Do you know what drugs should not be taken with CBD?
We have known for some time now that medications can interact inside your body with supplements if you take them at the same time. Every single time you go into the doctor's office, they ask you what medications you are taking for a reason.
They aren't just being nosey, the doctor actually needs to know if a medication they prescribe you will have a negative interaction with that medication you are already taking. That’s why it is important to always be very clear with your doctor about everything you take! Even over-the-counter medications and supplements can produce unpredictable, harmful effects when mixed with the wrong drug in your system.
CBD is still fairly new to the world, and what drugs should not be taken with CBD is an ongoing discovery.
What is CBD?
CBD is short for cannabidiol, one of over 100 chemicals known as cannabinoids found in cannabis plants. It is found in all cannabis plants, including industrial hemp and the two strains of marijuana, cannabis sativa and cannabis indica. Depending on the strain, people can consume a significant amount of CBD when they consume cannabis. In most strains, you'll find more THC than CBD, which is known for its psychoactive properties that cause the cannabis "high".
Unlike THC, CBD is not a psychoactive substance, it creates no “high.”
With CBD being such a popular thing, we can expect more research professionals to conduct more studies that will provide new data. It will likely take years for the studies to be completed and papers to be published, to set expectations, so time will be needed to fully understand the data on what drugs should not be taken with CBD. Until then, experiments with CBD will always be conducted at the user’s own risk.
Generally speaking, mixing CBD with any other medication that depends on CYP450 enzymes, inhibits the production of CYP450, or induces the production of CYP450 enzymes, and is asking for trouble. Medical science can’t quite tell us exactly what kind of trouble and how much of it, but do you really want to find out?
Since more than half of all medications depend on CYP450 enzymes to be metabolized, check carefully which of your prescribed and over-the-counter medications fit this criterion and look for delayed or suppressed effectiveness, as well as extended side effects and possible signs of drug toxicity.
There is one class of drugs that you should also keep an eye on and they are called prodrugs. In order for these drugs to become active and therapeutic compounds, they need to be metabolized. The version of the drug you ingest is actually inert and depends on the biochemical reaction with CYP3A4 to become active at all. If CBD suppresses your CYP3A4 levels, a prodrug might not even work at all.
Examples of prodrugs include codeine, which gets synthesized into morphine in the liver. ADHD drugs Concerta and Vyvanse are two others.
How CBD May Interact with The Most Commonly Prescribed Prescription Drugs
Vicodin and CBD
When it comes to pain killers, Vicodin is the most commonly-prescribed. It is a habit forming opioid that can produce bad side effects including dizziness, nausea, impaired breathing, and cognitive impairment.
Opioids are not known to interact adversely with CBD. The exception is codeine, a prodrug that only activates as a painkiller when it is metabolized, a process that CBD can inhibit. Vicodin does not share this property with codeine.
Simvastatin and CBD
In a drug class known as "statins", Simvastatin is the first type of drug prescribed to persons suffering from high cholesterol. It happens to be the most frequently prescribed statin.
Simvastatin is metabolized by CYP3A4. If you end up taking CBD in conjunction with simvastatin it's possible that it can decrease the drugs efficacy. It can prolong the drugs side effects, and possibly lead to medication toxicity due to the drug’s prolonged presence in the bloodstream.
Lisinopril and CBD
When people are close to kidney failure, and are suffering from high blood pressure, they are usually prescribed Linisopril. Sometimes it can be prescribed for people suffering from diabetes and congestive heart failure.
Lisinopril is classified as angiotensin converting enzyme (ACE) inhibitor. While its function is to inhibit the production of enzymes, it is not known to inhibit CYP3A4, meaning it is unlikely to inhibit the function of CBD. It is also not a prodrug, unlike some of its analogs, meaning it is less likely to be affected by an inhibition of CYP3A4 that may result from ingestion of CBD.
Levothyroxine and CBD
Lovothyroxine is the generic form of the thyroid medication Synthroid. It is a synthetic thyroid hormone used to treat hypothyroidism (an underactive thyroid). An excess of this hormone can produce chest pain, rapid heart rate, headache, sweating, anxiety, and weight loss.
Lovothyroxine is known to inhibit CYP450 enzymes, meaning it could inhibit the effects of CBD oil.
Azithromycin and CBD
The antibiotic azithromycin is usually prescribed to treat throat, sinus, and ear infections. It can also be prescribed to treat bronchitis, pneumonia, and certain bacterial sexually transmitted infections. It may produce the side effects of vomiting, gas, bloating, and diarrhea.
Unlike its relative erythromycin, azithromycin only metabolizes weakly with CYP450 enzymes and is not known to either stimulate or inhibit the production of CYP450 enzymes. There is little or no indication that azithromycin will interact adversely with CBD.
Metformin and CBD
Metformin is a drug that is used to treat type 2 diabetes. It's the generic version of a drug called Glucophage. Common side effects include gas, nausea, bloating, reduced appetite, and diarrhea.
Metformin is not metabolized in the way most other drugs are, meaning changes in CYP3A4 due to CBD ingestion will most likely not affect it. However, metformin is known to be a strong CYP3A4 inhibitor in its own right, meaning it could inhibit the effectiveness of CBD metabolism.
Lipitor and CBD
Another statin drug is Lipitor. Lipitor is commonly prescribed to patients suffering from high cholesterol. It is also prescribed to patients suffering from coronary artery diseases as a safeguard against stroke, heart attack, and chest pain. It may also cause diarrhea, constipation, muscle pain, fatigue, gas, heartburn, and headaches.
Lipitor is metabolized by CYP3A4. Taking CBD in conjunction with Lipitor may decrease the drug’s effectiveness, prolong its side effects, and possibly lead to medication toxicity due to the drug’s prolonged presence in the bloodstream just like Simvastatin.
Amlodipine and CBD
Amlodipine is the generic form of the drug called Norvasc. These drugs are both calcium channel blockers. It is prescribed to prevent chest pain and treat high blood pressure. Side effects it can cause include headaches, dizziness, chest pain, and swollen extremities.
Amlodipine is metabolized by CYP3A4. Taking CBD in conjunction with Amlodipine may decrease the drug’s effectiveness, prolong its side effects, and possibly lead to medication toxicity due to the drug’s prolonged presence in the bloodstream.
Amoxicillin and CBD
Amoxicillin, a relative of the revolutionary antibiotic penicillin, is used to treat many kinds of bacterial infections, including skin, throat, ear, tonsil, and urinary tract infections. Possible side effects include heartburn, nausea, rash, diarrhea, itching, and abdominal pain. Some people are also allergic to amoxicillin.
Studies have not demonstrated the propensity for amoxicillin to inhibit the production of CYP3A4, meaning it is unlikely to produce an adverse reaction with CBD.
Hydrochlorothiazide and CBD
One of the most common diuretics on the market is Hydrochlorothiazide. It is prescribed to patients suffering from high blood pressure. It is known to produce side effects like electrolyte imbalance, rash, fatigue, light sensitivity, and low blood pressure.
Hydrochlorothiazide is not metabolized by CYP3A4, nor is it known to inhibit or stimulate the production of the enzyme. This means it is not likely to produce an adverse reaction with CBD.
Conclusion
Hopefully we've helped you get a better understanding on what drugs should not be taken with CBD. It's important to understand drug interactions with CBD and what the potential risks are. Consult with your physician if you have any doubt.
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