Avoid using CBD oil with pain relievers like morphine. You also want to avoid using CBD oil with benzodiazepines. Since it may cause extreme drowsiness, discuss the risks of CBD drug interactions when you take a depressant medication.
Hemp-derived CBD oil is safe for most users, largely because CBD leaves your system fairly quickly, and the negative side effects of CBD are relatively few, but CBD drug interactions raise concerns about your health. When you take blood-thinning medications, like Warfarin, you may have side effects or interactions with the hemp oil. Hemp oil and blood thinners do not have a positive interaction. Studies into the use of blood thinners and CBD oil show that it actually increases the amount of the blood thinner in the blood.
The use of CBD oil for inflammation and pain has become an exciting options for people who suffer (see our article, What is CBD? for more information). It offers a natural alternative to pain relievers that may help reduce certain health risks. The challenge is recognizing the potential dangers from interactions with your prescription medications. By evaluating the risks, you are able to discuss the benefits of using CBD oil with a medical professional to avoid potential drug interactions.
Depressant Medications With CBD Use
The negative side effects of CBD oil are not limited to medications that your liver breaks down or that thin your blood. CBD drug interactions with depressants are an area of concern. You should not use CBD oil and alcohol, or any other depressant, at the same time. The CBD oil may cause extreme drowsiness or sleepiness when combined with a depressant.
If you take Warfarin or a similar blood thinning medication, then you may need to reduce your dosage while you use CBD oil for pain management or other health concerns. Discuss the risks associated with hemp oil and blood thinners with your doctor before you start using CBD oil for pain management or other symptoms.
Since your liver breaks down the medication, the CBD oil may enhance the effects of the medication. This is one of the rare negative side effects of CBD. Depending on the medication, it may lead to a bleeding risk or other health risks due to the changes to your medication. You want to pay particular attention to non-steroidal anti-inflammatory medications, or NSAIDs, because the medication and the CBD oil have a similar impact on your body. CBD drug interactions with NSAID medications relate to the impact of the medication. Hemp oil and NSAIDs both focus on reducing inflammation in the body.
When you take a medication that your liver breaks down into a different substance in your body, such as Prilosec or Motrin, you may have interactions with CBD oil. CBD drug interactions with different medications depend on the way your liver breaks down the medication and uses the medication in your body. In many cases, the interaction will cause your body to increase the effectiveness of the drug or increase the amount of the drug in your system.
Caution is also advised when prescribing cannabis to people who are in therapy with sedative-hypnotics like barbiturates or benzodiazepines. This also includes other psychoactive drugs with an effect on the central nervous system. Cannabis has the potential to have an additive or synergistic effect with these drugs which can cause severe drowsiness, dizziness and other unwanted side-effects(3).
As a doctor who considers prescribing cannabis or a patient wishing to try CBD or medicinal cannabis, you need to be aware of how the cannabinoids might interact with other medications in the body.
Since some cannabinoids can inhibit enzymes like cytochrome P450 liver enzymes (CYP) as well as P-glycoprotein and UDP-glucuronosyltransferases it has the potential to interact with medications that are metabolised by these enzymes. One of the major patient groups to consider is the one with cardiovascular disease using blood thinners, so-called anticoagulant or antiplatelet treatment.
Cannabidiol can increase the risk of stroke by inhibiting CYP2C19 in people using clopidogrel
It is essential always to think carefully before initiating cannabis treatment and to monitor patients closely who have a history of unstable cardiovascular disease, myocardial infarction or stroke. If you are a doctor who has a patient on anticoagulant medications whom you know, or suspect uses cannabis, it might be worth bringing up this risk.
Delta-9-tetrahydrocannabinol, also known as THC, may inhibit cytochrome P450 enzyme CYP2C9, which is responsible for metabolising Warfarin, a blood thinner used for people who receive new heart valves, among others. This can cause the INR (elevated international normalisation ratio), a measurement of the time it takes the blood to clot to go up, which in turn can cause internal bleeding(1).
Cannabidiol (CBD) has been shown to inhibit the CYP2C19, which is responsible for converting clopidogrel to its active thiol metabolite. Clopidogrel is often given to people who had a heart attack (myocardial infarction) or a cerebral stroke. Since CBD can block the activity of CYP2C19, it has the potential to lead to sub-therapeutic levels of the active metabolite and consequently an elevated risk of stroke(2).
Lastly, cannabis might add to the depressive effects of alcohol on the central nervous system and you should advice patients to be careful when using these substances together.