What Does the Grapefruit Warning on My CBD Mean?

If you’ve ever dabbled in the CBD market, you might have spotted a peculiar warning on the label of your favorite product: something along the lines of “Avoid drinking large amounts of grapefruit juice,” or “Consult a doctor if you have been advised against eating grapefruit.” 

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Some seasoned medication users might be familiar with this warning, but to others, it can be baffling. Why would grapefruit have anything to do with medications? And perhaps more pressingly, what do CBD and grapefruit have to do with each other?

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You’ll need a bit of a chemistry lesson to understand what’s going on here. Below, we’ll dive into what grapefruit warnings mean, why you might see them on your CBD label, and what to do to follow them.

What’s the Deal With Grapefruit Warnings?

You might see what’s known as a “grapefruit disclaimer” on several medications. But why is grapefruit, specifically, a problem? Why aren’t other citrus fruits on trial, too?

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It all has to do with a compound found in grapefruits: furanocoumarins. When they enter your body, they bind with and essentially shut down enzymes in your gut. The problem? Those enzymes – namely CYP450 enzymes – are responsible for breaking down and eliminating drugs from your body.

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When these enzymes are out of commission, too much of the drug enters your liver and bloodstream. As it does, potency levels can rise rapidly, even to the point of posing serious health risks.

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While there are dozens of medications that grapefruit can interact with, some of the most common examples include those below.

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• Grapefruit and Antidepressants: It’s safe to consume grapefruit while taking many medications used to treat depression, anxiety, and other mental health conditions. However, some exceptions include sertraline (Zoloft), buspirone (BuSpar), and certain tricyclic antidepressants (TCAs).
• Grapefruit and Other Medications: Calcium channel antagonists and statin medications are among the most significantly impacted drugs. Most other “problem” medications affect some part of your cardiovascular health, blood, or immune system. This includes things like anticoagulants, immunosuppressants, cholesterol medications, and more. 

What CBD and Grapefruit Have in Common

So, grapefruit might not be the best snack to chow down on if you take certain prescription medications. But where does CBD come into the mix? We already know that CBD interacts with prescription medications; in some cases, it’s for the same reason that grapefruit does. 

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Like grapefruit, CBD binds with neutralizing enzymes and renders them unable to do their job. In fact, research suggests that CBD has an even more potent effect because it binds to multiple areas of the gut and liver – grapefruit mainly affects the small intestine. 

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Regardless, it can take days for enzyme function to return to normal. So, you might see a warning indicating that you shouldn’t consume CBD if you’ve been advised to avoid grapefruit.

Bringing it All Together: Understanding the Risks

It’s easy to brush off CBD and grapefruit warnings: we don’t often hear about the realities of cannabis drug interactions in the news. But that doesn’t mean these concerns never arise or shouldn’t be taken seriously. When you mix CBD or other cannabinoids with medications that aren’t compatible, you’re risking a lot more than the efficacy of your medicine.

Overdoses

The main problem with CBD and grapefruit alike is that they neutralize enzymes your body usually uses to flush drugs from your system. Without that mechanism in place, drug doses can quickly build up in your organs and bloodstream. 

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Even if you don’t continuously take more doses of a medication, the fact that your body can’t break it down means it might stick around for much longer than you’d think.

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Sometimes, mixing cannabinoids and medications – say, Xanax and CBD – can prove to have serious consequences. More medication than your body can handle might build up without you even realizing it. And when the medications you’re taking come with dangerous side effects, it’s especially important to dose as instructed by your doctor.

Uncertainty About Interactions

Another key issue is that we just don’t know which medications – or doses of medications – will interact with CBD problematically. While there are some examples we’re aware of, there’s always the chance that there are more out there than we currently know of.

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To exemplify this, a 2020 study conducted by researchers at the Penn State College of Medicine looked at information on cannabis-based prescription medications like Epidiolex. The review identified 139 medications that might be affected by cannabinoids. 57 of those medications can have dangerous consequences when their concentrations are altered. 

Unintended Side Effects

Both CBD and the medications it interacts with can have side effects. On its own, CBD can cause nausea, diarrhea, drowsiness, and headaches. But when you take CBD with a medication with its own side effects, you double the risk of experiencing unwanted symptoms. 

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That might not sound so bad, but it’s important to consider potential safety risks. Overwhelming sleepiness, for instance, might put you at risk for falls or accidents while driving. 

Are CBD, Grapefruit & Cannabis Off the Table?

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So, what do you do if you take a medication with a grapefruit warning? Unfortunately, if you can’t have grapefruit, cannabis might not be for you either. The only way to know whether CBD is safe for you is to talk to your doctor. Only a professional can evaluate your risk level and advise you on how, if at all, you can safely use CBD, THC, or other products.

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There is some logic that suggests some forms of CBD might be worse than others, too. Since inhaling cannabinoids gets them into your blood the fastest, smokeable products are probably not the best low-risk option. Topical CBD products like creams likely won’t put enough cannabinoids in your bloodstream to cause a problem at all. 

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But since we don’t know much for sure, it’s always best to check in with a healthcare provider. Your health isn’t something to mess around with, no matter how tempting your favorite cannabis products may be.

The Bottom Line: Like Grapefruit, CBD Isn’t for Everyone

You probably never thought of CBD and grapefruit as one and the same, but to your gut enzymes, they essentially are. That means medications with grapefruit warnings essentially come with CBD warnings, too. 

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We can blame CBD’s ability to keep the body from ridding itself of medications for this phenomenon, but that doesn’t mean it’s all bad news. Once you talk to your doctor and understand whether CBD is right for you, it may still be possible to find products that fit your needs. 

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You can always count on us at The Green Dragon CBD to give you the information and advice you need to make a sound decision. To learn more, contact us for a free consultation today. 

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Do you suffer from diabetes? Read here about CBD for Diabetics.