CBD can interact with medication and mess up its levels in the body's systems. The cannabis derivative inhibits the CYP450 enzyme responsible for metabolizing drugs. Herein, we discuss the basics of drug metabolism, metabolism of CBD, the relationship between drug metabolism and CYP450, CBD and CYP450, reactions to taking drugs with CBD, and research on CBD with drug interaction.
Cannabidiol (CBD) has become a household name in recent years. Its wide array of benefits has grown its popularity. CBD is known to treat various symptoms, making it a safe drug for multiple medical conditions. Unlike tetrahydrocannabinol (THC), it is non-psychoactive; you will not experience the "high" effect associated with marijuana. However, it may interact with certain medications, leading to adverse effects.
Basics of Drugs Metabolism
Metabolism refers to how drugs are broken down in the body. Li et al. (2019) stated that drug metabolism is how a drug is processed and used in the body, mainly in the liver. Once ingesting a drug, it is broken down into active compounds in the liver. Afterward, specific enzymes transform the drugs into metabolites; it is the metabolites that affect various processes in the body.
The Relationship between Drug Metabolism and CYP450 Enzymes
The liver plays a significant role in drug metabolism. However, organs like the gut also make a significant contribution. Paniri et al. (2020) noted that CYP450, also known as cytochrome P450, is a group of enzymes responsible for converting chemical products to ease how they are eliminated in the body. Medications affect CYP450 differently; some may slow them down while others speed them up. The interference alters how the body processes certain drugs, leading to a drug interaction.
CBD and CYP450
According to Anderson et al. (2021), CBD is a supplement that may interact with the CYP450 in the liver. Cannabidiol binds to the region where enzyme activities take place. In turn, it competes with the CYP450 system by metabolizing other products. Various factors affect the inhibitory effects on CYP450, such as the dose of CBD, type of CBD, and an individual's physiology.
Reactions to Taking CBD with Other Medications
CBD is not a biologically inert chemical. The mechanism behind its medical benefits proves it. Its pharmacokinetics and pharmacodynamics show that it is complex and identical to other medications. Thus it can interfere with the metabolism of specific drugs. Any medication that depends on CYP450 can be affected by CBD.
Taking CBD Safely While Under Other Medications
Before taking CBD to ease whatever you are going through, you must communicate with a health practitioner first. They may help you know if the product and dosage are safe for you. Never cease taking your medications due to CBD unless advised to do so by your doctor. Beware that you can use other forms of CBD, like topicals, since they do not enter the bloodstream like vapes or oils.
CBD and Potential Drug Interactions
Grape Fruit Warning
Though studies are still ongoing concerning the interaction of CBD and other drugs, the one rule of thumb that helps is; to avoid CBD if the drug has a grapefruit warning. The warning notifies individuals that consuming grapefruit or its products is prohibited while taking that medication; it may cause higher medication concentration in the blood. Additionally, it may cause adverse effects or an overdose. Up to eighty-five drugs interact with grapefruit. The furanocoumarins (a compound in grapefruit) inhibit CYP3A4 drugs like CBD. As a result, it slows down medication metabolism.
Research on CBD and Its Interaction with Medications
Scientists are still researching how CBD interacts with different medications. A fair amount of data shows that CBD could interfere with medication levels even when taken under prescription. However, more research is needed to know how severe CBD interacts with specific drugs.
CBD Safety and Side Effects
You are required to use CBD only if your doctor has approved so. Your doctor will carefully supervise how your body reacts to CBD and other medications. When taking CBD and other drugs, you should look for changes that show how CBD affects you. Urits et al. (2020) noted that some of the adverse effects of CBD include:
changes in weight and appetite
Reasons for Talking to Your Doctor First
Before taking any CBD products, talking to a doctor first is recommended; doctors help you find the proper routine, eliminating negative interactions. Furthermore, some compounds work in tandem with CBD, so talking to a doctor may help maximize the treatment effect.
The Bottom Line
The World Health Organization and other health agencies confirm that the body tolerates CBD; hence it rarely causes side effects. Since CBD affects various systems, it is used for many therapeutic benefits. However, its therapeutic versatility makes it interacts with multiple medications. So, before taking CBD while taking any other medicine, seek medical advice; talking to a doctor helps establish a plan that works for you. Therefore, you may prevent the adverse effects of negative interaction between vital medication and CBD.
Li, Y., Meng, Q., Yang, M., Liu, D., Hou, X., Tang, L., ...& Bi, H. (2019). Current trends in drug metabolism and pharmacokinetics. Acta PharmaceuticaSinica B, 9(6), 1113-1144.
Anderson, L. L., Doohan, P. T., Oldfield, L., Kevin, R. C., Arnold, J. C., Berger, M., ...& McGregor, I. S. (2021). Citalopram and cannabidiol: in vitro and in vivo evidence of pharmacokinetic interactions relevant to the treatment of anxiety disorders in young people. Journal of clinical psychopharmacology, 41(5), 525-533.
Paniri, A., Hosseini, M. M., Rasoulinejad, A., &Akhavan-Niaki, H. (2020). Molecular effects and retinopathy induced by hydroxychloroquine during SARS-CoV-2 therapy: role of CYP450 isoforms and epigenetic modulations. European Journal of Pharmacology, 886, 173454.
Urits, I., Gress, K., Charipova, K., Habib, K., Lee, D., Lee, C., ...& Viswanath, O. (2020). Use of cannabidiol (CBD) for the treatment of chronic pain. Best Practice & Research Clinical Anaesthesiology, 34(3), 463-477.