Updated on March 6, 2024

Drugs that should not be taken with CBD

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Key takeaways

  • Combining CBD with other medications can lead to increased sedation, interaction with liver enzymes, affect blood pressure and increase the potential side effects of medications.
  • Interaction between CBD and liver enzymes may affect the breakdown of drugs, leading to higher or lower levels of the medication in the bloodstream than intended.
  • CBD should not be mixed with alcohol, caffeine, opioids, and grape fruit juice or grape fruits.
  • Drugs like blood thinners, antidepressants, sedation medications, and immunosuppressants should not be mixed with CBD.

CBD's interactions with various enzymes and receptors have been documented by several researchers. While these interactions make CBD a valuable addition to our medical world, it also poses some risk of drug-to-drug interaction. In this article, we will explore common drugs and substances that should not be mixed with CBD.

Why CBD may not mix well with some medications?

Combining CBD with other medications can be risky for the following reasons:

  1. Increased Sedation: CBD has a sedative effect, and combining it with other medications that also cause drowsiness, such as certain painkillers, anxiety medications, or sleep aids, can intensify sedation. This may lead to excessive drowsiness, making it unsafe to drive or operate machinery.
  2. Interaction with Liver Enzymes: CBD can interact with enzymes in the liver responsible for metabolizing many medications. This interaction may affect the breakdown of drugs, leading to higher or lower levels of the medication in the bloodstream than intended.
  3. Blood Pressure Effects: CBD may cause a temporary drop in blood pressure. When taken with medications that also affect blood pressure, there's a risk of hypotension (low blood pressure), which can result in dizziness or fainting.
  4. Potential for Adverse Effects: CBD might interact with specific medications, potentially causing adverse effects or reducing the effectiveness of the drugs. This is particularly crucial for medications with a narrow therapeutic window, where small changes in concentration can have significant effects.
  5. Individual Variations: People's bodies react differently to medications and substances. What works well for one person may not be suitable for another. Combining CBD with medications without proper guidance increases the risk of unpredictable reactions.

Drugs that should not be taken with CBD

CBD can interact with certain medications, potentially affecting their efficacy or leading to unintended side effects. It's crucial to consult with an expert before combining CBD with any prescription or over-the-counter medications. Here are some types of medications and classes of drugs that may interact with CBD:

  1. Blood Thinners (Anticoagulants): CBD has been reported to inhibit certain enzymes that play a role in blood clotting. Combining CBD with blood thinners may increase the risk of bleeding.
  2. Anti-Seizure Medications: There is some evidence to suggest that CBD may interact with certain anti-seizure medications. It's important to consult with an expert if considering using CBD alongside medications like clobazam, valproate, or others.
  3. Antidepressants and Anti-Anxiety Medications: CBD has potential interactions with medications used to treat depression and anxiety, particularly those in the selective serotonin reuptake inhibitor (SSRI) class. Adjustments to medication dosages may be necessary.
  4. Antipsychotic Medications: CBD may interact with medications used to treat psychotic disorders. It's important to discuss the use of CBD with an expert if taking antipsychotic medications.
  5. Immunosuppressants: CBD's potential effects on the immune system may interact with medications used to suppress the immune response, such as corticosteroids or immunosuppressive drugs after an organ transplant.
  6. Sedatives and Sleep Medications: CBD can have sedative effects, and combining it with medications that cause drowsiness may intensify this effect. It's crucial to be cautious when using CBD with sedatives or sleep aids.

Substances that should not be mixed with CBD

Combining CBD with certain substances can pose potential risks and should be approached with caution. Here are some substances that should generally not be mixed with CBD:

  1. Alcohol: Both CBD and alcohol can have central nervous system depressant effects. Combining them may intensify the sedative effects and increase the risk of impairment, such as dizziness and coordination difficulties.
  2. Opioids: CBD may interact with opioids, potentially amplifying their effects. This interaction could lead to increased sedation, making it important to use caution and consult with a healthcare professional if considering combining CBD with opioids.
  3. Other Substances with Sedative Properties: Substances such as kava, melatonin, St. John's Wort, and other herbal supplements known for their sedative effects may enhance the drowsiness caused by CBD, leading to excessive sleepiness.
  4. Grapefruit and Grapefruit Juice: CBD may interact with enzymes in the liver in a manner similar to grapefruit. Substances that interact with grapefruit can impact the metabolism of certain medications, potentially leading to higher or lower levels in the bloodstream.
  5. Caffeine: While not necessarily contraindicated, some individuals may experience an interaction between CBD and caffeine. CBD can have calming effects, while caffeine is a stimulant. Combining them might lead to unexpected reactions in sensitive individuals.

Frequently asked questions

Is CBD bad with antibiotics?

CBD alters the production of specific enzymes in your liver, causing a slowdown in the rate at which your body metabolizes antibiotics. Consequently, the levels of the antibiotic in your bloodstream may exceed the recommended dose, elevating the potential for side effects, some of which could be severe.

Can you mix CBD with cold medicine?

For the majority of individuals using cannabis, it is not recommended to mix marijuana with cold medicine. If you choose to consume cannabis while using cold medication, exercise caution.

When should you avoid CBD?

People who are thinking about using CBD products should consistently exercise caution especially if they are taking other medications or have pre-existing medical conditions such as liver disease, kidney disease, epilepsy, heart problems, a compromised immune system, or are on medications that may suppress the immune system.

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Balachandran, P., Elsohly, M., & Hill, K. P. (2021). Cannabidiol Interactions with Medications, Illicit Substances, and Alcohol: A Comprehensive Review. Journal of General Internal Medicine, 36(7), 2074-2084. https://doi.org/10.1007/s11606-020-06504-8

Antoniou, T., Bodkin, J., & Ho, W. (2020). Drug interactions with cannabinoids. CMAJ : Canadian Medical Association Journal, 192(9), E206. https://doi.org/10.1503/cmaj.191097

Harold Wilson-Morkeh, Ahmad Al-Abdulla, Lauren Sien, Hodan Mohamed, Taryn Youngstein, Important drug interactions exist between cannabidiol oil and commonly prescribed drugs in rheumatology practice, Rheumatology, Volume 59, Issue 1, January 2020, Pages 249–251, https://doi.org/10.1093/rheumatology/kez304

Alsherbiny, M. A., & Li, C. G. (2019). Medicinal Cannabis—Potential Drug Interactions. Medicines, 6(1), 3. https://doi.org/10.3390/medicines6010003

Brown, J. D., & Winterstein, A. G. (2019). Potential Adverse Drug Events and Drug–Drug Interactions with Medical and Consumer Cannabidiol (CBD) Use. Journal of Clinical Medicine, 8(7), 989. https://doi.org/10.3390/jcm8070989

The content on Nesa's Hemp blog is for educational purposes only. We meticulously research and cite our sources, but advise consulting a professional before making decisions based on our information. We derive our content from reputable studies and publications, but individual circumstances may vary. We cannot guarantee the accuracy or applicability of our content to every situation. Nesa's Hemp blog and its authors are not liable for any loss or inconvenience resulting from reliance on our information. By using our blog, you waive any claims against us regarding the accuracy or completeness of our content.

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