The New CBD products seem to be popping up everyday due to the increasing market demand for CBD oil. More and more people are taking CBD oil to help with a variety of health problems. However, many people are taking prescription medications, using over the counter medications, or taking herbal supplements as well as CBD.

But, are there any drug interactions between these products and CBD oil? Is your health at risk as a result?

What are Drug Interactions?

“Drug interactions” is a term which describes drugs that can conflict with each other in your body when taken together. Sometimes one drug can decrease the effectiveness of another drug or even cause it to build up in the body leading to toxicity or unwanted side effects.

Contrary to popular belief, drug interactions can happen with over the counter medications and even herbal supplements, not just with prescription medications. This is why it is important to always be clear with your healthcare providers about ALL the medications you take – including the over the counter drugs and supplements. They can help you determine interactions and find solutions for them. Often you can take them at different times of the day (i.e. one in the morning or one in the evening) or just adjust the doses so there will not be any problems between them.

In fact, drugs can also interact with food or drinks you eat or drink as well. One of the most popular examples of this is grapefruits or grapefruit juice with certain medications. Additionally, in some cases dairy products can interact with medications.

So, are there interactions with CBD oil? Luckily with more people taking CBD oil, research is exploring whether CBD oil is safe to take with other medications or supplements.

 How Can CBD Oil Interact with Drugs?

The liver breaks down many drug and chemicals, including CBD oil. If you take other drugs or supplements that are also broken down in the liver, there is a potential for interactions between them to take place.

CBD oil actually acts on similar enzymes in the liver like grapefruits and grapefruit juice. This enzyme system is known as CYP450. Enzymes are simply proteins that break down things in the body. CBD oil can slow down the activity of these enzymes, making them not break down substances as fast as they normally would.  Drugs or supplements that get broken down by those enzymes can build up in your system. This means that you have “backing up” in your blood. Sometimes, these higher drug levels can lead to harmful side effects. In general, altering the dose of CBD will take care of this issue.

 What is the CYP450 System?

CYP450 is the short name for the cytochrome P450 system which is an enzyme system in the liver. This system metabolizes, or breaks down, the majority of drugs and supplements. CYP450 is name of the group of enzymes, but it can be broken down into specific sets of enzymes. For example, although CBD is broken down by CYP450 in general, specifically it goes through CYP3A4, CYP2C19, and CYP2C9.

Drugs can also inhibit certain enzymes, meaning that they can stop or slow down the enzyme from breaking down other drugs. As mentioned before, this can cause a build up of drugs in your body which may cause serious side effects. Some research shows that CBD can inhibit CYP3A4 and CYP2D6.

What Drugs Interact with CBD?

Knowing the specific enzymes that CBD deals with helps us to determine which drugs may interact with CBD oil. So, what are the drugs to look out for?

As mentioned above, CBD can inhibit CYP3A4 and CYP2D6. It may even inhibit CYP2C9. This means that taking CBD can cause some drug levels to increase in our blood, which may be harmful depending on the drug. Drugs that go through CYP3A4 include cholesterol medications, HIV/AIDs medications, antibiotics, and a lot of others.  CYP2D6 digested drugs include pain medications like opioids and antidepressants. Drugs processed through CYP2C9 include blood thinners and over the counter pain relievers like nonsteroidal anti-inflammatory drugs (NSAIDs). Therefore, CBD oil may cause interactions with any of these drugs.

So, what are some specific drugs that can interact with CBD oil?

• CBD Oil and Prednisone:  CBD may increase levels of the popular steroid, prednisone, which may cause increased restlessness and many other side effects.

• CBD Oil and Beta Blockers: Common beta blockers include carvedilol and metoprolol. These medications are used for heart conditions. CBD oil can also cause these levels to increase, leading to tiredness and greater effects on slowing the heartbeat.

• CBD Oil and Antidepressants:  Antidepressant levels can be increased when taking CBD oil as well. The side effects depend on the specific antidepressant, but in general this can cause drowsiness and in severe cases possible overdose.

• CBD Oil and Ibuprofen:  Ibuprofen is a common NSAID used for pain relief. Ibuprofen levels may increase due to CBD which can lead to a greater risk of gastrointestinal (GI) bleeding.

• CBD Oil and Warfarin:  CBD can make the popular blood thinner known as warfarin stay in the body longer. This leads to higher warfarin levels in the blood which could increase the risk of bleeding.

• CBD Oil and Clobazam:  Clobazam is a seizure medication that can interact with CBD according to a study in epileptic children. It can increase levels of clobazam which may lead to increased drowsiness or confusion.

• CBD Oil and Valproic Acid: Valproic Acid is another seizure medication, that when taken together may result in increased risk of liver damage. Although, this was studied with larger doses of CBD than what many normally take.

It is important to note that these interactions are mostly speculations through limited research. Drug interactions with CBD need to be researched further before we can say for certain what interacts with it and how big of an impact it actually has.

Do Not Take These Drugs with CBD

Contraindication means that drugs interact and should not be taken together. It turns out as of now CBD oil does not have many contraindications. The only one so far is if you are allergic to cannabinoids or any of the oils contained in the CBD products. If you are, be sure to investigate alternative products with a different oil base or avoid CBD and hemp products altogether if you are allergic to cannabinoids. Make sure to always check the ingredients of CBD oils if you have any known allergies or sensitivities.

Is CBD Safe to Take with Alcohol?

There is not a lot of data looking into taking CBD with alcohol. However, a small study showed that taking CBD and alcohol together resulted in lower blood alcohol levels than alcohol by itself. Although, the effects on the brain of both together were the same as the alcohol alone. Therefore, in moderation it is probably okay, but as with everything checking with a healthcare professional (especially if you are taking other medications) is a good practice.

Overall, there is still a lot to learn about CBD oil and drug interactions. CBD oil by itself is relatively safe and well tolerated, but taking it with other drugs and supplements may cause unintended harm. If you educate yourself on possible interactions with any of your medications then you can easily eliminate this risk. Please talk to your healthcare provider as well to ensure your safety. As the saying goes, it is better to be safe than sorry!