Is CBD Safe to Take with Prescription Drugs?
Raise your hand if this has ever happened to you: You’re taking CBD, whether as part of a medical routine or just because you enjoy the health benefits, but then, without warning, you get sick. Maybe it’s an infection, maybe’s it’s an injury, or maybe it’s just a random disease that needs treating, but you’re sick.
So, your doctor puts you on medication. “That’s it, no more CBD for me!” you think. Surely you are not supposed to mix CBD and other prescription medications… right?
Well, to be able to answer that, you first need to fully understand what CBD is, as well as why it would possibly interact with any other type of medication. In this article, we discuss whether or not it’s a good idea – or even safe – to take CBD with other medications.
What is CBD?
CBD is one of the cannabinoids found within the cannabis plant. These compounds are unique to this type of plant, evolved over millennia for the purpose of stopping mammals from eating their precious leaves.
Cannabinoids interact with a health system found within all mammals called the endocannabinoid system. When any cannabinoids are introduced to your body, they begin to interact with this system, stimulating the CB1 and CB2 receptors, both of which trigger different effects, which vary depending on what type of cannabinoid has interacted with them.
CBD interacts with both receptors, causing them to engage and trigger a variety of healing responses throughout the body. This healing response is different depending on which receptor is being specifically targeted.
For example, the CB1 receptor is primarily linked to the central nervous system and the brain, allowing it to affect the sensation of pain, as well as the release of neurochemicals like serotonin. The CB2 receptors, however, are spread more liberally throughout the body and are responsible for the healthy propagation of new cells.
Additionally, the CB2 receptors can help reduce the effect of inflammation, first discovered in the famous study by Carrier et al. CBD has the potential to help treat a huge number of different conditions, both physical and mental, thanks to the ECS. What’s especially interesting is the way in which CBD works when compared to THC.
When you consume regular, THC-laden cannabis, the THC binds itself to the ECS receptors and over-stimulates them, creating the famous mental high. With CBD, however, it triggers the cannabinoid receptors more gently, stimulating the receptors indirectly and thus engaging them slowly, allowing you to get the full effect of its healing properties without suffering from the negative effects of a high, or having reduced inhibitions.
What’s more, CBD isn’t really a drug in the same that THC – and thus, regular marijuana – is, primarily because it isn’t at all addictive. Alongside this, there have been no recorded deaths due to any kind of cannabis overdose in history, so you can see why it’s so popular.
However, if you’re taking a prescription drug, there are some valid concerns that it could interact with the drug, or your body, negatively. But why would CBD conflict with a drug — and is there really any risk?
Why Would CBD Conflict With Other Drugs?
To understand whether CBD could conflict with other drugs and cause problems, we need to understand how the body processes most drugs. When you put a drug into your system, either through ingesting it in the form of a pill or a drop or injecting it using a syringe, it all ends up in the same place: the liver.
The liver is where the body breaks down substances that aren’t digestible through the stomach. It contains special enzymes that work at breaking down substances so that your body can use them. The principal enzyme responsible for this is called Cytochrome P-450. This enzyme, commonly just called CYP450, is basically the entire reason that drugs work on us at all. Most of the time, when we take a drug, it won’t have any effect on the human body until it is broken down by CYP450.
When the drug is inside your liver, CYP450 works methodically to break down the enzymes and compounds within the substance, allowing your body to either utilize it or discard it as waste. Where problems can occur is if the operations of CYP450 are stalled or otherwise inhibited.
This is commonly seen in patients who eat grapefruit. A study for the Canadian Medical Association Journal found that, when a patient took prescription medication at the same time as eating grapefruit, the effects of the drug were disrupted.
What’s worse, the combination of the citrus fruit and the medication could potentially have serious health ramifications. This happens because, when you ingest grapefruit, it contains a natural enzyme that somewhat mimics CYP450. The body thinks that you already have enough CYP450, so it tells your already existing CYP450 enzymes to slow down and not work as efficiently. This means that your liver isn’t actively breaking down the drugs in your system.
This can be dangerous if the drug a patient is taking is important to their health, like for example if it is targeting a particular infection or illness, or such as when someone takes heart medication. However, the real danger comes from the potential of overdose.
Generally speaking, when you take a prescription drug, you take it multiple times over the course of the day. If you take a pill in the morning and then eat some grapefruit, the drug won’t be broken down. However, if you then take another pill later in the day as part of your prescription, only this time you haven’t eaten grapefruit, your body is suddenly forced to break down twice as much of the drug as would have normally.
This is because the drug remains sitting in your liver, unable to be broken down; it has nowhere to go, so it just sits quietly until enough CYP450 wakes up again. For patients taking drugs that can cause serious side effects, such as increased heart rates or the like, it can be quite fatal to eat grapefruit with them.
When it comes to CBD, it’s actually pretty much the same problem. CBD is similar to grapefruit in that it tricks the body into thinking you have enough of the CYP450 enzyme. Though it doesn’t work at nearly the same rate as grapefruit does, CBD can indeed still tell your body to shut off the CYP450 enzymes and stop working properly.
If you’re taking a vital medication prescribed by your doctor – especially one with serious side effects like overdose – then there is the potential for serious problems. However, the effect of CBD on your CYP450 is far, far reduced compared to grapefruit, similar in efficacy to watercress. That’s right; the most boring sandwich filler in the world can actually cause complications to your prescriptions drugs (it’s a good thing no one actually eats watercress).
So, Is it Safe to Take CBD with other Medications?
Despite the interesting aspects of CBD, both on a molecular level and on a physiological one, what’s really important is whether or not it’s actually safe to take with prescription drugs. The answer, as might be expected with anything medical, is to check with your doctor.
The amount required to negatively affect many prescription drugs are extremely high, far higher than any standard dose frequently recommended by doctors, so it is pretty unlikely that your CBD dose will affect your medication.
Where you might be better safe than sorry is in the case of heart medication – especially blood pressure reducers. This is because CBD, alongside all of its other medical benefits, reduces blood pressure thanks to its vascular relaxant properties. Combine CBD’s natural blood pressure reduction with the fact that it can cause drugs to not be metabolized in the liver, and you might find your blood pressure sinking very suddenly.
This happens because your blood pressure medication isn’t being metabolized due to your intake of CBD, but CBD is still lowering your blood pressure. Then, when CBD’s effects on your CYP450 enzyme wear off, you’ve likely taken another blood pressure relaxant, but this time it’s also mixing with the previous dose you’ve taken. In short, you’re likely in for a bad time if you’re on any kind of heart medication.
There is a lot of really interesting research being done into CBD oil’s capabilities to avoid metabolization within the liver due to Intestinal Lymphatic Drug Delivery, wherein CBD is absorbed directly into the intestinal lining thanks to its combination with coconut oil. However, until we know more about that, it’s likely best to stay away from CBD if you’re taking heart medication; you wouldn’t want your blood pressure to suddenly sink.
For most other medications, however, the best thing to do is consult your doctor. And don’t worry, CBD isn’t like THC, it’s legal pretty much everywhere. Your doctor isn’t going to give you a hard time about your CBD routine; he or she should be primarily concerned with making sure you don’t hurt yourself unintentionally.