We would not be living without our livers. Our livers detoxify our body from anything that could potentially harm us and actually has its own cleansing system called the cytochrome p450 enzymes system. According to research the system contains more than 50 enzymes that process and eliminate toxins from our bodies. There are drugs that may interact with CBD.

Why is this something to bring up about in relation to CBD? As most of us are coming to understand, CBD has the potential to effectively treat various illnesses and diseases by manipulating the endocannabinoid system with no “dirty” side effects. However, there may be one side effects to keep in mind, which is the inhibition of the cytochrome p450 enzyme system.

By inhibiting the cytochrome p450 system, it may lead to an overall increase in the processing of the other drugs in your system. Thus the other drugs may not metabolize as they should. This can lead to higher levels of the other medication in your system at one time, which can cause unwanted side effects and even overdose. so, if you’re taking a medication that could be affected by cannabidiol, you may need a dose adjustment in order to take both medications safely.

Medications that are known to use the cytochrome p450 enzyme system

Here is a list of medications that are known to use the cytochrome p450 enzyme system, according to the Indiana University Department of Medicine:

Angiotensin II blockers

Antibiotics

Anti-arrhythmic

Anti-depressants

Anti-epileptics

Anti-histamines

Anti-psychotics

Benzodiazepines

Beta-blockers

Calcium channel blockers

HIV antivirals

HMG CoA reductase inhibitors

Immune modulators

NSAIDs

Oral hypoglycemic agents

Prokinetics

PPIs

Steroids

Sulfonylureas

Before you begin to worry, not every medication in each of the categories listed will cause an interaction. But, be aware that this list does not necessarily contain every medication that could be affected by Cannabidiol. While it’s true that taking CBD by itself has not been shown to cause any unwanted side effects, it may increase the chances of experiencing side effects from other medications you might be taking at the same time.

If you feel worried that your cytochrome p450 enzyme system may not be functioning properly, doctors can test the system to ensure that medications you are you take are metabolizing as expected. Before starting CBD, especially if you’re on other medications, it is wise to consult your doctor or physician first.

CBD and grapefruit

Naturally occurring compounds in grapefruit also impact our cytochrome p450 enzymes, just as CBD does. That’s why it’s recommended to avoid grapefruits and their juice while taking certain medicines. If a warning like this exists on your current medications, it is an indication that they may also be impacted by CBD.

CBD and antibiotics

Fluoroquinolone antibiotics, in particular, can interact with CBD. They are commonly used to treat a variety of illnesses, such as respiratory and urinary tract infections. Examples include:

Ciprofloxacin (Cipro)

Gemifloxacin(Factive)

Levofloxacin (Levaquin)

Moxifloxacin(Avelox)

Norfloxacin (Noroxin)

Ofloxacin (Floxin)

CBD and beta-blockers ( β-blockers)

CBD has been linked with lowering blood pressure, however, can have negative interactions with beta-blockers and other blood pressure medication if taken together. Cannabidiol can affect how our bodies process beta-blockers and can cause undesired effects – consult your prescribing doctor.

CBD and heart and cardiovascular medications

CBD has the potential to interact with many different heart medications, such as statins, a class of lipid-lowering medication and beta-blockers ( β-blockers), which are medications that treat irregular heart rhythms and are applied following heart attacks. Examples of heart medications that have interaction warnings include:

Amiodarone (Cordarone)

Atorvastatin (Lipitor)

Carvedilol (Coreg)

Celiprolol (Celicard)

Clopidogrel (Plavix) Ticagrelor (Brilinta)

Nifedipine (Adalat, Procardia)

Pitavastatin (Pravachol)

Quinidine

Talinoloa

Valsartan (Diovan)

CBD and blood pressure medications

Calcium channel blockers, blood thinners, and medications treating blood pressure and abnormal heart rhythms have a strong interaction warning with using CBD. For instance, CBD reduces the body’s ability to break down the prescription blood thinner warfarin, thereby increasing its intended effect. Other examples of medications that may interact with CBD include:

Amlodipine (Norvasc)

Diltiazem (Cardizem)

Felodipine (Plendil)

Isradipine (DynaCirc)

Nifedipine (Adalat, Procardia)

Torsemide (Demadex)

Valsartan (Diovan)

Verapamil (Calan, Isoptin, Verelan)

CBD and sedative medications (benzodiazepine)

Benzodiazepines (sometimes called ‘benzos’) are used for managing: anxiety, insomnia, nausea, depression and panic attacks. CBD can slow down the body’s ability to process some benzodiazepines, namely the widely used alprazolam (Xanax) and diazepam (Valium). This may result in higher blood concentrations of the drug, producing side effects. Other typical benzodiazepines which may have an interaction with CBD include:

Alprazolam (Xanax)

Diazepam (Valium)

Midazolam (Versed)

Pitavastatin (Pravachol

Quazepam (Doral)

Triazolam (Halcion)

CBD and statins

Cholesterol decreasing medications like statins can be impacted by CBD. CBD can pre-occupy the body’s system for processing certain drugs, this can cause medicines to remain in one’s system for longer, resulting in a potentially dangerous buildup.

Other medications that have CBD interaction warnings:

Anti-fungal medications: Ketoconazole (Nizoral) & Itraconazole (Sporanox)

Anti-histamines: fexofenadine (Allegra) & Terfenadine (Seldane)

Anti-inflammatory drug: Troglitazone and Methylprednisolone

Cholesterol and lipid-lowering medication: Simvastatin (Zocor)

Cholesterol treatment: Lovastatin (Mevacor)

Malaria medications: Artemether (Artenam, Paluther) & Halofantrine

Viagra (Sildenafil)

Sources:

https://www.ncbi.nlm.nih.gov/m/pubmed/26651971/

http://medicine.iupui.edu/clinpharm/ddis/main-table/