What drugs should not be taken with CBD? We know that drugs interact inside your body with supplements if you take them at the same time. What about CBD? CBD, or cannabidiol, is a chemical compound just like any other substance on our beautiful planet. Just like any other compound, it has the potential to interact with other compounds, such as medications that metabolize in the same part of the body. Can CBD oil help treat hypertension? And is it safe to take with existing blood pressure medications?
What Drugs Should not be Taken With CBD?
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 still being discovered.
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.
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.
What Drugs Should Not Be Taken With CBD?
CBD, or cannabidiol, is a chemical compound just like any other substance on our beautiful planet. Just like any other compound, it has the potential to interact with other compounds, such as medications that metabolize in the same part of the body. There are a whopping 98 identified drug interactions just for caffeine, some of which stop the other drug from working completely. Even grapefruit can’t be eaten if you’re on certain prescription medications – which means it’s no surprise that CBD and some drugs just shouldn’t mix.
Fortunately, unlike caffeine and grapefruit, most of the potential interactions with CBD and other drugs have been identified as harmless or mild. In some cases, other drugs and CBD can work in combination with each other favorably instead of having adverse side effects. We always recommend speaking with a certified health professional or physician prior to taking CBD oil or adding it into your daily routine, especially if you are currently on or plan on taking prescription medications. Today, though, we’re going to cover some of the drugs that have been shown to interact with CBD in some way to look at which drugs should not be taken with CBD.
How CBD Might Interact with Other Drugs
We see a range of ways for how CBD interacts with other drugs, medications, and chemical compounds. Cannabidiol may potentially reduce the metabolism of other drugs that compete for the same enzyme as it does. Metabolized by the cytochrome enzymes CYP2C19 and CYP3A4 in the body, this can raise the blood levels of other medications that metabolize the same way, which would require your doctor to do a downward adjustment on your doses. It can inhibit CYP2D6, the enzyme targeted by risperidone and omeprazole medications. Likewise, it could reduce the metabolization of diclofenac and warfarin by inhibiting the hepatic enzyme, CYP2C9.
It was found to increase the bioavailability of Hexobarbital, a barbiturate derivative with sedative and hypnotic effects that’s often sold in both sodium salt and acid forms like Tobinal, Evipan, and Citopan. While cannabis may increase the potency or effectiveness of other drugs, close monitoring by your physician or a medical professional is important. Your dosage may need to be adjusted even if the drug interact is beneficial, so make sure you’re staying honest with your doctor if you’re interested in using CBD.
The CYP450 Enzyme
CBD interacts with more than one cytochrome enzyme, including one located primarily in the liver and brain that’s involved in helping the body process about 60% of the pharmaceuticals on the market right now.
In short, cannabidiol has the potential to interact with a lot of medications just from this enzyme alone.
In fact, here are some of the drugs that have been shown to use the CYP450 enzyme system in our bodies:
· Oral hypoglycemic agents
· Calcium channel blockers
By interacting or saturating this enzyme system, CBD could potentially prevent other drugs from accessing the same enzyme. This causes those medications to build up in the bloodstream instead, which simply makes the drug more potent. However, it could also prevent medication from having a timely effect or releasing into the bloodstream when it’s expected to. On the bright side, just using CBD oil or another CBD product doesn’t mean that your CYP450 enzyme system is affected. Those results came from observing consistently high doses of CBD.
The lower dosages that come in a CBD oil tincture bottle will likely not cause the same extreme effects. We still need more research before we can find the exact dose of CBD required to make any significant difference for a drug interaction. As a rule of thumb, it’s safe to assume that the risk of drug interaction increases the more CBD you take in a daily sitting.
Serum Concentration Increase
CBD may cause an increase the amount of medication in your blood, otherwise known as serum concentrations, according to the District of Columbia’s Department of Health. Just like grapefruit, this means it may interact with beta blockers, calcium channel blockers, antiretrovirals, antihistamines, and antidepressants. Allergy pills, blood pressure medication, and even cholesterol drugs may absorb differently due to CBD blocking the liver enzyme it’s trying to metabolize through.
Again, this is only found in very high doses of CBD, some of which are stronger than an entire standard bottle of a CBD oil tincture. Low amounts of CBD such as standard serving sizes throughout the day don’t appear to affect how your body is processing other medicine (though a doctor’s second opinion is always recommended).
Timing Might be Everything
While you need to discuss with your physician the schedule for taking your drugs, some research suggests that the timing of when you take other medications and CBD might play a huge role in CBD’s interaction with those drugs. The goal is to reduce the workload of the liver. Medication that metabolizes in the liver enzymes are already causing the liver to perform its bodily function. However, all drugs have a half-life, and it doesn’t stay in your liver once it has been metabolized. You just have to wait long enough for the enzymes in your liver to regain a sufficient level of their function before using CBD oil. Drug interactions between CBD and other liver enzyme metabolizing medications may diminish after waiting a couple hours between taking your prescription medication and taking the cannabidiol. Your chances of a drug interaction could be lower by trying CBD throughout different times of the day.
Everyone processes CBD and other drugs differently, so you may experience different interactions than others or have little to no reaction even when you take medication in combination with cannabidiol. Heavily influenced by our body size, age, genetics, and sensitivity to chemical compounds, the effect medication will have and how our bodies will process it can vary greatly. This is just one of the reasons you want to speak with a certified health professional if you’re taking other medication to make sure it doesn’t interfere with a daily serving or more of cannabidiol.
The CBD Product You Choose Matters
There are a tremendous variety of CBD products available now – from CBD oil tinctures, to soft chews, to topicals, we see new products released every day for the industry. The way you decide to use CBD will contribute greatly to how it interacts with any medication you’re on. How much cannabidiol gets into the bloodstream varies from method to method.
For example, applying a topical CBD cream to a target area on the body, or maybe over a muscle spasm, means that the cannabidiol is only interacting with the CB receptors on the skin. The amount of CBD absorbed into the bloodstream topically is likely negligible, making it one of the safest options if you want to use CBD but don’t want it to interact with a more important prescription medication you’re taking. You can also ingest the cannabidiol directly through a CBD oil tincture, soft chew, or other edible product.
This reduces how much and how fast the CBD hits the bloodstream, taking the long route through the gastrointestinal system before heading to the liver to reach those important liver enzymes we keep talking about. Using this method to consume your CBD, you still lessen some of the CBD that’s absorbed into the enzymes in the liver. CBD oil sublingually is the second-best way to get the most effective dose possible. Swishing it around in your mouth, through your teeth, and substantially under your tongue will allow it to hit the highest surface count of capillaries. This is a direct route to your bloodstream, so you can expect the effects to hit the fastest and most effectively, lasting around the same amount of time as an edible might. While this is one of the best ways to get the most out of a CBD oil bottle, it also runs the chance of causing the CBD to interact most severely with any other medication.
The most direct route, an IV is the only way to get the CBD anymore directly into your bloodstream. However, you can also vape or smoke the product; some CBD oil formulas can even be used for both vaping and sublingual doses.
Don’t mix substances without receiving medical advice from a doctor first. We love seeing how many people have found the effectiveness of CBD daily, but your health is the most important factor. We use CBD to promote general wellness, so we want to be upfront about anything that substance might interact with.
Whether you’re taking your prescribed medications or you’re new to cannabidiol, speak with a certified health professional before you take your first serving. Alternatively, you can also check out our lab reports to feel more confident about the lack of contaminants and pollutants and accuracy of the cannabinoid content level we report. You can also check out the FAQ section for any other CBD related answers you are looking for.
In the meantime, we hope this answers any questions you had about how cannabidiol metabolizes in the body, how CBD interacts with other medications or prescription drugs, and, ultimately, which drugs should not be taken with CBD.
Blood Pressure Medication and CBD Oil Interaction
A growing number of Americans are turning to cannabidiol (CBD) to address a wide range of concerns from stress and anxiety, to pain and inflammation. But, with so many people using CBD oil, questions start to arise about potential interactions with common prescriptions, including blood pressure medications.
If you rely on blood pressure medication and want to use CBD oil as an alternative or supplement to your current treatment plan, here is an overview of everything you need to know about using CBD oil while taking blood pressure medications.
CBD Oil and Blood Pressure Medication Interaction
Because there are such a wide range of pharmaceuticals prescribed for lowering blood pressure, it’s impossible to speak in broad terms about how CBD oil interacts with them all. However, if you’re taking one of the more common medications for hypertension (valsartan, metoprolol beta blocker, lisinopril, amlodipine besylate, or hydrochlorothiazide), there are a few things you should take into consideration before using cannabidiol oil.
CBD oil is generally recognized as a safe and well-tolerated compound with little to no known side effects. However, while conclusive studies have not been published, it has been suggested that CBD oil may affect the efficacy of blood pressure medication in controlling hypertension. Conversely, blood pressure medication is also believed to potentially reduce the efficacy of CBD oil.
Furthermore, because cannabidiol is an inhibitor of the cytochrome P-450 enzyme system , CBD oil should be used cautiously when combined with medications that use this pathway; in the case of high blood pressure medications, metoprolol and amlodipine besylate specifically.
The cytochrome P-450 system is comprised of liver enzymes that break down medications into smaller substances that the body can more easily process. Cannabidiol and other natural substances like grapefruit slow down this pathway. This may cause medications that rely on the P-450 system, including metoprolol and amlodipine besylate, to remain for longer periods in the system and increase the likelihood that you experience their adverse side effects.
Side Effects of Using CBD Oil and Blood Pressure Medication
While adverse interactions between CBD oil and blood pressure medication are rare, they should be combined with caution and only under doctor supervision. In some cases, blood pressure medications may delay and/or reduce the beneficial effects of CBD oil. In others, CBD oil may delay and/or reduce the effectiveness of your prescribed blood pressure medication.
For reference, this table breaks down a few of the more common blood pressure medications and the side effects you may feel if taking them in conjunction with CBD oil.
|Generic Name (Brand Name)||Possible Side Effects of Combining Medication + CBD Oil|
|Valsartan (Diovan)||CBD oil may be metabolized slower when used in conjunction with Valsartan|
|Metoprolol (Lopressor; Toprol XL)||The antihypertensive function of Metoprolol may be decreased when combined with CBD oil|
|Lisinopril (Prinivil; Zestril)||The antihypertensive function of Lisinopril may be decreased when combined with CBD oil|
|Amlodipine besylate (Norvasc)||CBD oil may be metabolized slower when used in conjunction with Amlodipine besylate|
|Hydrochlorothiazide (HCTZ)||The antihypertensive function of Hydrochlorothiazide may be decreased when combined with CBD oil|
Another important thing to note is that since CBD oil reduces blood pressure on its own, when it is taken in tandem with medication designed to perform the same action, you essentially have two compounds bringing down your levels. If your blood pressure is reduced too much in a short amount of time, you may feel weak and lethargic. It is for this reason that starting with a small initial dosage of CBD is key.
Avoiding the Side Effects
With the above possible side effects in mind, you may feel dissuaded from trying CBD oil while on blood pressure medication. On the other hand, you might also consider using CBD oil on its own to manage hypertension. Amongst other benefits, CBD oil has been shown to reduce blood pressure by relieving anxiety, reducing stress, and widening blood vessels.
CBD oil’s anti-anxiety and stress-relieving properties encourage a lower heart rate, which ultimately reduces blood pressure. CBD oil’s ability to dilate blood vessels allows for easier blood flow in arteries with plaque build-up, which also reduces the symptoms of hypertension. In fact, a 2017 study found that a single dose of cannabidiol significantly lowered the blood pressure of test subjects both when at rest and in stressful conditions.
In a cumulative 2017 review of numerous studies on cannabidiol’s effect on blood flow, it was concluding that “ CBD may be used as a treatment for various cardiovascular disorders, such as hypertension, myocardial infarction, and stroke.” It is important to mention that the majority of these results were found in animal studies and more clinical research is needed in humans. Still, the findings are promising.
How to Safely Use CBD Oil and Blood Pressure Medication Together
Whether your goal is to supplement your current hypertension treatment plan with CBD oil, or to completely replace your blood pressure medication with CBD oil, you should begin by speaking with your doctor . Because CBD oil can interact with your current blood pressure medications, consulting with your physician on the possible risks—and benefits—is crucial for your safety and health.
You will want to be conscientious of dosage especially since CBD oil may amplify the effects of the medications you’re taking. CBD products generally come with an information leaflet that provides a recommended dosage, but you may want to start with an amount lower than what is recommended and gradually increase your dosage over time as needed. This will allow your body to build a tolerance to CBD oil and reduce the risk of having a sudden drop in your blood pressure.
For more information on proper CBD oil dosage, check out our dosage guide here .
Over a period of time, you may even find you are able to lower the dosage of your blood pressure medication as the CBD oil becomes most effective. If you choose to do this, speak to your doctor before discontinuing or altering your prescription medication. Any changes to your treatment plan are best done under the supervision and guidance of a medical professional.
If you’re still in need of guidance or would like more information on using CBD oil as a medical supplement, consider speaking with a naturopathic doctor who specializes in natural health treatments.
Best CBD Oil to Use with Blood Pressure Medication
In order to find the best CBD oil product, you need to know what you’re looking for. With thousands of products available online and in stores, how do you know where to start?
First, investigate the different CBD oil delivery formats to decide which one best fits your goals and lifestyle. CBD oil drops, edibles , capsules, and vapes a few of the more common options.
While the majority of people new to CBD oil opt for capsules and edibles because of their convenience and familiarity, it is worth keeping in mind that these will enter your body through the digestive system and therefore lose some potency and take longer before you feel the effects. Inhalants or sublingual drops meanwhile, allow the CBD oil to enter the bloodstream more readily, providing quick and effective results. Experiment with the different delivery methods to decide which works best for your needs and lifestyle.
Once you have decided on your preferred delivery format, look for top-rated CBD oil products that are sustainably sourced, organically grown, and third-party lab tested to ensure quality and purity. Taking these steps is the best way to ensure that your CBD oil product is free from any harmful pesticides, herbicides, and added chemicals.
And when you’re ready to shop, check out our list of the Top 10 Best CBD Products to Buy.