People considering or consuming CBD products should always consult their doctor before doing so, especially if they are taking other medications or have underlying medical conditions such as liver disease, kidney disease, epilepsy, heart problems, a weakened immune system, or are taking medications that can weaken the immune system. While generally considered safe, CBD can cause drowsiness, lightheadedness, nausea, diarrhea, dry mouth and, in rare cases, liver damage. Taking CBD with other medications that have similar side effects may increase the risk of developing unwanted symptoms or toxicity. In other words, taking CBD together with over-the-counter or prescription medications and substances that cause drowsiness, such as opioids, benzodiazepines (such as Xanax or Ativan), antipsychotics, antidepressants, antihistamines (such as Benadryl), or alcohol, can lead to increased drowsiness, fatigue, and possibly accidental falls and accidents while driving. Increased sedation and tiredness can also occur when using certain herbal supplements, such as kava, melatonin, and St.
Taking CBD with stimulants (such as Adderall) may cause a decrease in appetite, while taking it together with the diabetes medication metformin or certain heartburn medications (such as Prilosec) may increase the risk of diarrhea. CBD can be harmful to the liver. People with liver failure should be careful or avoid it. Although CBD is legal at the federal level, it's not without safety risks. With the growing popularity of over-the-counter CBD products, it's important to know the potential side effects and drug interactions that may arise.
Drug interactions with CBD can be a cause for serious concern, especially for people who take frequently prescribed medications, such as antidepressants and blood thinners. Drug interactions with CBD can lead to increased side effects or other problems if left unchecked. One aspect of CBD makes it particularly susceptible to drug interactions. CBD is not only processed by CYP enzymes, but it can also act as an inhibitor of the CYP enzyme.
Specifically, CBD can block enzymes that process other medications, such as certain anti-seizure medications, antidepressants, and pain relievers. Simply put, taking CBD can lead to increased blood levels and the side effects of other medications. CBD is commonly used together with anticonvulsants or anti-epileptic drugs, but is known to interact with several anti-epileptic drugs. Certain antiepileptic drugs, such as carbamazepine, oxcarbazepine, phenobarbital, and phenytoin, can affect CBD metabolism and cause a decrease in CBD levels.
Combining CBD with these anti-epileptic drugs may ultimately reduce the effects of CBD. Studies have shown that taking CBD with Depakote (valproic acid or valproate) can cause abnormally high levels of liver enzymes, which may indicate liver problems. Patients using CBD with these antiepileptic drugs should be monitored for liver diseases or injuries. In addition, CBD may increase the effects of some antiepileptic drugs, such as phenobarbital and phenytoin, which could cause toxicity due to these antiepileptic drugs.
People who combine anti-epileptic drugs and CBD may need to adjust the dose and increase monitoring. CBD can block the action of the CYP2D6 enzyme, which can lead to decreased metabolism and increased blood levels of certain antidepressants, including tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs). This interaction can lead to increased side effects of antidepressants. The side effects of CBD and antidepressants can also overlap, as CBD and antidepressants are associated with side effects in the central nervous system (CNS), such as drowsiness and sleep disorders.
In addition, CBD and antidepressants may increase the risk of suicidal thoughts or behavior. CBD can alter the metabolism of benzodiazepines, which are prescription drugs that can treat insomnia, anxiety, or seizures. In particular, the use of CBD can increase blood levels of several benzodiazepines, such as clobazam, diazepam, and lorazepam, which can lead to increased side effects of these benzodiazepines. Some side effects of CBD and benzodiazepines may overlap.
There may also be a greater risk of drowsiness and coordination problems when using CBD with benzodiazepines. Health care providers will want to closely monitor the use of benzodiazepines. with CBD to prevent serious side effects. The use of CBD can also alter the metabolism of different anticoagulants, including anticoagulants and antiplatelet agents.
Taking CBD with warfarin may increase the risk of bleeding. A case report found that a patient taking CBD and warfarin needed to reduce their warfarin dose by 30% to decrease the risk of bleeding. Clopidogrel is an antiplatelet agent that is metabolized into a active form in the liver. CBD can block the metabolism of clopidogrel, making the drug less effective and increasing the risk of stroke.
Special precautions should be taken for people who are more likely to experience an interaction while taking CBD. Products containing cannabidiol (CBD) obtained at commercial retail outlets in the state of Mississippi are compared to what is stated on the label. People considering or considering using CBD products should always talk to their doctor, especially if they are taking other medications or have underlying medical conditions, such as liver disease, kidney disease, epilepsy, heart problems, a weakened immune system, or if they are taking medications that can weaken the immune system (such as anticancer drugs). When sertraline, an SSRI, was administered in combination with CBD in a mouse model of post-traumatic stress disorder, the combination produced a synergistic action on cognitive and emotional disorders (intense anxiety and aggressive behavior).
CBD inhibits CYP2C19 and CYP3A4, which catalyze the metabolism of N-desmethylclobazam (NCLb), an active metabolite of clobazam11,31—33. Research shows that CBD may have several benefits for various ailments, such as pain, inflammation, and anxiety. CBD is a non-psychotomimetic phytocannabinoid that has a wide range of potential therapeutic effects, including anxiolytic, antidepressant, neuroprotective, anti-inflammatory, and immunomodulatory properties without stimulating or convulsive properties. A recent trial investigated the impact of CBD on the steady-state pharmacokinetics of clobazam (and NCLb), stiripentol, and valproate. CBD-rich oral cannabis induces clinical but not endoscopic response in patients with Crohn's disease, a randomized controlled trial.
Drugs that increase the activity of the CYP enzyme, called enzyme inducers, can accelerate the metabolism of CBD and decrease its overall effectiveness. The consequences of drug interactions also depend on many other factors, such as the dose of CBD, the dose of another medication, and the person's underlying health status. However, Epidiolex is the only FDA-approved CBD oil, which is available to treat certain types of seizures. The sedative effects of CBD are similar to those of alcohol, so it's not a good idea to use it if you need to drive or do any activity that requires mental acuity.
In addition, CBD may interact with naproxen, tramadol, celecoxib, etoricoxib, fluoxetine, and tofacitinib, as they are metabolized in the liver by cytochrome P450 enzymes. These include the known side effects of CBD, but also unwanted interactions with supplements, herbal products, and over-the-counter medications. (OTC) and prescription drugs. In animal models, CBD (a) blocks or reduces the spread of generalized seizures induced by maximal electroshock or gamma-aminobutyric acid (GABA) inhibitor drugs, (b) blocks simple partial seizures induced by the topical application of convulsive metals to the cortex, and (c) increases the seizure threshold for electrical combustion.