Is CBD Safe to Take With Prescribed Medications?


One of the biggest questions I’ve come across lately is related to CBD and other medical drug interactions and if CBD is safe to take with other medications?


Considering we do not know what is really in some of these prescribed medications and how they work with the body compared to how Cannabidiol (CBD) works with the body, this is indeed a very legitimate question.


First and foremost, virtually every chemical compound, including CBD, will interact with other compounds. As an example there are 82 identified drug interactions with caffeine (of which most you cannot even pronounce, let alone know what they are used for) that are mostly related to the heart. I’ll bet you didn’t know that your morning grapefruit is known to interact with many prescription drugs.


When it comes to cannabis, most potential interactions that have been identified are relatively mild. And, in fact, some drugs seem to work together with cannabis favorably.


Let’s start with the good…

Drugs That Affect Blood Sugar Levels

There is lose evidence to suggest CBD may decrease insulin resistance, improve the metabolic process, and improve blood sugar control. This could potentially help diabetic patients, however, most evidence comes from large epidemiological studies that analyze general patterns, including the causes and effects of various health conditions within specific populations. Based on several of these studies that found that cannabis users had lower rates of obesity and diabetes when compared to non-users, it has been inferred that CBD can help diabetic patients. However, far fewer studies look specifically at how THC, CBD, or other cannabinoids interact with other drugs, such as insulin, that have known effects on blood sugar.


Anecdotal evidence suggests it’s possible that CBD may work together with certain drugs favorably. Most importantly, there is always a risk that cannabis combined with other drugs could lower glucose levels too much.


Suffice to say, patients should continually monitor the effects under the guidance of their physician to mitigate potential risks and adjust medication appropriately.


Drugs That Lower Blood Pressure

If you are taking CBD with THC, one of the major features of THC is that it activates the CB1 and CB2 cannabinoid receptors. Activating both receptors induces a cardiovascular stress response that can elevate cardiac oxygen consumption while reducing blood flow in coronary arteries, which can reduce blood pressure while maintaining optimal cardiac oxygen consumption (myocardial oxygen supply is the amount of oxygen provided to the heart by the blood which is controlled by the coronary arteries). While reports of adverse events are relatively rare, patients who are taking blood pressure medication need to be aware that CBD with THC may compound effects and need to consult their physician before taking any CBD or cannabis.


Opioids

Most studies suggest there is a relational response between the body’s natural opioid system (that controls pain, reward and addictive behaviors) and the body’s natural cannabinoid system (the endocannabinoid system). Identifying the specific method by which they interact has been challenging.


Having said this, CBD (that includes THC) pain-relieving properties are well-studied. An increased number of medical professionals have come forward to suggest CBD, that includes THC, as an alternative pain medication that could play a role in slowing down the overuse of prescription drugs and opioids.


It is hard to question CBD as a first-line recommendation for management of chronic pain as substitute to opioid pain medications from an overall abuse potential and toxicity perspective. READ MORE


Alcohol

Mixing alcohol with virtually any drug is generally never a good idea. In fact, mixing it with some drugs (particularly opioids and central nervous system depressants like benzodiazepines, barbiturates, and sleep meds) can prove fatal. However, many of us take prescriptions drugs without ever reading the label to see if there are adverse effects to drinking while take these medications.


There’s no doubt: CBD and alcohol is becoming a popular combination. But what does the research say? Is mixing these two substances okay? Overall, drawing a conclusion based on available research is subject to interpretation and personal biases.


READ MORE


That being said, users still needs to be cautious. For one, alcohol and CBD together pose a greater danger while driving than when using alcohol independently. Second, if someone has had too much to drink, to the point where they need to vomit to get the alcohol out of their system, we know that CBD can inhibit nausea and vomiting. By stopping yourself from vomiting, you’re putting yourself at greater risk of suffering from alcohol poisoning. Always proceed with caution when alcohol is in the mix.


Sedatives

Many sedatives–including the aforementioned alcohol, benzodiazepines (Ativan, Valium, etc.), some antidepressants, phenobarbital, and codeine–effect your neurotransmitters in the central nervous system, which produces an overall calming effect.


When combined with sedatives, CBD produces an additive effect. CBD doesn’t seem to elevate blood levels or enhance the sedative, therefore, while it’s not as risky as mixing alcohol with sedatives (which can prove deadly), the combination can still be risky. CBD users should exercise extreme caution or even avoid the combination altogether.


CBD and Cytochrome P450 And Blood Thinners

CBD may increase the effect of drugs used for blood thinning, such as warfarin or heparin. Included in these are drugs known to carry their own risk of blood thinning, such as ibuprofen, naproxen, etc.


How? By slowing down the metabolism of these drugs. What does this mean? It means that these drugs take longer for your body to break them down and can increase the intended effects. As an example, CBD inhibits breakdown of warfarin (a blood thinner), thereby increasing its duration of action and effect that could potentially be problematic for the patient.


Although evidence shows that CBD is largely safe, well-tolerated, and non-addictive (in some instances anti-addictive), in some cases it can have a synergistic effect (beneficially or adversely) with other drugs. Patients taking CBD should pay close attention to changes in blood levels and adjust dosage under the supervision of their doctor. In addition, patients who are undergoing chemotherapy and taking CBD should be aware that the same dose of chemotherapy may have a similar effect.


Final Thoughts

For the majority of people, CBD is safe, well-tolerated, and carries fewer risks of drug interactions than many other commonly prescribed drugs. Just listen to the end of a commercial on TV with all the disclosures. CBD derived from hemp is a complex plant comprised of numerous compounds from cannabinoids to terpenes. These cannabinoid and terpene have potential drug interactions, both good and bad. Coming up with broad conclusions on how this “miracle plant” interacts with other drugs simply too difficult to be precise.


Nonetheless, given its therapeutic qualities, as one of the most compelling arguments for CBD is that it can actually decrease the need to combine multiple medications that have a high risk potential of producing adverse interactions with similar effects.

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