HealthCan CBD Interact With Medications - All Facts & Side Effects 2024

Can CBD Interact With Medications – All Facts & Side Effects 2024

There has been a significant increase in the popularity of Cannabis sativa, primarily due to the increased use of CBD in recent times. This surge is attributed to the documented benefits of this natural remedy, resulting in a growing interest among individuals seeking relief from health issues such as chronic pain, insomnia, and anxiety.

It is crucial to have a discussion with your health care professional about the various supplements, vitamins, prescription drugs, and over-the-counter medications that you routinely take. In this article, you will gain insight into potential drug interactions associated with CBD.

Does CBD Interact With Medications?

Despite CBD's recent positive reputation, individuals with medical conditions who are prescribed medications should exercise caution regarding potential interactions between CBD and multiple medications.

Numerous studies support the safety of CBD with minimal side effects, but it is important to acknowledge that CBD may interact with other medications. Before beginning CBD use, it is imperative to inform and seek guidance from healthcare providers to mitigate any potential complications.

How Long Have People Been Using CBD?

People have been turning to CBD for centuries, with historical roots dating back to ancient civilizations. From traditional remedies to modern wellness trends, CBD has become a popular natural remedy for various ailments. Its enduring presence in human history demonstrates the enduring fascination with its potential health benefits.

What Types Of People Would Benefit From Using CBD?

CBD can offer potential benefits to a wide range of people. Those dealing with chronic pain, such as arthritis sufferers, may find relief in CBD’s anti-inflammatory properties. People with anxiety or sleep disorders may experience a sense of calm and improved sleep patterns.

Athletes can use CBD to aid in post-workout recovery, while individuals dealing with stress and everyday life challenges can turn to it for relaxation and stress management. However, it’s important to consult with a healthcare professional before incorporating CBD into your routine, as its effectiveness can vary from person to person.

Is CBD Safe To Use With Other Medications?

CBD interaction with medications image

Before incorporating CBD as a therapy to alleviate symptoms associated with certain health conditions, it is imperative to seek medical guidance from your physician. They should evaluate the type of CBD product, appropriate dosage, and scheduling to ensure that it does not interfere with your existing medications and is completely safe. In certain cases, medical professionals may monitor plasma levels of certain medications you are currently taking.

Stopping your regular medications to experiment with CBD is not advisable unless specifically directed by a healthcare provider. It’s worth noting that ingesting CBD via capsules, drops, vaping, or edibles is just one option. You can also explore CBD topicals, creams, lotions, and ointments. Unlike edibles, CBD oils, vaping solutions, and topicals typically do not enter the bloodstream, unless they are designed as transdermal solutions.

Understanding CBD Drug Interactions

Research conducted by two professors at Pennsylvania State Medical University has compiled a list of potential drug interactions involving CBD. Their investigation focused on identifying cannabinoids in CBD products that could affect the rate at which our bodies metabolize other drugs or compete for the same target receptors.

They studied products containing pure CBD as well as those containing delta-9-tetrahydrocannabinol (THC), evaluating a total of four cannabinoids. The researchers examined enzymes responsible for metabolizing both THC and CBD in the body and compared their findings with prescribing information for similar medications to identify potential drug interactions.

The resulting list of 57 drugs known to interact with CBD is available on the Pennsylvania State website. These medications include oral contraceptives, pain-relieving opioids, sedatives, and thyroid hormone treatments. CBD has the potential to increase blood levels of the anticoagulant drug Coumadin, as well as certain other medications, using a mechanism similar to that of grapefruit juice.

These drugs fall within a narrow therapeutic index, which indicates a minimal margin between an effective dose and a toxic dose. Such narrow margins make these interactions a significant medical concern because they can amplify the effects of the drugs. The researchers have also compiled a list of 139 drugs that may interact with cannabidiol but pose a lower risk. This list will be updated regularly as new evidence emerges.

Ongoing studies aim to uncover more potential interactions between prescription drugs and CBD. In the meantime, individuals considering CBD use should be cautious. They should avoid CBD if their medications contain grapefruit or have a grapefruit warning on the label. Such warnings indicate that grapefruit consumption should be avoided while taking these medications.

According to the FDA, consuming grapefruit while taking these medications can lead to increased drug levels in the bloodstream, potentially resulting in an overdose or adverse effects. Since both CBD and grapefruit juice can interfere with drug metabolism, any medications that are incompatible with grapefruit juice should also be avoided when using CBD.

The Role Of Cytochrome P450 In CBD And Drug Interactions

Cytochrome P450 is a group of enzymes responsible for the metabolism of cannabidiol (CBD), with a crucial enzyme called CYP3A4, which belongs to the same enzyme family, playing a significant role. However, CBD also has the potential to interfere with this enzyme. It’s worth noting that CYP3A4 is responsible for metabolizing about 60% of prescribed medications.

When CBD inhibits CYP3A4, it hinders the enzyme’s ability to efficiently break down medications in our system. Conversely, many drugs can also inhibit CYP3A4. Therefore, when you take medications along with CBD, your system may struggle to process CBD effectively. Slower metabolism of medications in the body means that there is an excess of medication present despite adhering to a normal dosage.

This excess of medication can intensify its effects, leading to potentially harmful and unwanted side effects. In addition, certain drugs can increase the activity of the cytochrome P450 enzyme group. When these substances activate these enzymes, medications may be metabolized too quickly, resulting in insufficient medication remaining in the body to treat the intended health condition.

Understanding Drug Metabolism And the Cytochrome P450 Enzyme

When drugs or other substances enter our bodies, they are metabolized or broken down. Drug metabolism takes place in several parts of the body, with a significant amount taking place in the liver. The cytochrome P450 family of enzymes plays a key role in this process by facilitating the conversion of foreign substances for easy elimination from the body.

However, certain drugs can affect the activity of CYP450 enzymes by either speeding up or slowing down the metabolism of drugs. These variations in metabolism can significantly affect how our bodies process medications or supplements, potentially leading to drug interactions in our bodies.

Drug & CBD Interactions – What Medications Should Be Avoided With CBD?

Many medications come with a grapefruit warning, but not all of them require the avoidance of grapefruit. Therefore, individuals considering the use of CBD or grapefruit in conjunction with these medications should prioritize seeking medical guidance before starting CBD.

  • Antibiotics and antimicrobials
  • Anticancer medications
  • Anti-anxiety, antidepressants, and drugs used to treat mood disorders
  • Antiepileptic drugs, valproic acid
  • Antihistamines
  • Antihypertensive medicines
  • Blood thinners
  • Cholesterol medications
  • Corticosteroids
  • Gastrointestinal medications used to treat GERD, nausea
  • Heart rhythm medications
  • Immunosuppressants
  • Medications for erectile dysfunction
  • Pain killers

What Research Reveals About Combining CBD With Medication

Medical CBD was first approved for the treatment of severe cases of epilepsy, specifically Dravet syndrome and Lennox-Gastaut syndrome. As a result, the FDA approved a CBD drug known as Epidiolex for these specific indications.

Numerous clinical trials have been conducted. In one study of 25 children, 13 of whom received both CBD and clobazam, an increase in clobazam levels was observed. The researchers noted that the use of both clobazam and CBD appeared to be safe, but they recommended careful monitoring of drug levels during treatment.

Another study involved 42 children and 39 adults who were already taking anti-epileptic drugs in addition to Epidiolex. The dosage of Epidiolex was gradually increased every two weeks, and researchers monitored serum levels of the antiepileptic drugs throughout the study. For most participants, serum levels remained within acceptable ranges. However, two drugs, desmethyl clobazam and clobazam, caused serum levels to fall outside the therapeutic range.

Safety And Side Effects Of Combining CBD With Other Medications

Under the vigilant supervision of a healthcare professional, it is generally safe to use medications in conjunction with CBD, even if they come with grapefruit warnings. Your doctor should closely monitor plasma serum levels of the prescribed medications and assess liver function. Therefore, if you’re using both CBD and medications, it’s important to remain vigilant for potential changes in how they affect you.

In cases where the dosage of either CBD or medication is increased, you may experience certain side effects, including drowsiness, nausea, sedation, and a potential reduction in the effectiveness of medications, such as breakthrough seizures medications. Common side effects associated with CBD use on its own include fatigue, weight fluctuations, changes in appetite, and diarrhea.

It’s important to note that CBD use may increase the risk of heart problems, and changes in blood pressure and heart rhythm may occur when combining medications with CBD, especially if they have similar effects on the cardiovascular system.

CBD In Combination With Alcohol

Combining CBD with alcohol can create a unique and surprisingly harmonious experience for some people. While alcohol is known for its potential to impair judgment and induce anxiety, CBD has a calming influence that can counteract these effects. Many people report feeling more relaxed and less prone to the typical jitters associated with alcohol when they consume CBD alongside it.

This combination can provide a smoother and more balanced way to enjoy a drink without the usual hangover or regret. However, it’s important to remember that individual reactions can vary, and moderation is the key to a safe and enjoyable experience when mixing CBD and alcohol.

What Effective Alternatives To CBD Are There?

Exploring alternatives to CBD opens up a world of possibilities for those seeking natural remedies. One intriguing option is kratom, a plant native to Southeast Asia known for its pain-relieving and mood-enhancing properties. Another alternative is kava, a root from the Pacific Islands that can promote relaxation and reduce anxiety.

For those looking to reduce stress and improve focus, adaptogenic herbs such as ashwagandha or rhodiola rosacea offer promising solutions. In addition, traditional herbal remedies such as valerian root can be effective for sleep problems.

These alternatives demonstrate the rich diversity of natural remedies available, allowing individuals to tailor their choices to their specific needs and preferences. It’s important to do your research and consult with a health care professional when considering any alternative therapy.

Frequently Asked Questions

Is it safe to take CBD alongside my regular medications?

CBD can interact with certain medications, potentially affecting their effectiveness. It’s essential to consult your healthcare provider before combining CBD with any prescribed drugs to ensure your safety and optimize treatment outcomes.

Can I stop taking my prescribed medications and switch to CBD?

No, abruptly discontinuing prescribed medications can be dangerous. Always follow your healthcare provider’s guidance regarding medication changes. They can help you explore safe options for integrating CBD into your treatment plan if appropriate.

What are the potential side effects of combining CBD with medications?

Side effects may include drowsiness, nausea, sedation, or reduced medication effectiveness. Monitoring and adjustments may be necessary to manage these effects.

How can I ensure my safety when using CBD with medications?

Consult with your healthcare provider for personalized advice. They can monitor your medication levels, liver function, and overall well-being to help you safely incorporate CBD into your treatment regimen.

What should I do if I experience side effects when using CBD alongside my medications?

If you encounter side effects, promptly inform your healthcare provider. They can help you adjust dosages or explore alternative treatments to minimize any adverse reactions.


When considering the use of CBD products alongside other medications, it is crucial to consult with a healthcare professional. Discontinuing prescribed medications in favor of CBD can pose serious risks to your health and well-being.

Exercise caution with medications that carry grapefruit warnings. In summary, always prioritize seeking professional guidance before embarking on a regimen that combines CBD with other prescription medications. Your health and safety are paramount.


  1. U.S. Food and Drug Administration. (2021). Grapefruit juice can affect how well some medicines work. Read Article.
  2. Abu-Sawwa, Renad, Scutt, B., and Park, Y. (2020). Emerging Use of Epidiolex (Cannabidiol) in Epilepsy. The journal of pediatric pharmacology and therapeutics, 25(6), pp. 485–499. Read Article.
  3. Geffrey, A.L., Pollack, S.F., Bruno, P., and Thiele, E.A. (2015). Drug-drug interaction between clobazam and cannabidiol in children with refractory epilepsy. Epilepsia, 56(8), pp. 1246–1251. Read Article.
  4. Chang, B.S. (2018). Cannabidiol and Serum Antiepileptic Drug Levels: The ABCs of CBD with AEDs. Epilepsy Currents, 18(1), pp. 33–34. Read Article.

Jayson Peterson is an experienced pharmacist, naturopathic physician, medical examiner, and minister. After earning his Doctor of Pharmacy degree from the Medical University of South Carolina, Jayson Peterson completed clinical rotations at several prestigious healthcare institutions and has been affiliated with several pharmacy chains throughout his career. His main passion and zeal is focused on providing world-class patient care by giving precise details and thorough instructions to those who need it most.



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