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How CBD Reacts with Prescription Medications

As the research continues to roll in, the therapeutic benefits of CBD become more and more clear. Users of CBD are finding relief from a variety of ailments, including anxiety, epilepsy, chronic pain, and insomnia. But many of us also take more traditional prescription medications to help relieve unwanted symptoms of illnesses or diseases. If you are taking a prescription medication, it’s important to understand how to safely add CBD to your daily routine. This article will go over how CBD interacts with your body, how it can affect the metabolism of certain medications, which medications are most likely to interact with CBD, and how to come up with a safe routine for taking CBD. Let’s get started.

What Is CBD?

Cannabidiol (CBD) is a chemical compound known as a cannabinoid. Cannabinoids are found in a variety of plants, including cannabis and hemp, as well as naturally within your own body. Inside your body, there is a network known as the endocannabinoid system (ECS). The ECS is a system of receptors, endogenous cannabinoids (called endocannabinoids), and enzymes that are tasked with keeping the body’s other systems in a state of balance, or homeostasis. When a system is out of balance, the body creates endocannabinoids and sends them to either activate or deactivate the appropriate receptors to restore that system to its proper state.

However, sometimes your body’s ECS is unable to perform this balancing act all on its own. This can happen due to illness, injury, stress, diet, or environmental factors. This is where CBD works its magic. By supplementing the ECS with outside cannabinoids like CBD, the body can overcome its shortcomings and restore homeostasis to those systems that need the extra help. Because the ECS is responsible for regulating so many of the body’s internal processes, adding CBD to your daily routine can offer a variety of therapeutic benefits.

Once the cannabinoids like CBD or the endocannabinoids produced by your body have done their work on the appropriate receptors, it is up to enzymes within your body to metabolize and remove them. This is where we find the potential impact of CBD on other prescription medications.

How CBD Can Affect Drug Metabolism

After you ingest a medication, be it prescription or over the counter, the body must break it down so that it can be eliminated from the body after it has done its job. This process happens in various parts of the body like the digestive system, liver, and kidneys.

When it comes to metabolizing and eliminating medications, one family of enzymes carries the bulk of the responsibility. Cytochrome P450 (CYP450) is a family of enzymes that helps to break down medications once they’ve been introduced to the body. 

When determining the correct dosage of a medication, it is important that CYP450 enzymes can metabolize it at a relatively consistent rate. If they metabolize too fast, you may end up with too little medication in your system and diminish its effects. If they metabolize too slow, you could have a potentially dangerous buildup of the medication in your system that might lead to unwanted side effects.

According to a 2018 study, the CYP450 family, and one enzyme within that family known as CYP3A4, is responsible for breaking down both prescription medications and CBD. A study done in 2017 has suggested that CYP3A4 may play an important role in metabolizing as much as 60% of prescription medications. Because CYP3A4 is involved in the metabolism of both CBD and many medications, using both simultaneously may influence the speed at which either or both are broken down and eliminated from the user’s body.

Potential Drugs That May Interact With CBD

Studies are currently underway that aim to understand the interaction between CBD and prescription medications more clearly but there is still a lot of work to be done. However, there is one good rule of thumb that can be used when determining whether to tread carefully when mixing CBD and prescription medications: the grapefruit warning.

Close-up of a warning label about consuming grapefruit on a bottle of prescription medication.

The Grapefruit Warning

I know, it sounds a little farfetched, but the grapefruit warning is a solid and reliable indicator that a medication should be approached with caution when it comes to using CBD alongside it. Grapefruits, and certain other citrus fruits like Seville oranges, pomelos, and tangelos, contain a chemical compound known as furanocoumarin. According to the United States Food and Drug Administration, these furanocoumarins found in grapefruits inhibit CYP3A4 and may lead to a higher concentration of the medications in the bloodstream than intended. This increased level of the medication can lead to unwanted side effects, and in dramatic cases, even overdose. Because CBD can also inhibit CYP3A4 in a similar way to grapefruit, the grapefruit warning listed on certain medications is the best indicator we currently have for medications that may have a negative interaction with CBD.

Common Medications with Grapefruit Warnings

According to a study published in 2013, there are over 85 medications that interact with grapefruit to some degree. Some of the types of medications that come with grapefruit warnings include:

  • Antibiotics
  • Antimicrobials
  • Anticancer Medications
  • Antihistamines
  • Antiepileptic Drugs
  • Blood Pressure Medications
  • Blood Thinners
  • Cholesterol Medications
  • Corticosteroids
  • Erectile Dysfunction Medications
  • Gastrointestinal Medications
  • Heart Rhythm Medications
  • Immunosuppressants
  • Mood Medications
  • Pain Medications
  • Prostate Medications

Not every medication within a given category will come with a grapefruit warning, so be sure to read your prescription information carefully or consult your pharmacist.

Young male pharmacist giving prescription medications to senior female customer in a pharmacy with female pharmacist in the background

Creating A Plan for CBD And Prescription Medication

With the right help and the right approach, you can still add CBD to your lifestyle for additional therapeutic relief of symptoms. The first, and most important step in that process is to make an appointment with your doctor.

With your doctor’s help, you can determine a dosage of CBD as well as a schedule so that you can safely add CBD as part of your treatment plan. By keeping your doctor involved and informed, you can also more closely monitor your symptoms and improvement, as well as monitor blood plasma levels of the prescription medications you’re taking to make sure that they aren’t becoming overly concentrated in your body.

doctor handing over prescription medication

It is important that you do not stop taking any of your prescription medications and replace them with CBD unless you have first been advised by your doctor that it is safe to do so.

Once you and your doctor have come up with a plan, you’ll want to keep a close eye on how you’re feeling in the weeks that follow up. You can read all about how to keep an effective CBD journal here. A good strategy is to make a list of the potential side effects that can arise from the medication, like nausea or drowsiness, and monitor whether any new or increased symptoms occur. You should also be looking out for any kind of decreased effectiveness of the medication. This would involve the return or worsening of symptoms the medicine was designed to treat.

FAQs

How does CBD interact with prescription medication?

CBD can sometimes interact with prescription medication by affecting the way the body metabolizes them. This is because CBD impacts the group of enzymes known as CYP450, which is used in the metabolization of both CBD and several prescription drugs.

What types of drugs interact with CBD?

Because CBD research is relatively new, we’re still studying which drugs specifically interact with CBD and how. However, drugs with the grapefruit warning on their label should be approached with caution.

Can I take CBD while on prescription medication?

Yes, you can take CBD while on prescription medication, but you should first consult your physician so that you can formulate a plan on what dosage to take and how often, as well as how to monitor its impact on drug metabolization.

Can I replace my prescription medication with CBD?

You should never replace a prescribed medication with CBD without first receiving the go-ahead from your doctor.

Wrapping It Up

When you’re taking prescription medications, you should always be mindful of how they may interact with the other things you’re putting in your body. It is possible that some medications could interact with CBD but right now the available research is limited. A good rule of thumb for determining if your medicine might interact with CBD is if it has a “grapefruit warning”. If you are on prescription medications, you should consult your doctor before starting a CBD routine so that you can make sure you safely add CBD to your treatment plan. After you and your doctor have decided on a plan, The Green Dragon is ready and waiting to help you find the perfect CBD product for your specific needs. We carry a variety of types and dosages of CBD products, all sourced from the most reputable producers. You can even get a one-on-one consultation through our contact page or simply leave us a message in the comments below!

ABOUT THE AUTHOR, SCOTT JONES

Scott Jones is a freelance writer, author, and digital marketer from Akron, Ohio. He loves to research and write about any and all topics that fascinate him, including CBD. He could afford to watch a few fewer movies and eat a few more vegetables. Connect with him on LinkedInInstagram, or read other posts by Scott.

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