Short answer: CBD drug interactions are processed in the liver via a specific enzyme (cytochrome P450-complex enzymes). Approximately 60% of prescriptions are metabolized by CYP3A4. (Source)
- Talk to your doctor before starting any type of CBD product to make sure there are “zero” CBD drug interactions with your medication.
Calculate your CBD dosage, with various CBD products.
CBD Drug Interactions meaning?
To begin understanding CBD drug interactions meaning, there’s a little bit of foundational information to wrap your mind around.
The DOH (Department Of Health) put together a 38-page slide show with the objective of finding common contraindications with cannabis, CBD, and other cannabinoids interactions.
According to MedlinePlus.gov, “contraindications” is when a specific drug, surgery, or procedure should “not” be used – due to adverse or harmful effects on the person.
Two types of contraindications are relative and absolute:
- Relative means to take caution when combining two or more drugs or procedures and only proceed if the benefits outweigh the risk.
- Absolute means mixing two or more drugs and/or procedures can be life-threatening and MUST be avoided.
Critical adverse events can occur in those who are pregnant, have allergies, or high blood pressure.
DOH (Department Of Health) slide show says the chemical profile more important than specific strain and should use analytical chemistry to determine cannabinoid and terpenoid content.
What are cannabinoids?
Cannabinoids are a class of chemical compounds existing in cannabis plants and naturally occurring in the human body.
Phytocannabinoids come from plants and endocannabinoids naturally occur in humans.
Cannabinoids interact with the human ECS (endocannabinoid system) and produce many physiological functions. Physiology is the “normal” function of an organism and its subsequent parts.
The ECS (endocannabinoid system) consists of CBR (cannabinoid receptors) located on nearly every cell and is one of the largest single systems in the human body.
All herbs – including Cannabis – are poly pharmaceutical, meaning it contains several drugs or chemical compounds.
In 2008, 108 cannabinoids have been identified and isolated.
What are terpenoids?
Terpenoids are organic compounds and are often found in several plants containing aromatic properties.
Common terpenes found in cannabis include myrcene, pinene, limonene, βcaryophyllene, and much more.
There are up to 420 other chemical compounds occurring in cannabis.
All quality CBD product companies lab test their products and provide a detailed COA (certificate of analysis) to display most of the chemical compounds.
Methods for consuming cannabis.
There are several types of cannabis/hemp products and only a handful of ways to consume them.
Common cannabis consumption methods include:
- Inhaling: Smoking or vaporizing – (40% bioavailability).
- Oral: Edibles or capsules – (13-19% bioavailability).
- Sublingual (under the tongue): Drops or extract paste – (15-25% bioavailability).
- Topical/Skin Balm – (Lower variable rate).
- Rectal: Suppository – (13.5% bioavailability).
- And more.
Bioavailability is the amount of the chemical compound the enters the body and has an active effect.
A higher bioavailability, the more of the “drug” gets fully absorbed into the body to initiate an effect.
What are the common adverse effects of cannabinoid consumption?
The DOH (Department Of Health) provides a list of the more common potential side effects triggered by phytocannabinoid consumption
Common cannabinoid side effects include:
- Reddened eyes.
- Decreased eye blink rate.
- Altered sense of time.
- Reduced tear flow.
- Changes in visual perception.
- Decreased sperm count.
- Dry mouth.
- Possibly associated with cavities & periodontitis (inflammation of gums and supporting structures of teeth).
- Slowed pupillary response to light.
- Reduced coordination.
- Ataxia (loss of full control of body movements).
- Dysphoria (unease or generalized dissatisfaction with life).
Now that we understand the effects of “only” cannabinoids – on the human body – it’s time to dig into what the research is saying about CBD interactions with other drugs and chemical compounds.
How does the human body process drugs?
When food, or drugs, are ingested – they first enter the stomach where they are digested.
After digested, they’re absorbed by the small intestine and then transported to the liver – via the portal vein. Once in the liver, they’re detoxified and then distributed throughout the circulatory system (heart, blood vessels, etc).
There are three phases in metabolizing food and drugs including:
- Phase 1: Enzymes Cytochrome P450 are responsible for small changes and make the substance more hydrophilic (wetter by water).
- Phase 2: Transferase enzymes makes more soluble (able to dissolve) if phase 1 wasn’t sufficient.
- Phase 3: Uses drug transporters to carry drugs over cell barriers.
Cytochrome P450 is the enzyme that metabolizes (degrade, wear down, and eliminate) drugs.
Government website MedlinePlus.gov has a running list of medications that CBD can interact with. CBD has the potential of interacting with certain medications, specifically, drugs changed and/or broken down by the liver.
What’s specific drugs, do we know of, that you should NOT combine with CBD and what drugs should you proceed with STRICT caution?
It’s HIGHLY recommended you do “not” take CBD in combination with the following prescription drugs:
- Valproic acid.
These two drugs are a “major” DO NOT take in combination with CBD and may cause increased side effects of clobazam. Taking CBD with valproic acid can trigger liver damage.
Be “cautions” when combining CBD with the following medications:
- Cytochrome P450 (1A1, 1A2, 1B1, 2A6, 2B6, 2C19, 2C9, 2D6, 3A4, & 3A5)
- Sedative medications (might cause too much sleepiness).
- Pentobarbital (Nembutal).
- Phenobarbital (Luminal).
- Secobarbital (Seconal).
- Thiopental (Pentothal).
- Fentanyl (Duragesic, Sublimaze).
- Propofol (Diprivan).
- And others.
MedlinePlus also cautions combining CBD with certih supplements and herbs (potentially causing too much sleepiness) including:
- California poppy.
- Jamaican dogwood.
- St. John’s wort.
- And others.
Until more specific research is conducted, we’re limited by what’s known.
Before adding CBD to your routine, please take a few moments to discuss it with your primary healthcare physician.