CBD and other medications: Proceed with caution – Harvard Health Blog
Products containing cannabidiol (CBD) seem to be all the rage these days, promising relief from a wide range of ailments, from insomnia and hot flashes to chronic pain and seizures. Some of these claims have merit for them, while others are just hype. But it won’t hurt to try, right? Well, not so fast. CBD is a biologically active compound and, as such, it can also have unintended consequences. These include the known side effects of CBD, but also unintended interactions with supplements, herbal products, and over-the-counter and prescription drugs.
Double the side effects
Although generally considered safe, CBD can cause drowsiness, dizziness, nausea, diarrhea, dry mouth, and in rare cases, liver damage. Taking CBD with other drugs that have similar side effects may increase the risk of unwanted symptoms or toxicity. In other words, taking CBD along with over-the-counter or prescription drugs and substances that cause drowsiness, such as opioids, benzodiazepines (like Xanax or Ativan), antipsychotics, antidepressants, antihistamines (such as Benadryl), or alcohol can cause increased drowsiness, fatigue and possibly accidental falls and driving accidents. Increased sedation and fatigue can also occur when using certain herbal supplements, such as kava, melatonin, and St. John’s Wort. Taking CBD with stimulants (such as Adderall) may cause decreased appetite, while taking CBD with the diabetes medicine metformin or certain heartburn medicines (like Prilosec) may increase the risk of diarrhea.
CBD can alter the effects of other drugs
Many drugs are broken down by enzymes in the liver, and CBD can compete with or interfere with these enzymes, causing the drug to be over or under concentration in the body, called altered concentration. The altered concentration, in turn, may cause the drug to malfunction or an increased risk of side effects. These drug interactions are usually difficult to predict but can lead to unpleasant and sometimes serious problems.
Researchers at Penn State College of Medicine evaluated the existing information on five cannabinoid drugs CBD and delta-9-tetrahydrocannabinol (THC): antinausea drugs used during cancer treatment (Marinol, Syndros, Cesamet); a medicine used primarily for muscle spasms in multiple sclerosis (Sativex, which is not currently available in the United States, but available in other countries); and an anticonvulsant drug (Epidiolex). Overall, the researchers identified 139 drugs that could be affected by cannabinoids. This list has been reduced to 57 drugs, for which a modified concentration may be dangerous. The list contains a variety of drugs ranging from heart drugs to antibiotics, although not all drugs on the list are affected by CBD-exclusive products (some are affected only by THC). Potentially serious drug interactions with CBD included
- a common blood thinner, warfarin
- a heart rhythm medicine, amiodarone
- a thyroid medicine, levothyroxine
- several seizure medications, including clobazam, lamotrigine, and valproate.
The researchers further cautioned that while the list can be used as a starting point to identify potential drug interactions with marijuana or CBD oil, plant-derived cannabinoid products can provide widely varying cannabinoid concentrations ( unlike the FDA-regulated prescription cannabinoid drugs mentioned earlier), and may contain many other compounds that may increase the risk of unintended drug interactions.
Does the form of CBD matter?
Absolutely. Inhaled CBD enters the bloodstream the fastest, reaching a high concentration within 30 minutes and increasing the risk of acute side effects. Edibles take longer to absorb and are less likely to spike high, although they can eventually reach levels high enough to cause a problem or interact with other drugs. Topical formulations, such as creams and lotions, may not absorb and enter the bloodstream in sufficient amount to interact with other drugs, although there is very little information on how much CBD is entering. possibly in the blood. All of this is further complicated by the fact that none of these products are regulated or controlled for their purity, strength or safety.
The bottom line: talk to your doctor or pharmacist if you use or plan to use CBD
CBD has the potential to interact with many other products, including over-the-counter drugs, herbal products, and prescription drugs. Some drugs should never be taken with CBD; the use of other drugs may need to be changed or reduced to avoid serious problems. The consequences of drug interactions also depend on many other factors, including the dose of CBD, the dose of another drug, and a person’s underlying health condition. Seniors are more susceptible to drug interactions because they often take multiple drugs and because of age-related physiological changes that affect the way our bodies process drugs.
People who are considering or taking CBD products should always mention their use to their doctor, especially if they are taking any other medications or have underlying medical conditions, such as liver disease, kidney disease. , epilepsy, heart problems, a weakened immune system or are on medication. which can weaken the immune system (such as cancer medicines). A pharmacist is a great resource to help you learn more about a potential interaction with a supplement, herbal product (many of which have their own drug interactions), or over-the-counter or prescription medication. Don’t assume that just because something is natural doesn’t mean it’s safe and trying it won’t hurt. It could very well.
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