Drugs that May Interact with CBD Oil

CBD Oil Drug Interactions – The CYP450 Pathway

Research has begun to demonstrate that cannabidiol (CBD) has the potential to effectively help a large number of people. CBD interacts with the endocannabinoid system in a way that produces very few unintended side-effects. While the majority of the vast majority of the science indicates CBD is safe for use and consumption, it does pose a few risks that, if not properly understood, could be dangerous. One of these risks is the inhibition of the cytochrome P450 enzyme system.

 

What is the Cytochrome P-450 System?

Found within the liver, the cytochrome P450 enzyme system is responsible for metabolizing potentially toxic compounds, including over 60% percent of any drugs you have consumed. According to Davis’s Drug Guide, this system contains more than 50 enzymes that process and eliminate toxins.

Why Does CYP450 Matter?

In order to determine the appropriate dosages of medications, doctors make calculations using the average amount of time it takes for various drugs and medications to be processed through the cytochrome P450 system. If only one drug is being processed, and the system is generally healthy, these averages provide accurate dosage information. However, certain substances have the ability to affect processing times within this system, making drugs metabolize faster or slower than they would on their own. Similarly, if the cytochrome P450 system is unhealthy due to problems with the liver or other pre-existing conditions, drugs may not metabolize as they should.

 

Cannabidiol in the Cytochrome P-450 System

Cannabidiol can inhibit the cytochrome P450 system’s ability to metabolize certain drugs, leading to an overall increase in processing times. Interestingly, CBD is not alone in its effect on drug metabolism. Grapefruit, watercress, St. John’s Wort, and goldenseal all have a similar impact in terms of CYP450 inhibition. When the CYP450 system is impacted in this way, it leads to higher levels of certain drugs in your system at one time. This can cause unwanted side effects, and sometimes, an overdose. If you are taking a medication affected by cannabidiol, you should consult your doctor to make sure that it is safe for you to supplement your personal care routine with CBD. From there, the two of you may consider adjusting the dosage on your medications so that you can use both products safely.  

 

Drugs that Interact with Cannabidiol

Any drug metabolized by CYP450 enzymes could potentially interact with cannabidiol. According to the Indiana University Department of Medicine, drugs known to use the CYP450 system include:

  • Steroids

  • HMG CoA reductase inhibitors

  • Calcium channel blockers

  • Antihistamines

  • Prokinetics

  • HIV antivirals

  • Immune modulators

  • Benzodiazepines

  • Antiarrhythmic

  • Antibiotics

  • Anesthetics

  • Antipsychotics

  • Antidepressants

  • Anti-epileptics

  • Beta blockers

  • PPIs

  • NSAIDs

  • Angiotensin II blockers

  • Oral hypoglycemic agents

  • Sulfonylureas

 

This list does not include all of the potential medications impacted by cannabidiol. Nor will every medication in the categories contained on this list will cause an interaction. For these reasons, you should consult with a medical professional before supplementing with CBD. There are certain medications, known as “prodrugs,” that need to be metabolized to produce the therapeutic compound. In other words, you ingest an inactive compound and once in the body, it is processed into the active drug. If this processing is dependent on CYP3A4 (part of the larger CYP450 system), then inhibitors can result in too little active drug in the body for the desired therapeutic effect. Codeine, for example, is a prodrug that is metabolized into morphine which provides the effect. Vyvanse and Concerta are two other popular pharmaceutical medications for ADHD that fall into this category. If you are worried that your CYP450 pathway may not be functioning properly, physicians can test the system to ensure that the medications you take are metabolizing as expected. 

 

Can CBD Oil Be Addictive?

One of the most common questions we get is: Can I get addicted to CBD oil? The answer depends on what you mean by “addicted.” When looking at the chemical impacts of CBD, the answer is no. Cannabidiol is not physically addictive in the same way opiates, cocaine, alcohol, and other drugs can be. Also, CBD does not produce any physical withdrawal symptoms when you stop using it. In fact, CBD is currently being researched as a potential tool for minimizing the severe withdrawal from drugs like opiates. But, having said that, human beings can get addicted to just about anything including exercise, music, sex, and food. Because CBD can alter essential liver enzymes, it is crucial to do your research, talk to your physician, and figure out how to best consume CBD for your specific situation. Information and education will be your most powerful weapons going forward.

 

How to Use CBD Oil

When taking cannabidiol, it is important to consume only the recommended serving size. Raising or lowering this amount may produce the opposite of the desired effect. Keep in mind that some people may metabolize cannabidiol differently because of anomalies within the cytochrome P45O (CYP450) enzyme system. And depending on when you take your medications, you may find an unintended increase or decrease in CBD concentrations in your blood. If you suspect that you are not metabolizing CBD as expected, ask your doctor to test your cytochrome P450 enzyme system before adjusting your dosage.

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