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CBD continues to gain popularity at an incredible pace, and many people view this non-intoxicating cannabinoid as perfectly safe since it does not have any serious side effects . At the same time, however, cannabidiol is a powerful compound that can dramatically alter your biochemistry, so it’s only natural that CBD interacts with certain prescription drugs .
In most cases, these potential interactions between CBD and prescription drugs only cause mild negative effects, and you might be surprised by how many prescription drugs CBD doesn’t interact with at all. If you plan to use CBD or you’re already using this cannabinoid, however, you should be aware of CBD’s potential to interact with popular prescription drugs and what you can do to avoid any resulting unwanted effects.
Does CBD interact with prescription drugs?
Whenever you take a drug, supplement, or another kind of bioactive substance, your body needs to break that substance down via a process called metabolism. In the context of prescription drugs, this process is called drug metabolism , and various substances you ingest can change how your body metabolizes prescription drugs. In recent years, scientists have learned a lot about how CBD affects your body, and they’ve identified one mechanism in particular by which this cannabinoid could dramatically affect the drug metabolism process.
CBD and CYP450 enzymes
Your body primarily uses digestive enzymes within the CYP450 family to metabolize CBD and most other cannabinoids. Within this family, one enzyme, in particular, CYP3A4, is mainly responsible for breaking CBD down and making it usable within your body’s various tissues.
While it is being used to break down CBD, CYP3A4 is prevented from metabolizing other drugs that you take subsequently or that were already in your system before you ingested CBD. Research indicates that up to ⅔ of all prescription drugs rely on CYP3A4 for proper metabolism, which means that taking CBD is more likely to interfere with drug metabolism than not.
Taking prescription drugs can also reduce the effectiveness of CBD since substances that use CYP3A4 for metabolism have to “fight” over this enzyme when they are ingested together. If you rely on prescription medication for your health, however, your primary concern is how CBD might make your prescribed drugs less effective.
CBD and the grapefruit warning
Have you ever seen a prescription drug label that warns you not to eat grapefruit while using the drug in question? These warnings are provided because grapefruit , like CBD, contains substances that can inhibit the action of CYP3A4 in your body.
While most prescription drugs that might interact negatively with CBD don’t offer warnings stating as much, it’s become the norm to add grapefruit warnings to drugs that are reliant on CYP3A4 for proper metabolism. As a result, it’s relatively easy for prospective or current CBD users to determine whether their medications might be unsafe to use with CBD.
It’s not only grapefruits that contain substances that interfere with CYP3A4. Many types of citrus fruits, such as pomelos, tangelos, and oranges can also cause problems with drug metabolism. Consult with your doctor if you’re not sure whether a drug you’re taking might be inhibited by ingesting grapefruit, other citrus fruits, or CBD.
How does CBD interact with popular prescription drugs?
Just because CBD interacts with the majority of prescription drugs doesn’t mean that this cannabinoid necessarily interacts with the drugs you’re taking. Plus, the severity of CBD’s potential drug interactions varies from drug to drug. It’s always a good idea to consult with a doctor before you start using CBD if you’re using prescription medications, but start by looking through the following information to learn more about how CBD interacts with prescription drugs you might be taking:
CBD and opioids
Most opioids do not interact with CBD since they metabolize into your system without using enzymes in the CYP450 family. Codeine is the only opioid drug known to interact with CBD , and in recent years, this drug has mainly been replaced with hydrocodone and other modernized opioids.
CBD and metformin
Metformin is a drug that is commonly used to treat diabetes. This drug is not metabolized using CYP3A4 enzymes, so its effects are not hindered by CBD. Metformin does, however, inhibit CYP3A4 even though it isn’t dependent on this digestive enzyme, which means that taking metformin could reduce the potency of CBD that you ingest.
CBD and benzodiazepines
Benzodiazepines, such as Xanax, are reliant on CYP3A4 for metabolism. Taking CBD with Xanax, therefore, may increase the amount of time this benzodiazepine remains in your system, which could intensify this common anti-anxiety medication’s adverse effects.
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Statins, which are used to lower cholesterol and decrease the likelihood of developing cardiovascular conditions, are metabolized using CYP3A4. CBD may, therefore, increase the intensity and duration of the effects provided by statins, making it more likely that you will experience adverse effects.
CBD and metoprolol
Metoprolol is a beta-blocker that reduces your heart rate by decreasing the amount of epinephrine your body produces. Since one of the most commonly reported side effects of CBD is reduced blood pressure, taking metoprolol and CBD together could result in dangerously low blood pressure levels.
CBD and amlodipine
Amlodipine is a cardiovascular drug that reduces blood pressure and treats heart pain. Your body metabolizes this drug using CYP3A4 , so taking amlodipine and CBD together could decrease this drug’s effectiveness and lead to toxicity issues.
Which types of drugs might interact negatively with CBD?
In general, any drug that interacts with the CYP450 family of enzymes in your body could negatively interact with CBD. When used without the presence of any prescription drugs in your system, CBD’s inhibition of CYP3A4 is harmless and could even be beneficial. Since so many prescription drugs are reliant on CYP3A4 for their metabolism, however, using CBD in combination with your prescriptions could cause harmful effects that may even become seriously dangerous under certain circumstances.
Keep in mind, however, that these negative effects are not caused by CBD specifically. Rather, it’s the fact that both CBD and many prescription drugs have to “fight” over CYP3A4 enzymes that makes it potentially dangerous to take CBD with drugs you’ve been prescribed. Just because CBD can interact with prescription drugs does not make this cannabinoid dangerous or toxic. Rather, you simply need to be careful about which drugs you take when you decide to use CBD.
After trying CBD, many people have decided to stop using their prescription drugs altogether. This is not a decision that should be taken lightly, and you should always consult with your doctor before making any changes in your daily drug intake. With everything we’re learning about CBD and its potential benefits, however, you may find this natural, largely side-effect-free cannabinoid to be preferable to conventional prescription treatments, which can cause serious side effects.
How do the different ways you can take CBD to affect drug interactions?
In most cases, research into the potential interactions between CBD and prescription drugs has been conducted in the context of orally ingested CBD. Based on the limited studies that have been published, the greatest risk for interaction between CBD and prescription drugs occurs when you ingest this substance orally, and other routes of administration may decrease the potential of harmful interactions.
Any substance that enters your bloodstream, however, eventually needs to be metabolized by CYP3A4 or a similar metabolic system. This means that even if you don’t take CBD orally, the potential for this cannabinoid to interact with drugs you’ve been prescribed still exists as long as the ingestion method you’ve chosen introduces CBD into your bloodstream.
The only CBD administration method that doesn’t deliver this cannabinoid into your bloodstream in high concentrations is topical administration. Unless a CBD topical has specifically designed for transdermal absorption (absorption through the skin and into the bloodstream), the effects of topical creams, salves, and lotions containing CBD generally remain localized to the site of application.
What about inhaling CBD?
While it would be convenient if smoking or vaping CBD overcame the drug interaction potential associated with orally ingesting this cannabinoid, inhaling CBD delivers this cannabinoid into your bloodstream with even greater bioavailability than oral ingestion. As a result, the potential of a drug interaction occurring when you inhale CBD is even higher than when you orally ingest a CBD tincture, capsule, or edible.
Therefore, it’s important to be incredibly cautious when using CBD in conjunction with prescription medications. Even applying this cannabinoid topically could result in negative drug interactions, and we still don’t know enough about CBD to appreciate the true scope of this cannabinoid’s ability to interact with common prescription drugs. The results of interactions between prescription drugs and CBD are usually so mild that they aren’t even noticed, but an abundance of caution is still merited.
Is CBD safe if I’m not taking prescription drugs?
Over the years, scientists have done their best to discover any side effects of CBD that may merit removing this cannabinoid from the consumer market. Try as they might, however, the best drug researchers of our time have been unable to come up with a coherent argument that CBD is fundamentally unsafe.
While it’s true that CBD’s interactions with your body’s CYP3A4 enzymes can cause issues when you use this cannabinoid in conjunction with prescription drugs, CBD does not appear to cause any serious harmful effects at all when used on its own.
In some cases, CBD can cause minor digestive discomforts such as indigestion, diarrhea, or nausea, and this cannabinoid is also commonly reported to cause drowsiness, sedation, or dry mouth. Compared to the sometimes life-threatening side effects of common prescription drugs, however, it’s clear why so many consumers have decided to accept these minimal risks and use CBD for a wide variety of different serious conditions.
Always consult with your doctor
If you are unsure whether CBD will interact with a prescription medication that you are currently taking, you should consult with your doctor before using cannabidiol for the first time. This non-intoxicating, non-addictive cannabinoid exerts remarkably gentle effects, and the same even holds true for CBD’s potential drug interactions.
In every case, it isn’t CBD that’s the culprit behind the dangerous effects that occur when you take this cannabinoid with other drugs. It’s just the fact that many prescription drugs on the market are only safe when they’re metabolized at a specific rate, and CBD can inadvertently make these drugs become toxic by causing them to stay in your system for longer than they should.
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CBD alone, with no other medications or supplements, has positive results for patients with high blood pressure.
So, the first and foremost reason patients combine CBD with heart medications like beta-blockers is for high efficacy.
Meaning, many patients combine CBD with beta-blockers to experience an effective reduction of high blood pressure or expect stabilized blood pressure levels throughout the day.
The second and perhaps the most overlooked reason why CBD oils are combined with beta-blockers is to negate the side effects of beta-blockers.
How CBD Oil Helps Relieve the Side Effects of Beta-Blockers
Some of the most common side effects of beta-blockers are nausea and fatigue. Many user experiences believe the use of CBD has a high potential to relieve these common side effects.
However, some users also state, CBD oil may sometimes worsen the side effects of beta-blockers if you take the wrong dose.
CBD oil in general helps to reduce the experience of nausea across a range of health conditions. This can range from general motion sickness to chemotherapy-induced nausea.
Along these lines, some users also make the connection that the use of CBD oil will also help to negate nausea induced by beta-blockers. This is why some will advocate for taking CBD oil if you begin to feel nauseous after taking a beta-blocker.
CBD is also being studied in an ongoing process to assess its effectiveness in promoting wakefulness.
Surprisingly, many studies have concluded that taking smaller doses of CBD oil helps increase wakefulness, alleviating daytime sleepiness caused by factors like sleep apnea, substance abuse, or certain medications.
So, it’s reasonable to say that patients who experience fatigue or drowsiness as a result of beta-blockers may find relief in taking CBD oil along with beta-blockers.
Interactions of CBD Oil and Beta-Blockers
CBD is a natural compound and is generally considered very safe with tolerant compounds. This also makes CBD oil exhibit very few unintended side effects.
However, CBD oil inhibits the cytochrome P-450 enzyme system in the liver. So, because of this, any medications that use this cytochrome P-450 enzyme system as a pathway for processing the medication face a threat or a risk.
One such medication that uses this specific pathway for processing medications is beta-blockers. So, CBD oil can interact with beta-blockers, and in turn, the effectiveness of both beta-blockers and CBD oil may be undermined.
Giving a clearer breakdown of this, the P-450 enzyme system breaks down toxins into substances the body can process.
These toxins include certain medications too. Taking CBD oil, along with natural compounds like grapefruits, has resulted in slowing down the metabolic process of the P-450 enzyme pathway.
CBD Inhibits Pathways
When the P-450 pathway is filled or occupied with something like CBD oil, the time taken for your body to process other things, like beta-blockers, is delayed.
This is because CBD inhibits the pathway’s ability to break down the medication and enable it to work in the body.
When the beta-blockers are not broken down, higher amounts of active ingredients stay in the system for a longer period. Not only that, but the active ingredients from beta-blockers also stay unmetabolized for longer in the P-450 pathway.
This delayed time required to process and metabolize beta-blockers increases the likelihood that you’d experience the side effects of the interaction.
So, it’s pretty clear, CBD oil can interact with beta-blockers, and the primary reason for this comes with CBD oil inhibiting your body’s ability to break down beta-blockers.
Side Effects of Combining CBD Oil and Beta Blockers
The side effects of taking CBD oil and beta-blockers include low to very low blood pressure.
This is because beta-blockers are designed in a way to reduce your heart rate by slowing down or preventing the release of the stress hormone “adrenaline.” This is primarily how beta-blockers help with lowering blood pressure and relieving stress.
On the other hand, CBD oil does the same thing. CBD oil relieves stress and is shown to be effective in lowering high blood pressure.
Nevertheless, CBD oil also amplifies the effects of beta-blockers. This means as beta-blockers reduce high blood pressure, CBD reduces the blood pressure even further.
This will result in your body lowering blood pressure beyond what would be considered healthy.
Feeling tired, lethargic, dizzy, and weak are some common symptoms of low blood pressure. In extreme cases, such as when your blood pressure reduces too much, you could faint or even move into a state of shock, which are all medical emergencies.
How to Safely Use CBD Oil with Beta-Blockers
As it’s clear, both CBD oil and beta-blockers reduce blood pressure levels, so the key to using both safely is to find the right balance.
To find the right balance, the first and foremost thing to do is consult your doctor.
You can also speak to a professional in alternative medicine who specializes in CBD-based medical treatments.
It would be typically recommended that if you were to combine CBD oil and beta-blockers that you start with the lowest dose possible. You can then gradually increase your dose if need be. However, you must consult your doctor for medical advice to ensure you are not putting yourself at any risk.
Tolerance to CBD Oil
Some patients find their body beginning to build a tolerance to CBD oil. This means that they can phase out the use of beta-blockers.
For this, you can try lowering the dose of beta-blockers and gradually increase your CBD oil dosage.
However, this must be done under the guidance and advice of your doctor.
For some, CBD oil might be seen as a natural alternative to beta-blockers, and this may be the case for you. But tread with caution. Beta-blockers can serve as a life-preserving medication and should not be messed with lightly.
So, before taking CBD oil and beta-blockers, always consult your doctor regarding any changes in these medications.
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