CBD and other medications: Proceed with caution – . Health Blog

Products containing cannabidiol (CBD) seem to be all the rage these days, promising relief for a variety of illnesses, from insomnia and hot flashes to chronic pain and seizures. Some of these claims are justified while others are just hype. But it doesn't hurt to try, does it? Well, not that fast. CBD is a biologically active compound and as such can also have unintended consequences. These include known side effects of CBD, but also unintended interactions with dietary supplements, herbal products, and over-the-counter (OTC) and prescription drugs.

Doubling the side effects

Although CBD is generally considered safe, it can cause drowsiness, drowsiness, nausea, diarrhea, dry mouth and, in rare cases, liver damage. Taking CBD with other medications with similar side effects can increase the risk of unwanted symptoms or toxicity. In other words, taking CBD with OTC or prescription drugs and substances that cause drowsiness, such as opioids, benzodiazepines (like Xanax or Ativan), antipsychotics, antidepressants, antihistamines (like Benadryl), or alcohol, can cause increased drowsiness, Fatigue and possible accidental falls and accidents while driving. Increased calmness and fatigue can also occur when certain herbal supplements such as kava, melatonin, and St. John's wort are used. Taking CBD with stimulants (like Adderall) can lead to decreased appetite, while taking it with the diabetes drug metformin or certain heartburn medications (like Prilosec) can increase the risk of diarrhea.

CBD can change the way other drugs work

Many drugs are broken down by enzymes in the liver, and CBD can compete for or interfere with these enzymes, causing too much or too little of the drug in the body, known as altered levels. The changed concentration can in turn mean that the drug does not work or there is an increased risk of side effects. Such drug interactions are usually difficult to predict, but they can cause uncomfortable and sometimes serious problems.

Researchers from Penn State College of Medicine evaluated existing information on five prescription-only CBD and delta-9-tetrahydrocannabinol (THC) cannabinoid drugs: antinausea drugs used during cancer treatment (Marinol, Syndros, Cesamet); a drug primarily used for muscle spasms in multiple sclerosis (Sativex, which is not currently available in the US, but is available in other countries); and an antiseizure drug (Epidiolex). In total, the researchers identified 139 drugs that can be affected by cannabinoids. This list has been narrowed down to 57 drugs for which an altered concentration could be dangerous. The list includes a wide variety of medications, from heart medications to antibiotics, although all drugs on the list of CBD products may not be affected (some are only affected by THC). Potentially serious interactions with CBD are included

• a common blood thinner, warfarin
• a heart rhythm drug, amiodarone
• a thyroid drug, levothyroxine
• various seizure medications, including clobazam, lamotrigine, and valproate.

The researchers also warned that while the list can serve as a starting point for identifying potential drug interactions with marijuana or CBD oil, herbal cannabinoid products may deliver vastly different cannabinoid concentrations (unlike the previously mentioned FDA-regulated cannabinoid prescription drugs). and may contain many other compounds that can increase the risk of unintended drug interactions.

Does the form of CBD matter?

Absolutely. Inhaled CBD gets into the blood fastest, reaches high concentrations within 30 minutes and increases the risk of acute side effects. Foods take longer to ingest and are less likely to produce a high concentration peak, although they may be high enough to cause a problem or interact with other drugs. Topical formulations like creams and lotions may not be able to absorb and get into the blood in sufficient quantities to interact with other drugs, although very little information is available on how much CBD ultimately gets into the blood. All of this is made more difficult by the fact that none of these products are regulated or checked for purity, concentration, or safety.

Bottom line: speak to your doctor or pharmacist if you are using or considering CBD

CBD has the potential to interact with many other products, including over-the-counter drugs, herbal products, and prescription drugs. Some medications should never be taken with CBD. The use of other drugs may need to be changed or reduced to avoid serious problems. The consequences of drug interactions also depend on many other factors, including the dose of CBD, the dose of another drug, and a person's underlying health. Older adults are more prone to drug interactions due to their frequent use of multiple drugs and age-related physiological changes that affect how our bodies process drugs.

Individuals considering or taking CBD products should always tell their doctor about their use, especially if they are taking other medications or have underlying conditions such as liver disease, kidney disease, epilepsy, heart problems, a weakened immune system, or taking medications that may affect the immune system weaken (like cancer drugs). A pharmacist is a great resource for educating you about a potential interaction with a diet supplement, herbal product (many of which have their own drug interactions), or an over-the-counter or prescription drug. Don't assume that just because something is natural is safe and it won't do any harm if you try. It could very well be.