Over the last few years, research has started to show that cannabidiol (CBD) has the potential to help a large number of people who suffer from an array of medical conditions. On its own, CBD is believed to be a very safe substance. The fact is that it interacts with our bodies in a way that produces very few side effects. Sure, a few people who use the drug may experience appetite changes, mild tiredness, or the occasional case of diarrhea. But for most, these side effects are rare and worth going through if CBD can help them to treat anxiety, inflammation, and lots more.
However, we’ve all heard about how alcohol could counteract the effects of certain pharmaceutical drugs or in some cases have serious side effects when mixed. So, what about CBD? There are a lot of people who use CBD for medicinal reasons, which makes this a very important issue to consider.
While most of us know that cannabis is a much safer option than the pharmaceutical and even other recreational drugs out there, being “safer” doesn’t necessarily mean that it’s 100% safe. On its own, CBD is a very reliable medication. But there’s still a lack of information when it comes to the compound. We are still unsure about how it may react with other substance that we consume. So, let’s take a look at what we do know thus far when it comes CBD and its interactions with other medications.
The Cytochrome P450 System and Drug Interactions
Drug interactions all come down to the role of the cytochrome P450 system. The cytochrome P450 enzyme system is found within the liver, and it helps to metabolize any potentially toxic compounds, including over 60% of all pharmaceuticals. According to research, this system contains over 50 enzymes that are responsible for processing and eliminating toxins.
In order to determine the adequate dosages of medications, doctors make their calculations based on the average amount of time it will take for various medications and drugs to be processed via the cytochrome P450 system. If there is only one drug being processed, and this system is overall healthy, these average calculations provide accurate dosage information.
However, there are certain substances that will affect processing times within the system, which can make drugs metabolize either faster or slower than they typically would on their own. Also, if the cytochrome P450 system is unhealthy because of problems in the liver or due to any other pre-existing condition, the drugs may not metabolize as they should.
CBD and the Cytochrome P450 System
What’s potentially dangerous about CBD is that it takes full control of the cytochrome system and requires all of its attention. When we take CBD, the liver stops metabolizing any other drugs that use the same enzyme. If you are taking a powerful painkiller such as oxycodone, taking CBD at the same time could cause the oxycodone to stay in the system for longer than it should.
This could be very harmful, since these drugs are carefully dosed to stay in the system for a specific period of time. Anything longer than that, and there’s the risk that you could suffer from side effects like nausea and drowsiness. With regular use, one of the more serious consequences of this slow-down in the metabolic process could be liver damage.
Ultimately, CBD can inhibit the ability of the cytochrome P450 system to metabolize certain drugs, and this can lead to an overall decrease or increase in processing times. Interestingly, CBD isn’t alone in its effect on drug metabolism. Even grapefruit, watercress, and goldenseal all have a similar impact when it comes to the inhibition of the CYP450.
When this system is impacted in this way, it causes higher levels of certain drugs to be in the system at one time. This can result in unwanted side effects, and in some cases even an overdose.
Research Suggests That CBD Could Interact with Most Medications
While little is known about how CBD could affect other drugs that people are taking, nearly 60% of all medications that are on the market are metabolized via the set of liver enzymes that known as cytochrome P450 as discussed above. Ultimately, CBD will affect any drug that is metabolized by the liver. This means that anything from antidepressants to steroids and antibiotics will be affected (and the list goes on).
Since CBD is a very strong inhibitor of the CYP450 enzymes, any other drug which passes through the same system will be affected. If you take CBD while on other medication, it could block these critical enzymes, which would allow more of that medication to get into your system.
So, let’s say you’re on a medication like Xanax to treat your anxiety. If CBD is taken together with this drug, it could potentially increase any side effects and may cause you to feel more drowsy or sedated. In rare cases, the combination of these drugs could become toxic or even interfere with the respiratory system.
How intensely these interactions play out in the body has a lot to do with the dosage of both the medication and the CBD that you are using. If the CBD concentration is high enough, it is able to inhibit the activity of the enzymes, meaning you would get more of the drug into your system. However, very low amounts of CBD don’t seem to have much of an impact at all on how your body processes other medications. But to date, there hasn’t been enough research done to determine how much CBD can be considered as “safe.”
Other Factors That Could Affect How CBD Interacts with Other Medications
The timing of when you take both your medication and your CBD can also have an effect on how the drugs will interact in the body. Spacing out doses of medication helps to reduce the workload on the liver. For instance, depending on the half-life of a drug, the ability that it has to inhibit the liver enzymes might diminish after a few hours, depending on the dose among other factors. Therefore, liver enzymes may regain sufficient function by the time the second drug is taken later on.
What this means is that the risk of having a serious drug interaction could be significantly lower if you take your CBD and medication at different times of the day.
Also interesting to note is that the form in which you consume CBD could also contribute to the interaction with other medicines. Whether you consume CBD orally, topically, or sublingually changes how much of the substance actually makes its way to your bloodstream. This will vary based on your consumption method.
Using CBD sublingually (under the tongue) or inhaling it is likely to give your body the most amount of CBD. Eating or drinking CBD would be next. When ingested, the CBD has to pass through the gastrointestinal system, and this reduces some of the absorption in the bloodstream before making its way to the liver, which is where those very important enzymes are found.
The least potent route of administering CBD is through the skin. The amount of CBD that your body absorbs and then sends to the bloodstream via the skin is likely negligible. Thus, chances are very low that you would experience any sort of interaction with your medication if you are using CBD topically, like in a lotion or cream.
It’s also important to remember that everyone responds to drugs differently. While some people may be very sensitive to certain substances, other people may have little to no reaction. Ultimately, how our bodies process medication is influenced by certain genetic factors, age, and body weight.
Final Thought on CBD Interactions with Other Medications
Ultimately, you should not mix CBD with other medications before talking to your doctor first. This is especially important if you are already taking medications that are metabolized by the liver, such as blood thinners or anti-anxiety drugs. If you’re unsure, it’s always a good idea to talk to your doctor first.
The fact is, there is still very limited research available on CBD and how it affects other medications. As the saying goes, you would “rather be safe than sorry.”