CBD Info

What Drugs Should Not Be Taken With CBD?: Prescription & OTC

Cannabidiol, or CBD, is a supplement that is often touted as something of a cure-all. It’s important to know CBD has the potential to interact with other medications. But which ones?

Be wary of any medication that has a grapefruit warning, because that means CBD can either intensify or nullify the effects. Drugs that should not be taken with CBD include:

Blood thinners
Antiepileptic Drugs
Antidepressants and Anxiety Medications
Heart and Blood Pressure Medications
Opioid analgesics
Immunosuppressants

Fortunately, those prescription medications that can interact with CBD can be easily identified with a bit of research. In this guide, we’ll break down specific details about a variety of common medications as well as symptoms to look out for.

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Does CBD interact with prescription drugs?

CBD often has a similar effect on medications as grapefruit juice, often either intensifying the effects of medications or weakening them when consumed at the same time.

This effect occurs because CBD is broken down by the same liver enzymes, the most prominent of which being CYP450 enzymes, as many common prescription and over the counter drugs. Since we only have a limited amount of these enzymes, if they’re all being used to break down CBD, the other drugs will not be broken down properly which may leave greater or lesser amounts of the drug to be absorbed into the bloodstream than the dosage intended.

This intensifying effect does not occur with all medications, but it can be potentially dangerous when interacting with drugs used to treat serious health conditions.

What medications should not be taken with CBD?

Based on the available information, several medications should not be taken with CBD or require
careful monitoring when used together.

Here’s a list of drugs that may interact with CBD:

Brivaracetam (Briviact)
Carbamazepine (Tegretol)
Clobazam (Onfi)
Lamotrigine
Phenytoin
Valproate
Citalopram (Celexa)
Fluoxetine (Prozac)
Lorazepam
Midazolam (Versed)
Warfarin
Amiodarone (heart rhythm medication)
Omeprazole (Prilosec)
Levothyroxine (thyroid medication)
Theophylline
Opioid analgesics (e.g., Morphine)
Benzodiazepines (e.g., Xanax)
Sedative medications (CNS depressants)

It’s important to note that this list is not exhaustive, and CBD has the potential to interact with
many other medications. The interactions can occur through various mechanisms,
including affecting liver enzyme metabolism (particularly CYP3A4 and CYP2C19) and inhibiting
UGT2B7 activity.

Potential consequences of mixing CBD with these drugs

While some individuals find they can and do mix these medications with CBD, these interactions can lead to:

Increased medication levels in the blood
Enhanced side effects of medications
Decreased effectiveness of medications
Potential liver function changes

Given the wide range of potential interactions, it’s crucial to consult with a healthcare provider
before using CBD, especially if you’re taking any prescription medications, over-the-counter
drugs, or herbal supplements. Your doctor may need to monitor medication levels and adjust
dosages accordingly.

Does CBD interact with common over the counter drugs?

Yes, CBD can interact with several common over-the-counter (OTC) drugs. Here are some notable interactions:

Acetaminophen (Tylenol): CBD may affect how the body metabolizes acetaminophen, potentially increasing its levels in the bloodstream.
NSAIDs (e.g., ibuprofen, naproxen): CBD might interact with these drugs, although more research is needed. Caution is advised, especially with diclofenac.
Antihistamines (e.g., diphenhydramine, loratadine, cetirizine): CBD may increase serum concentrations of antihistamine.
Caffeine: CBD might decrease how quickly the body breaks down caffeine, potentially increasing caffeine levels in the body.
Omeprazole (Prilosec): CBD may interact with this common acid reflux medication.

It’s important to note that while there haven’t been reports of serious drug-drug interactions with over-the-counter CBD products, these products are relatively new and not well-studied.

If you’re taking any OTC medications regularly, it’s advisable to consult with a healthcare provider before using CBD to ensure safe use and proper dosing.

Can you mix CBD and alcohol?

Yes, you can mix CBD and alcohol, but it’s important to understand the potential effects and risks:

Amplified effects: Combining CBD and alcohol may enhance feelings of relaxation and drowsiness.
Reduced blood alcohol levels: Some studies suggest that CBD might lower blood alcohol concentrations.
Impaired performance: The combination can lead to significant impairment of motor and psychomotor performances.
Potential protective effects: CBD may help reduce some alcohol-related harm, such as brain and liver damage.

However, caution is advised:

Moderation is key: It’s safest to consume both CBD and alcohol in low doses.
Individual responses vary: Effects can differ from person to person.
Limited research: Long-term effects of combining CBD and alcohol are not well-studied.
Increased risk of sedation: Both substances can cause drowsiness, potentially increasing accident risks

Can you take CBD oil with melatonin?

Yes, you can take CBD oil with melatonin. The two do not have any major negative interactions, and they may actually potentiate one another.

In fact, taking CBD oil with melatonin has anecdotally been shown to aid with sleeping problems, making it easier for people who might suffer from insomnia to get to sleep and stay asleep.

How can you avoid drug interactions?

If your medications come with a grapefruit warning, consider avoiding CBD, as this is an indication that this medication will need to be metabolized by CYP450 enzymes. Proceed with caution, and check with a doctor before starting a regimen.

Different products and dosages of CBD can mitigate or limit potential drug interactions. For instance, you may consider using CBD-infused topical medications, which does not enter the bloodstream but which may still provide the beneficial pain-relieving effects that you may be seeking from CBD.

Getting high-quality CBD products from reputable sellers is also quite important. Negative effects of CBD only become a serious threat if the CBD is mixed with other substances, which is why it is important to buy from trusted, well-reviewed sources. With our CBD directory, you can find a wide variety of CBD products, from topical creams, CBD isolates, gummies, oils, and more, for whatever your particular need or preference is, and you can feel confident in the quality of what you buy.

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Josh Murdoch

I was born with Cystic Fibrosis, and although it is incurable, cannabinoids have been allowing me to live my life as a healthy adult now for years. For that reason, I’ve dedicated my career to spreading the good news about cannabinoids. Currently, I work for a cannabis distribution company called Humble Cannabis Solutions which operates in California. Previously, I worked on two cannabis farms in northern California, one of which was located in the famous Humboldt County. I’ve also managed a medical cannabis delivery service in Marin County, California. I created CBD Facilitator to share what I’ve learned, and to recommend the best products that I have found in this chaotic market.