitoring drug levels during treatment.
In another study, 39 adults and 42 children who were taking AEDs were also given CBD in the form of Epidiolex. The CBD doses were increased every 2 weeks.
The researchers monitored the serum levels of the AEDs in the subjects over time. While serum levels were within the accepted therapeutic range for most drugs, two drugs - clobazam and desmethylclobazam - had serum levels outside the therapeutic range.
Initial studies show that CBD can definitely affect drug levels in the body, even if you take the prescribed dose. However, more research is needed to determine the severity of the interactions of CBD with various drugs and to develop recommendations for taking CBD with them.
Safety and side effects
Under the careful supervision of your doctor, you may be able to take CBD safely with medications, even those that contain a warning about grapefruit.
If necessary, your doctor may monitor the plasma serum levels of the drugs you are taking. He can also monitor your liver function.
When taking CBD with medication, it is important to watch out for possible changes in the way the drug or CBD works.
Talk to your doctor
The bottom line is that you should always consult your doctor first when trying out CBD, especially if you have a medical condition and are taking medication. Don't stop taking your prescription medication to try CBD unless your doctor has given consent.
Medications that come with a grapefruit warning can interact with CBD. But even if you're on any of these drugs, your doctor may be able to come up with a plan that will work for you by closely monitoring drug levels in your body. That way, you can use both your prescription drug and CBD as therapy.
Your doctor or pharmacist may also be able to recommend a good quality CBD product that will suit your needs. With a little research and knowing how to read CBD labels, you can find reputable products too.
Is CBD Legal? Hemp CBD products (containing less than 0,3 percent THC) are legal at the federal level, but are still illegal in some states. CBD products made from marijuana are illegal at the federal level, but legal in some states. Find out about the laws of your state and the laws of the country you are traveling to. Note that non-prescription CBD products are not FDA approved and may be inaccurately labeled.
