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Before we take a look at how CBD interacts with medications, first we need to understand how the body’s metabolism works in general, the systems involved in CBD metabolism, how CBD is metabolized and how CBD affects something called the Cytochrome P-450 system.

It is estimated that the CYP system is responsible for metabolizing over 60% percent of any drug that has been consumed. And interestingly, pharmaceutical researchers and doctors also use cytochrome P450 system to understand, calculate and predict drug dosages effects as well as its potential side effects.

What Is Metabolism?

As mentioned, CBD also has the ability to interact directly with the CYP system in the liver. Preclinical research is showing that the way in which CBD does is by binding to the site where the enzyme activity occurs acting as a “competitive inhibitor”, displacing its chemical competitors, and thus preventing the CYP system from metabolizing other compounds.

It does through a system called the cytochrome P450 system (CYP) which consists of a special group of enzymes containing heme as a cofactor to convert fat-soluble compounds into more water-soluble compounds and aiding in their absorption and use.

However, despite the fact that the vast majority of the science indicates CBD oil is safe to use on its own, CBD is a powerful compound that interacts with a variety of systems within the body. And as such, CBD not only shows potential as a powerful therapeutic agent, but can become less benign when taken together with other substances such as pharmaceutical drugs.

The same goes for benzodiazepines (or benzos) like Xanax or Ativan, which are used to treat anxiety. If CBD is taken in conjunction with one of these drugs, it could increase the side effects and potentially cause you to feel more sedated or drowsy. In some rare cases, the drug combo may become toxic or even interfere with your respiratory system, according to Henry. Doctors suspect that certain antibiotics and even NSAIDs (think Aleve or Advil) are altered by CBD consumption as well, Hurd said.

The interest in cannabidiol (aka CBD ) ― a nonpsychoactive chemical found in marijuana and hemp plants ― is only growing. It has made its way into our shampoos and lotions . There are CBD-infused smoothies, bath bombs and beer. There are even holiday treats (looking at you, CBD jelly beans).

Researchers suspect CBD could interact with most medications

You may have heard of the grapefruit rule , which suggests that the citrus fruit can impair how your body absorbs certain drugs — mainly cholesterol medications, blood pressure drugs and allergy pills. That same mechanism is no different than CBD’s, Harvard Medical School reported . According to Henry, grapefruit inhibits the same set of liver enzymes that CBD blocks. So, like CBD, grapefruit juice can boost levels of other medications in your blood.

On the flip side, very low amounts of CBD don’t seem to have that much of an effect on how well your body processes other medications. But unfortunately, there hasn’t been enough research to determine how much CBD is considered safe.

Little is known about how CBD could affect other medications a person is taking, according to Yasmin Hurd, a CBD researcher and the director of the Addiction Institute at the Icahn School of Medicine at Mount Sinai. Still, Hurd suspects the substance could very well negatively interact with most medications that are taken orally.