Talk To Your Doctor – CBD and Drug Interactions
To date, over 100 cannabinoids have been isolated, and there are likely many more to come. Cannabinoids are found in both the Hemp plant and the Marijuana plant. As we have reviewed in other topics, the hemp plant is naturally full of cannabinoids with only a minor/trace amount of THC (the component of marijuana that makes you feel high). In addition to the abundance of cannabinoids found in the Hemp plant, full-spectrum CBD products such as The Physician’s Choice-CBD make use of the entire cannabinoid spectrum available from the hemp plant, including terpenoids to make use of the whole plant to obtain maximal clinical potential value.
With the passing of the Farm Bill of 2018, which has provided a legalized standard for hemp, CBD products have exploded to be abundantly prevalent online, in stores, and even at roadside stands throughout the country. However, does that means CBD is safe for you to use? In general, the answer to that is yes. The World Health Organization published a document in 2017 outlining all of the known risks of CBD, and in comparison to THC, the safety profile of CBD was found to be resoundingly positive.
However, there have been publications that have outlined that many products sold online or in stores are potentially a risk to take due to having more THC in the product than what is allowed by federal regulations. ¹ There were also products people spent their money on, which had no CBD at all.
However, everyone must understand that there are potential interactions that exist when using CBD and other medications or supplements.
To better understand this, we must understand a key aspect of how our bodies metabolize and make use of medications and other substances we use.
Once many substances (medications, drugs – legal or not-legal, vitamins, supplements, etc.) enter the body, there is a process by which those substances are metabolized. This process is facilitated by proteins we have called cytochromes. Cytochromes have numerous roles, yet for this topic being an overview, it is simply put that they are responsible for the metabolism and biotransformation of these various substances.
Certain drugs or medications can make cytochromes work more or less efficiently, thereby having a potential effect on other drugs or medications work in our bodies.
CBD is a potential inhibitor of certain cytochromes; THC has this potential as well. One example is a study showing inhibitory effects of the cytochrome system related to those using a blood thinner called warfarin (Coumadin). This in vitro (in the lab) study confirmed this interaction, but there is very little published data on the in vivo (human) interactions and clinical relevance.
For example, a case study of a single patient taking warfarin and CBD was published in 2018.² There was an association of CBD use and changes in warfarin metabolism, requiring the patient to reduce the warfarin dose over time. However, this individual was using CBD in a form approved for treating seizures. Doses used to treat seizures are markedly higher, upwards of 1800 mg a day or more, compared to doses individuals commonly use to help with other symptoms such as pain, sleep, and anxiety. For the latter, the daily dose is most commonly less than 100 mg a day. Therefore, the findings in this study will not always translate to clinical relevance for all individuals.
There are other interactions between CBD and other medications which have been identified as well…³
These interactions, however, were appreciated when CBD doses were also taken in much higher doses than what is most commonly being used by the public. Again, it is important to recognize that these interactions do not always mean that CBD is not an option, much like is the case with any medication or supplements someone is considering taking. Drug-drug interactions, drug-supplement interactions, and supplement-supplement interactions are always going to be a consideration.
Cannabis products should be part of your medication and supplement list so that your provider can provide the most thorough recommendations for you in optimizing your health. Although CBD is widely available and simple for any consumer to take off a shelf and use, physician-guided treatment with CBD is strongly recommended. It is essential for individuals considering CBD as an option to communicate with healthcare providers to understand CBD and these potential interactions.
The Physician’s Choice CBD is supported by providers across the country, and its physician providers recommend communication between CBD users and healthcare providers regarding the safe use of CBD or any cannabis products. Shop here
Bonn-Miller, Marcel & Loflin, Mallory & Thomas, Brian & Marcu, Jahan & Hyke, Travis & Vandrey, Ryan. (2017). Labeling the Accuracy of Cannabidiol Extracts Sold Online. JAMA. 318. 1708. 10.1001/jama.2017.11909.
Grayson, Leslie & Vines, Brannon & Nichol, Kate & P. Szaflarski, Jerzy. (2017). An Interaction between warfarin and cannabidiol, a case report. Epilepsy & Behavior Case Reports. 9. 10.1016/j.ebcr.2017.10.001.
E. Gaston, Tyler & Bebin, Elizabeth & Cutter, Gary & Liu, Yuliang & P. Szaflarski, Jerzy. (2017). Interactions between cannabidiol and commonly used antiepileptic drugs. Epilepsia. 58. 10.1111/epi.13852.
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