The cannabis plant contains hundreds of chemicals and more than 100 different cannabinoids. CBD or cannabidiol is one of the second most common cannabinoids found in the cannabis plant after THC. However, CBD shows potential health benefits from various serious illnesses and diseases such as anxiety, depression, insomnia, and cancer. But one question that makes us wonder how safe is it to take CBD when taking other medications or drugs? Based on research and studies, if CBD is used in combination with other medical predetermined medicines, problems can arise. Experts need more research to determine the real problems caused by mixing CBD and other drugs.
In this article, we will discuss everything you should know about consuming CBD with other drugs.
The Drug metabolism process:
CBD mainly works by interacting with the endocannabinoid system and maintains body functions. Although CBD does not directly bind to ECS receptors, it can provide some of the best medical benefits. We can consume CBD in different ways through management methods, which play a fundamental role in how CBD is broken down and distributed in the body. Once our body consumes and absorbs CBD, it enters the liver, metabolized into various compounds used by cells. Then, CBD metabolites pass through the body from the liver, where they can interact with multiple receptors. This metabolism is carried out by the same set of enzymes responsible for breaking down approximately 60% of all medical drugs.
CYP450 and CBD:
Almost half of the drugs depend on CYP450 enzymes for their metabolism. But what is CYP450, and how is it related to CBD? Cytochrome P450 or CYP450 enzymes are essential for producing thromboxane A2, cholesterol, prostacyclin, and steroids. They are also necessary for foreign chemical detoxification and drug metabolism. These enzymes bind to cell membranes, contain heme pigment, and absorb light with a wavelength of 450 nm when exposed to carbon monoxide. Now, what is the relationship between CYP450 and CBD? CBD will disable CYP450 and vice versa. Cytochrome P450 enzymes metabolize CBD and at the same time acts as a competitive inhibitor of the same liver enzymes. CBD occupies the enzyme's active site and replaces its chemical competitors, preventing cytochrome P450 from metabolizing other compounds. However, if the dose of cannabidiol is low enough, it will not significantly affect CYP activity. Although, it can still play different roles of CBD in the human body.
What drugs should you avoid when taking CBD?
As we already mentioned, CBD is broken down by a large liver enzyme family called CYP450. However, CBD also inhibits some enzymes in this family. This causes them to break down certain drugs more slowly. This may increase the side effects of CBD. But since CBD also prompts other enzymes to accelerate the breakdown of certain drugs, their effects may be reduced. However, these drugs may still show an effect, but only if the doses are increased.
If CBD is used with the following drugs, you may experience more side effects:
- Antidepressants such as fluoxetine or Prozac
- Heart-related drugs that contain calcium channel blockers
- Drugs like antipsychotics, benzodiazepines that cause drowsiness
- Macrolide antibiotics like erythromycin, clarithromycin
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But how will you know which drugs should not be taken with CBD?
The easiest way to determine is to look for a grapefruit warning before mixing CBD with other drugs. Grapefruit is recommended on the label of any medication to warn against consuming citrus fruits while taking the medication. Grapefruit destroys CYP activity and slows down the way these proteins typically break down drugs. As a result, it increases the side effects and duration of the drug in the human system. Grapefruit can increase blood levels when it interacts with at least 85 different medications. After all, CBDs are like grapefruits; they can disrupt the normal function of cytochrome P450 enzymes and cause a toxic buildup of chemicals in the body. The type and quality of CBD manage how it interacts with your body and the drugs. When you take CBD and any other medicines, it will also affect the interaction of the drug in your body. However, it is also important to note that everyone's response to drugs varies with genetics, age, weight, and other health factors.
Some drugs affected by grapefruit include:
- Cytotoxic drugs
- Calcium channel blockers
CBD with other drugs:
The following are some of the researched information on how CBD reacts with some of the drugs:
- CBD and warfarin.
Warfarin is an anticoagulant, also known as a blood thinner. It is used to prevent harmful blood clots that can cause a heart attack or stroke. Some of the severe risks of warfarin include severe headache, bleeding, swelling, and sudden pain. According to research based on warfarin and CBD, CBD increases the effect of drugs used to thin the blood by slowing down how the body metabolizes warfarin and prolongs its presence in the system. However, since warfarin lasts longer in the body and CBD can worsen some Warfarin risks.
- CBD with Thyroid drugs
Generally, there are two different thyroid disorders. One of the well-known thyroid disorders is hypothyroidism. Hypothyroidism can be treated with thyroid hormone replacement. The second type of thyroid disorder is hyperthyroidism, an overactive thyroid gland. Hyperthyroidism can be treated with antithyroid drugs. Some of the side effects of antithyroid drugs are itching, fever, rash, pain, and headache. On the other hand, thyroid hormone replacement therapy includes chest pain, anxiety, vomiting, and headache. There are no proven studies, so to start or continue with CBD and antithyroid drugs, expert help is advised.
So, where do we stand now?
As we conclude, CBD, after all, can be a very effective medicinal drug that can help both human brains and bodies. However, there might be a risk of consuming other drugs while already at one. Make sure you consult an expert if you are a patient with existing drugs in your prescription. Otherwise, there is certainly no harm in CBD consumption.