CBD and Drug Interactions: What You Need to Know

CBD and Drug Interactions: What You Need to Know

Cannabidiol (CBD) has gained immense popularity in recent years as a natural remedy for various health conditions. However, the lack of research and regulations surrounding CBD products raises concerns about potential drug interactions.

CBD is a non-psychoactive compound derived from the cannabis plant. While it does not produce the "high" associated with THC, CBD can interact with other medications, altering their effects or causing adverse reactions. This is a significant concern as many people use CBD alongside prescription drugs without consulting their healthcare providers.

How CBD is Metabolised

CBD is primarily metabolised by the cytochrome P450 enzyme system in the liver. This system is responsible for breaking down and eliminating many drugs from the body. CBD can inhibit or induce certain cytochrome P450 enzymes, affecting the metabolism of other medications that rely on these enzymes.

When CBD inhibits these enzymes, it can lead to increased levels of certain drugs in the body, potentially causing adverse effects or toxicity. Conversely, if CBD induces these enzymes, it may accelerate the breakdown of some medications, reducing their effectiveness.

CBD and Common Drug Interactions

Several classes of drugs have been identified as potentially interacting with CBD, including:
  • Blood thinners (warfarin, clopidogrel): CBD may increase the risk of bleeding or bruising when taken with these medications.
  • Antidepressants (SSRIs like fluoxetine, tricyclics like amitriptyline): CBD can increase the levels of these drugs, leading to increased side effects like drowsiness and nausea.
  • Antiepileptic drugs (clobazam, valproic acid): CBD may increase the levels of these medications, potentially causing adverse effects.
  • Antibiotics (clarithromycin, erythromycin): These antibiotics can inhibit the metabolism of CBD, increasing its levels in the body.
  • Anesthetics: CBD may enhance the sedative effects of anesthetics used during surgery.
  • Opioids and pain medications (codeine, oxycodone): CBD can potentially increase the levels of these drugs, leading to increased side effects or respiratory depression.
  • Statins and blood pressure medications: CBD may interact with certain statins (atorvastatin) and calcium channel blockers, altering their levels and effects.

Minimising Risk of Interactions

To minimise the risk of drug interactions with CBD, it is essential to:
  • Consult with your doctor before taking CBD, especially if you are on other medications.
  • Space out the dosing of CBD and other drugs as much as possible to avoid overlapping peak levels.
  • Start with low doses of CBD and gradually increase as needed, monitoring for any adverse effects.
  • Be aware of potential side effects and report any unusual symptoms to your healthcare provider.

Grapefruit and CBD

Interestingly, CBD and grapefruit share similarities in how they affect drug metabolism through the cytochrome P450 system. Taking CBD and grapefruit together can potentially compound the risk of drug interactions, as both can inhibit the same enzymes responsible for metabolising certain medications.

Importance of Disclosure

It is crucial to disclose your CBD usage to all healthcare professionals, including doctors, pharmacists, and nurses. They can help evaluate potential interactions with any medications or supplements you are taking and provide guidance on safe usage.


While CBD shows promise as a therapeutic agent, its potential to interact with various medications is a significant concern. Until more research is conducted and regulations are established, it is essential to exercise caution when using CBD, especially if you are taking other medications. By consulting with healthcare professionals, starting with low doses, and monitoring for adverse effects, you can help minimize the risks associated with CBD and drug interactions.

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