CBD AND INTERACTIONS WITH MEDICATIONS
How does CBD work in conjunction with drugs? The combination of CBD and certain drugs may significantly increase or decrease the efficacy of the drug. If you are using products belonging to the group of medicines below, we recommend that you discuss the use of CBD products with your doctor.
On the website, we highlight the possible interactions of CBD with commonly used drugs
CBD works in the body through cannabinoid receptors and is excreted mainly by the liver. The cytochrome p450 enzyme plays a key role in the metabolism of CBD and CBD can increase the activity of these enzymes. These CYP enzymes are found especially in the liver, but also everywhere else in the body. CYP enzymes play a key role in drug metabolism. CBD and certain drugs may increase or decrease the effectiveness of the drug in a dangerous way.
On this page you will find a list of drugs that have been found to work in combination with CBD. The list is not complete and there may be interactions with other medicines in addition to those listed.
CBD AND EPILEPSY
In clinical trials, CBD has been shown to reduce epileptic seizures, e.g. in patients with Dravet’s syndrome. However, concomitant use of CBD and antiepileptic drugs has caused side effects in some patients. They have been common with carbamazepine (Tegretol), among others.
Other medicines that may interact:
Absenor, Deprakine, Orfiril, Frisium, Inovelo, Topimax, Zonegran, Zebinix.
CBD AND CHEMOTHERAPY
Many chemotherapy drugs are metabolized by the cytochrome p450 enzyme and may therefore have strong interactions with CBD. Caution should be exercised when using CBD with at least the following drugs:
Etoposide (e.g. Etoposide, Eposin)
Paclitaxel (Paclitaxin, Paclitaxel)
Interactions are not always negative. For example, the combination of paclitaxel and CBD reduces the resulting neuropathic pain
CBD AND CARDIOVASCULAR MEDICINAL PRODUCTS
CBD can interact with many heart medications, such as statins. Statins are drugs for fat metabolism that inhibit the liver’s own cholesterol synthesis. The liver thus produces less cholesterol-containing particles in the bloodstream. There are also several beta-blockers on the interaction list.
Nifedipine (Adalat, Procardia)
Valsartan (Valsartan, Diovan)
Pitavastatin (Livazo, Vezepra)
CBD AND MENTAL MEDICINES
Most antidepressants do not interact with CBD. Buspirone (Aksilon, Buspiron), used to treat generalized anxiety disorder, is often prescribed in addition to antidepressants. It is metabolised by the cytochrome p450 enzyme and may therefore have strong interactions with CBD. Clomipramine (Anafranil) also has similar strong interactions
CBD AND BLOOD PRESSURE MEDICINES (calcium channel blockers)
Calcium channel blockers, blood thinners, and medications used to treat high blood pressure and arrhythmias can cause severe symptoms with CBD. CBD reduces or prevents the breakdown of drugs, for example, with warfarin (Marevan), potentiating its effect.
OTHER drugs that cause interactions are at least listed below.
Valsartan (Amlodipine, Valsartan)
Nifedipine (Adalat, Nifedipine Alternova)
Torasemidi (Torasemid, Torem)
Felodipine (Felodipine, Plendil)
CBD AND CALMING MEDICINES (benzodiazepines)
Benzodiazepines are used to treat anxiety, insomnia, nausea, depression and panic disorder.
Some benzodiazepines, such as alprazolam (Alprox, Xanor, Alprazolam) and diazepam (Diapam, Diazepam Accord), do not degrade as rapidly as CBD. As a result, their concentrations may become too high.
Alprazolam (Alprox, Xanor, Alprazolam, Xanax)
Triazolam (Triazolam, Halcion)
Diazepam (Diapam, Diazepam Accord)
Midazolam (Dormicum, Midazolam)
Quatsepam (Aldizem, Cardizem)
Triazolam (Triazolam, Halcion)
CBD AND ANTIOBIOTS
In particular, fluoroquinolones (Ciprofloxacin) may interact strongly with CBD.
Ofloxacin (Tarivid, Exocin)
CBD AND OTHER INTERACTION MEDICINES
Cholesterol: lovastatin (Mevacor, Lovastatin)
Antimicrobials: ketoconazole (Nizoral) & itraconazole (Sporanox)
Cortisone preparation: methylprednisolone (Solu-Medrol, Solomet)
Antihistamines: fexofenadine (R Fexorin) & terfenadine (Telfast)
Erectile Dysfunction Drug: Sildenafil (Viagra)
Cholesterol lowering drug: simvastatin (Simvastatin, Zocor)
- Geffrey A.L. ym.l. Drug-drug interaction between clobazam and cannabidiol in children with refractory epilepsy. 2015. https://pubmed.ncbi.nlm.nih.gov/26114620/
- Gaston T.E. ym.. Interactions between cannabidiol and commonly used antiepileptic drugs. 2017. https://onlinelibrary.wiley.com/doi/abs/10.1111/epi.13852
- P Consroe, A Wolkin. Cannabidiol–antiepileptic drug comparisons and interactions in experimentally induced seizures in rats. 1977. https://pubmed.ncbi.nlm.nih.gov/850145/
- Holland M. L. Interaction of plant cannabinoids with the multidrug transporter ABCC1 (MRP1). 2008. https://pubmed.ncbi.nlm.nih.gov/18619955/
- Ward. S.J. Cannabidiol inhibits paclitaxel-induced neuropathic pain through 5-HT(1A) receptors without diminishing nervous system function or chemotherapy efficacy. 2014. https://pubmed.ncbi.nlm.nih.gov/24117398/
- Devitt-Lee A. Cannabinoid-Pharmaceutical Interactions. 2018. https://www.projectcbd.org/medicine/cbd-drug-interactions-what-you-need-know
- Yamaori. S. ym. Cannabidiol, a Major Phytocannabinoid, As a Potent Atypical Inhibitor for CYP2D6. 2011. https://dmd.aspetjournals.org/content/39/11/2049
- Dr. Roman. Clopidogrel and CBD Interaction. 2017. https://natureswaymedicine.com/clopidogrel-and-cbd-interaction/
- Multum. C. Drugs.com: Clomipramine 2020. https://www.drugs.com/mtm/clomipramine.html
- Ghovanloo M. ym. Inhibitory effects of cannabidiol on voltage-dependent sodium currents. 2018. https://www.jbc.org/content/early/2018/09/14/jbc.RA118.004929.full.pdf
- Kerstin Iffland & Franjo Grotenhermen. An Update on Safety and Side Effects of Cannabidiol: A Review of Clinical Data and Relevant Animal Studies. 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5569602/
- Showing BioInteractions for Cannabidiol (DB09061). https://go.drugbank.com/drugs/DB09061/biointeractions
- Stott C, ym. A Phase I, open-label, randomized, crossover study in three parallel groups to evaluate the effect of Rifampicin, Ketoconazole, and Omeprazole on the pharmacokinetics of THC/CBD oromucosal spray in healthy volunteers. Springerplus. 2013. 2:236.Crossref, Medline, Pubmed: https://pubmed.ncbi.nlm.nih.gov/23750331/
- Benowitz N.L ym. Metabolic and psychophysiologic studies of cannabidiol-hexobarbital interaction. Clin Pharmacol Ther. 1980;28:115–120.Crossref, Medline Pubmed. https://pubmed.ncbi.nlm.nih.gov/7389248/