cbd and latudaDecember 15, 2021
Researchers from Penn State College of Medicine evaluated existing information on five prescription CBD and delta-9-tetrahydrocannabinol (THC) cannabinoid medications: antinausea medications used during cancer treatment (Marinol, Syndros, Cesamet); a medication used primarily for muscle spasms in multiple sclerosis (Sativex, which is not currently available in the US, but available in other countries); and an antiseizure medication (Epidiolex). Overall, the researchers identified 139 medications that may be affected by cannabinoids. This list was further narrowed to 57 medications, for which altered concentration can be dangerous. The list contains a variety of drugs from heart medications to antibiotics, although not all the drugs on the list may be affected by CBD-only products (some are only affected by THC). Potentially serious drug interactions with CBD included.
Products containing cannabidiol (CBD) seem to be all the rage these days, promising relief from a wide range of maladies, from insomnia and hot flashes to chronic pain and seizures. Some of these claims have merit to them, while some of them are just hype. But it won’t hurt to try, right? Well, not so fast. CBD is a biologically active compound, and as such, it may also have unintended consequences. These include known side effects of CBD, but also unintended interactions with supplements, herbal products, and over-the-counter (OTC) and prescription medications.
While generally considered safe, CBD may cause drowsiness, lightheadedness, nausea, diarrhea, dry mouth, and, in rare instances, damage to the liver. Taking CBD with other medications that have similar side effects may increase the risk of unwanted symptoms or toxicity. In other words, taking CBD at the same time with OTC or prescription medications and substances that cause sleepiness, such as opioids, benzodiazepines (such as Xanax or Ativan), antipsychotics, antidepressants, antihistamines (such as Benadryl), or alcohol may lead to increased sleepiness, fatigue, and possibly accidental falls and accidents when driving. Increased sedation and tiredness may also happen when using certain herbal supplements, such as kava, melatonin, and St. John’s wort. Taking CBD with stimulants (such as Adderall) may lead to decreased appetite, while taking it with the diabetes drug metformin or certain heartburn drugs (such as Prilosec) may increase the risk of diarrhea.
CBD can alter the effects of other drugs.
CBD has the potential to interact with many other products, including over-the-counter medications, herbal products, and prescription medications. Some medications should never be taken with CBD; the use of other medications may need to be modified or reduced to prevent serious issues. The consequences of drug interactions also depend on many other factors, including the dose of CBD, the dose of another medication, and a person’s underlying health condition. Older adults are more susceptible to drug interactions because they often take multiple medications, and because of age-related physiological changes that affect how our bodies process medications.
The researchers further warned that while the list may be used as a starting point to identify potential drug interactions with marijuana or CBD oil, plant-derived cannabinoid products may deliver highly variable cannabinoid concentrations (unlike the FDA-regulated prescription cannabinoid medications previously mentioned), and may contain many other compounds that can increase the risk of unintended drug interactions.
Many drugs are broken down by enzymes in the liver, and CBD may compete for or interfere with these enzymes, leading to too much or not enough of the drug in the body, called altered concentration. The altered concentration, in turn, may lead to the medication not working, or an increased risk of side effects. Such drug interactions are usually hard to predict but can cause unpleasant and sometimes serious problems.
Absolutely. Inhaled CBD gets into the blood the fastest, reaching high concentration within 30 minutes and increasing the risk of acute side effects. Edibles require longer time to absorb and are less likely to produce a high concentration peak, although they may eventually reach high enough levels to cause an issue or interact with other medications. Topical formulations, such as creams and lotions, may not absorb and get into the blood in sufficient amount to interact with other medications, although there is very little information on how much of CBD gets into the blood eventually. All of this is further complicated by the fact that none of these products are regulated or checked for purity, concentration, or safety.
People considering or taking CBD products should always mention their use to their doctor, particularly if they are taking other medications or have underlying medical conditions, such as liver disease, kidney disease, epilepsy, heart issues, a weakened immune system, or are on medications that can weaken the immune system (such as cancer medications). A pharmacist is a great resource to help you learn about a potential interaction with a supplement, an herbal product (many of which have their own drug interactions), or an over-the-counter or prescription medication. Don’t assume that just because something is natural, it is safe and trying it won’t hurt. It very well might.
Doubling up on side effects.
Does the form of CBD matter?
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Cannabidiol (CBD) is a chemical in the Cannabis sativa plant, also known as cannabis or hemp. One specific form of CBD is approved as a drug in the U.S. for seizure.
Fatty foods or drinks, such as whole milk, and alcohol can also make the body absorb more CBD.
CBD can be taken with food or without food. But taking it with food can cause the body to absorb more CBD than when it is taken without food. This might increase the effects of CBD.
The effectiveness ratings for CANNABIDIOL (CBD) are as follows:
When taken by mouth : CBD is possibly safe to take in appropriate doses. Doses of up to 200 mg daily have been used safely for up to 13 weeks. With the guidance of a healthcare provider, a specific prescription CBD product (Epidiolex) has been used at higher doses and for longer durations.
CBD can cause some side effects, such as dry mouth, low blood pressure, light headedness, and drowsiness. Signs of liver injury have also been reported with high doses of the prescription form of CBD, called Epidiolex.
Over 80 chemicals, known as cannabinoids, have been found in the Cannabis sativa plant. Delta-9-tetrahydrocannabinol (THC) is the most famous ingredient in cannabis. But CBD is obtained from hemp, a form of the Cannabis sativa plant that only contains small amounts of THC. CBD seems to have effects on some chemicals in the brain, but these are different than the effects of THC.
CBD has most often been used by adults in doses of 200 mg or less per day. Speak with a healthcare provider to find out what dose might be best for a specific condition.
Children : It is possibly safe for children to take a specific prescription CBD product (Epidiolex) by mouth in doses up to 25 mg/kg daily. This product is approved for use in children with certain conditions who are at least 1 year old. It isn’t clear if other CBD products are safe in children.
Parkinson disease : Some early research suggests that taking high doses of CBD might make muscle movement and tremors worse in some people with Parkinson disease.
For information on using prescription CBD, a product called Epidiolex, speak with a healthcare provider.
Laws passed in 2018 made it legal to sell hemp and hemp products in the US. But that doesn’t mean that all CBD products made from hemp are legal. Since CBD is an approved prescription drug, it can’t be legally included in foods or dietary supplements. CBD can only be included in “cosmetic” products. But there are still CBD products on the market that are labeled as dietary supplements. The amount of CBD contained in these products is not always the same as what is stated on the label.
Pregnancy and breast-feeding : It may be unsafe to take CBD if you are pregnant or breast feeding. CBD products can be contaminated with other ingredients that may be harmful to the fetus or infant. Stay on the safe side and avoid use.
A prescription form of CBD is used for seizure disorder (epilepsy). CBD is also used for anxiety, pain, a muscle disorder called dystonia, Parkinson disease, Crohn disease, and many other conditions, but there is no good scientific evidence to support these uses.
Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.
Liver disease : People with liver disease may need to use lower doses of CBD.
When applied to the skin : There isn’t enough reliable information to know if CBD is safe or what the side effects might be.
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