Does CBD Interact With Medications?

As great as it would be if CBD was the only medicine we needed, it’s not a cure-all, and many people require other medications for various reasons.

Whether you’re taking antibiotics or birth control or anything in between, it’s important to know if CBD can affect your medication, after all, CBD is supposed to help you, not hurt you.

So, let’s get into it.

The Cytochrome P450 System

No, it’s not something out of science fiction.

The cytochrome P450 (CYP450) enzyme system is responsible for metabolizing over 60% of the drugs and medications you consume.

This system, found in your liver, contains more than 50 enzymes that process and get rid of toxins in your body.

Ever wonder how doctors determine the proper dosage for a medication? Their calculations are based on the average amount of time it takes for drugs and medications to be processed through your CYP450 system.

However, certain substances may affect processing times within the CYP450 system, causing drugs to metabolize slower or faster than they would on their own.

Ever been told to avoid eating grapefruit or taking St. John’s Wort with your medication? That’s because these are substances that can affect the processing times in your CYP450 system.

When your CYP450 system is inhibited, your body won’t metabolize drugs the way they’re meant to be metabolized, which could lead to the drugs being less effective, or even completely ineffective in your body.

Obviously, that’s not something you want to happen, which leads us to…

Does CBD interact with the CYP450 System?

Yes.

But don’t rush to throw out your CBD.

CBD is metabolized by your CYP450 system while also functioning as a “competitive inhibitor” of CYP450. Since CBD acts as an inhibitor, it can stop CYP450 from metabolizing other drugs.

The extent to which CBD acts as an inhibitor of CYP450 depends on a few factors:

  • How the CBD is administered: tincture, topical, edible, vape, etc.
  • Whole plant or isolate CBD
  • Unique attributes of the person taking CBD: weight, sex, genetics, age, etc.
  • Dosage of CBD

What Medications and Drugs Can CBD Affect?


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As stated earlier, the CYP450 system metabolizes over 60% of drugs. Any drug that is metabolized by the CYP450 system can potentially interact with CBD.

The Indiana University Department of Medicine has a chart showing which drugs are metabolized by the CYP450 system.

Some drugs people commonly used which are metabolized by the CYP450 system include:

  • Antibiotics
  • Antihistamines
  • Antidepressants
  • Anti-epileptics
  • Antipsychotics
  • Anesthetics
  • Caffeine
  • NSAIDS
  • Oral Contraceptives
  • PPIs
  • Steroids

Now, does that mean that every drug on this list will be useless if you take CBD?

No.

It’s important to know that CBD can interact with these drugs, not that it will.

If you’re taking a medication or drug that can be affected by CBD, you should consult with a doctor. Doctors can make sure that it’s safe to take CBD along with your other medications and adjust the dosage of your medications so that CBD is compatible with them. They can also run tests to make sure your medications are being metabolized by your CYP450 system properly.

Now, let’s break down the factors that determine the extent to which CBD acts as an inhibitor of CYP450:

How the CBD is administered

As you know, the way you consume CBD creates different amounts of bioavailability.

It makes sense that the method of consumption also determines the extent to which CBD influences the CYP450 system.

Since the CYP450 system is located in the liver, if you apply CBD topically, there will be no interaction at all with CYP450.

On the other hand, if you consume a CBD edible, the CBD will travel through your digestive system and make its way through your liver, thus potentially interacting with CYP450.

Placing CBD under your tongue (sublingual administration), spraying it (buccal administration), as well as vaping and smoking, all allow CBD to bypass your digestive system and directly enter your bloodstream, avoiding your liver. There should be no interaction with CYP450 if you use any of these methods, however, it would still be a good idea to check with a medical professional if you’re taking other medications.

Whole Plant vs Isolate

We know that whole plant CBD contains just that — the whole plant — cannabinoids, terpenes, and other cannabis plant compounds.

CBD isolate only contains CBD, nothing else.

Although whole plant and isolate both contain CBD, they can produce different effects and may interact with CYP450 differently.

Why would they interact with CYP450 differently?

If CBD can interact with CYP450, so can other cannabinoids, such as THC, CBG, and CBN. Little is understood about how various cannabinoids interact with the CYP450 system, and even less is understood about how various cannabinoids interact with it all at the same time.

Fortunately, despite the lack of research, doctors can monitor patients and adjust dosages when needed to ensure that your CBD product — whether whole plant or isolate — is compatible with other medications.

Unique Attributes


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Every person is unique, and there really isn’t a one size fits all medication or drug that suits everybody.

Your sex, age, weight, and genetics all influence how a drug interacts with your body. The extent to which CBD interacts with your CYP450 system is also influenced by these factors.

Again, a doctor can monitor you, run tests, and adjust the dosages of your medications depending on your unique needs to figure out the best regimen for you.

Dosage

If the dose of CBD is low enough, it won’t have a noticeable effect on CYP450 activity, but, unfortunately, there is no clearly established cut-off dose below which CBD doesn’t interact with other drugs.

Most CBD products shouldn’t contain enough CBD per dose to greatly inhibit CYP450 activity. For example, one dose of Brizo Pure’s Süthe is just two drops, containing just a few milligrams of CBD. See our Certificates of Analysis for a breakdown of milligrams per bottle.

Since there isn’t an established cut-off dose yet, and research is still lacking, once again, it’s important to visit a doctor who can make sure it’s okay for you to take CBD along with your other medications.

Conclusion

Long story short: please speak with a doctor if you’re taking CBD in conjunction with other medications or drugs.

Sources

https://www.projectcbd.org/science/cannabis-pharmacology/cbd-drug-interactions-role-cytochrome-p450

https://www.ncbi.nlm.nih.gov/pubmed/2191822

https://www.ncbi.nlm.nih.gov/pubmed/23750331

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