CBD has been shown to provide a wide range of potential benefits for its users, this is why it’s become so popular. However, side effects are present. One of the things to consider is if taking CBD can react with the other medicines.
Does CBD React with Other Medicines or Drugs? Yes CBD does react and alter how well medicines and drugs work. The other issue is everybody reacts differently to medication, supplements, and CBD, so the effect can vary.
Most side effects are rare and mild, including tiredness, appetite change, and diarrhea. However, could more serious effects of taking CBD to be present without you knowing?
CBD can have an inhibitory effect on other medicines. Similarly to grapefruits it can affect the group of enzymes in the cytochrome P450 system which is involved in your body’s drug metabolism system, often found in high levels in the liver.
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Why is the cytochrome P450 (CYP450) system important?
The enzymes in the CYP450 system are important for the metabolism of drugs. CYP450 enzymes are also involved in the production of molecules such as steroid hormones, fats such as cholesterol, and acids used to digest fats.
There are more than 50 CYP450 enzymes, they are mostly found in liver cells but can also be found in cells throughout the body. They are responsible for 45% of drug metabolism.
Inducers and inhibitors
Substances which result in CYP450 drug interaction are named as inducers or inhibitors.
Inducers increase the rate of drug metabolism, the dosage of the drug affected will likely have to be increased as the medication becomes less effective.
A quicker rate of drug metabolism means that the drug/medication is broken down quicker and a higher dosage is likely required in order to be more effective.
Inhibitors are the opposite. They can cause the drug level to rise to potentially harmful levels, meaning less dosage is likely to be required.
The CYP450 enzymes metabolize the drug slower, meaning that the drug stays active for a longer time so less is needed in order to achieve the desired effect.
CBD and the CYP450 system
CBD is an inhibitor to the CYP450 system. As with some other medications, CBD is metabolized in the body by the enzymes in the CYP450 system.
So, in competing for these enzymes, CBD can reduce the metabolism of other drugs, raising their blood levels and having the inhibitor effect described above.
Therefore, lower dosages are more likely to be required without knowing so which could lead to the potentially harmful levels suggested above.
Clinical trials have shown this where CBD is provided in hundreds of milligrams (mg) daily. The average CBD supplement pill can range from 10 to 40 mg, therefore the effect may not be as strong in smaller doses of CBD.
Grapefruit similarly inhibits elements of the CYP450 system, as such, warnings can be found on labels to not have grapefruit while taking those drugs.
Look for these warnings but always consult with your doctor before starting to take any drugs or supplements.
CBD and antibiotics
Antibiotics are processed through the CYP450 system that CBD effects, which means that CBD could inhibit some types of antibiotics – specifically the types that are processed through the CYP450 system.
More research is however needed on the effect of CBD with antibiotics. Some research is suggesting that CBD could be used as an antibiotic but that is a story for another day.
What antibiotics are affected by CBD? As they are the only antibiotics which are processed by the CYP450 system, only Macrolide antibiotics are affected by CBD. These types of antibiotics are commonly prescribed for:
- Ear, nose and throat infections
- Skin infections
- Chest infections
- Mouth and dental infections
- Sexually transmitted infections
The antibiotics affected are:
- Azithromycin
- Clarithromycin
- Erythromycin
- Spiramycin
- Telithromycin
Many variables have to be considered with CBD because it depends on the product, the quality of it and how some people metabolize CBD differently, just as with any biohacking supplement.
CBD and psychiatric drugs
Antidepressants
CBD aids the body in using its cannabinoids more efficiently which has been linked to changes in mood, emotions, and anxiety.
Studies have shown CBD to improve symptoms of depression and anxiety.
The risk of inhibiting antidepressant metabolization is present in taking CBD as with many drugs, however, people who have taken CBD alongside their antidepressants have suggested that their symptoms have improved.
Antipsychotics
The misconception that CBD has the same effects as cannabis (psychoactive effects) has lead to controversy in taking CBD for antipsychotic purposes. CBD does not contain the psychoactive substance THC and therefore does not provide a ‘high’ or any psychoactive effects. CBD has in fact been found to help schizophrenia patients.
Again, the potential for inhibition of antipsychotics is present when taking CBD as well. Checking with your doctor is recommended when considering taking CBD alongside any other medication.
Mood stabilizers
CBD has been found to improve mood in bipolar patients and can improve symptoms of seizure disorders, it can be used alongside other medications that treat these disorders, and may help to improve symptoms. However, as with antipsychotics and antidepressants, the potential for inhibition of these medications in the CYP450 system is present.
Benzodiazepines
Benzodiazepines are a type of sedative.
They are often prescribed for anxiety disorders which can cause distress and difficulty sleeping. CBD is renowned for its supposed benefit of reducing symptoms of anxiety, calming and relaxing the user.
In combination with benzodiazepines, CBD will likely increase sedation and calming effects. Constant monitoring should be done to ensure the safe use of these drugs together.
THC containing products can worsen anxiety.
Always be cautious in purchasing CBD products; buy from reputable, trustworthy sources.
CBD and alcohol
As both are relaxants, combining CBD and alcohol can increase the sedation and also make it last longer.
The more you take off both the worse the effect of either one alone, meaning more loss of control, coordination, and inhibition.
Although, the effect can depend on how you are when you are drunk.
If you feel happy when drunk the CBD could increase this feeling, if you’re a violent, aggressive drunk CBD can calm this down.
More research is needed on the combination, however, there are no upfront, life-threatening dangers of taking CBD and consuming alcohol at the same time.
CBD and caffeine
Becoming more and more popular is the combination of CBD with caffeine drinks.
Caffeine increases alertness and attentiveness but users report that it can also cause side effects such as nervousness, restlessness, anxiety, and agitation. CBD in combination with caffeine products is said to improve alertness while reducing the negative side effects suggested.
But, if too much CBD is used however, it could counter the stimulation that caffeine produces and instead increase sedation.
Conclusion
Caution should be taken when consuming CBD with other medicines which go through the same CYP450 system as adverse effects can be produced from the inhibition of drug metabolism that CBD causes.
Not all drugs/medicines are affected however, always contact and discuss with your healthcare provider before taking CBD alongside other medicines.
With alcohol, CBD is relatively safe to use it can increase the feeling of relaxation and sedation, bit always is cautious.
With caffeine, CBD can reduce or get rid of the negative side effects that are often associated with caffeine, when used in the right amount.
