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EFFECT OF CBD OIL WITH MEDICINES

A doctor with CBD oil in his hand.

CBD oil may interact with certain medications

What are the effects and side effects of CBD oil and other CBD products in combination with drugs? The main active ingredient in CBD oil and CBD products is CBD , which together with a combination of certain drugs may significantly increase or decrease the effect of the drug. If you are taking any of the medicines in the group below, we recommend that you discuss the use of CBD oil and products with your doctor.

Effect and side effects of CBD oil with drugs used in Finland.

CBD works in the body through cannabinoid receptors and is excreted mainly by the liver. The cytochrome p450 enzyme plays a key role in the metabolism of CBD and CBD can increase the activity of these enzymes. These CYP enzymes are found especially in the liver, but also everywhere else in the body. CYP enzymes play a key role in drug metabolism. CBD and certain drugs may increase or decrease the effectiveness of the drug in a dangerous way.

On this page you will find a list of drugs that have been found to work in combination with CBD. The list is not complete and there may be side effects with other medicines.

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CBD AND EPILEPSY

In clinical trials, CBD has been shown to reduce epileptic seizures, e.g. in patients with Dravet’s syndrome. However, concomitant use of CBD and antiepileptic drugs has caused side effects in some patients. They have been common with carbamazepine (Tegretol), among others. Read more in the article CBD and epilepsy .

Other medicines that may interact:
Absenor, Deprakine, Orfiril, Frisium, Inovelo, Topimax, Zonegran, Zebinix.


CBD AND CHEMOTHERAPY

Many chemotherapeutic agents are metabolised by the cytochrome p450 enzyme and may have severe side effects with CBD. Caution should be exercised when using CBD with at least the following drugs:

  • Etoposide (e.g. Etoposide, Eposin)
  • Methotrexate (Metoject)
  • Paclitaxel (Paclitaxin, Paclitaxel)

Interactions are not always negative. For example, the combination of paclitaxel and CBD reduces neuropathic pain caused by the former.

CBD AND CARDIOVASCULAR MEDICINAL PRODUCTS

CBD can interact with many heart medications, such as statins. Statins are drugs for fat metabolism that inhibit the liver’s own cholesterol synthesis. The liver thus produces less cholesterol-containing particles in the bloodstream. There are also several beta-blockers on the interaction list.

  • Tikagrelori (Brilique)
  • Quinidine (Kiniduron)
  • Atorvastatin (Lipitor)
  • Seliprolol (Selectol)
  • Amiodarone (Cordarone)
  • Clobidogrel (Clobidogrel)
  • Carvedilol (Carvedilol)
  • Nifedipine (Adalat, Procardia)
  • Valsartan (Valsartan, Diovan)
  • Pitavastatin (Livazo, Vezepra)

CBD AND MENTAL MEDICINES

 

The concomitant use of antidepressants with CBD is not recommended.
Some antidepressants pose a higher risk when taken with CBD oil than others.

Selective serotonin reuptake inhibitors (SSRIs) are currently the most commonly prescribed antidepressants and work in the same way as CBD because they block the absorption of serotonin back into the brain.

The most common SSRIs are:

Citalopram (Celexa)
Essitalopram (Lexapro)
Fluoxetine (Prozac)
Paroxetine (Paxil or Pexeva)
Sertraline (Zoloft)
Vilatsodone (Viibryd)

Serotonin-norepinephrine reuptake inhibitors (SNRIs) work in the same way as SSRIs and have the same level of risk, but may work better for some people.

Common SNRIs include:

Duloxetine (Cymbalta)
Venlafaxine (Effexor XR)
Desvenlafaxine (Pristiq)
Levomilnasipran (Fetzima)
Tricyclic antidepressants

These work by increasing the levels of norepinephrine and serotonin in the brain. They can be very effective, but can pose a much higher risk than other antidepressants.

Common tricyclic antidepressants include:

Imipramine (Tofranil)
Nortriptyline (Pamelor)
Amitriptyline
Trimipramine (Surmontil)
Desipramine (Norpramin)

 

SOOTHING MEDICINES (benzodiazepines)

 

Benzodiazepines are used to treat anxiety, insomnia, nausea, depression and panic disorder.

Some benzodiazepines, such as alprazolam (Alprox, Xanor, Alprazolam) and diazepam (Diapam, Diazepam Accord), do not degrade as rapidly as CBD. As a result, their concentrations may become too high. Caution should be exercised when using CBD with at least the following drugs:

  • Alprazolam (Alprox, Xanor, Alprazolam, Xanax)
  • Triazolam (Triazolam, Halcion)
  • Diazepam (Diapam, Diazepam Accord)
  • Midazolam (Dormicum, Midazolam)
  • Quatsepam (Aldizem, Cardizem)
  • Triazolam (Triazolam, Halcion)

Buspirone (Aksilon, Buspiron), used to treat generalized anxiety disorder, is often prescribed in addition to antidepressants. It is metabolised by the cytochrome p450 enzyme and may therefore have potent side effects with CBD. Clomipramine (Anafranil) has similar potent effects.

CBD AND BLOOD PRESSURE MEDICINES (calcium channel blockers)

 

Calcium channel blockers, blood thinners, and medications used to treat high blood pressure and arrhythmias can cause severe symptoms with CBD. CBD reduces or prevents the breakdown of drugs, for example, with warfarin (Marevan), enhancing its effect.

OTHER drugs that cause interactions are at least listed below.

  • Valsartan (Amlodipine, Valsartan)
  • Verapamil (Verpamil)
  • Nifedipine (Adalat, Nifedipine Alternova)
  • Diltiazem (Cardizem)
  • Isradipine (Lomir)
  • Torasemid (Torasemid, Torem)
  • Felodipine (Felodipine, Plendil)
  • Amlodipine (Ampodipine)

CBD AND ANTIOBIOTS

In particular, fluoroquinolones (Ciprofloxacin) may interact strongly with CBD.

  • Ciprofloxacin (Ciprofloxacin)
  • Gemifloxacin (Gemifloxacin)
  • Levofloxacin (Levofloxacin)
  • Moxifloxacin (Moxifloxacin)
  • Norfloxacin (Norfloxacin Sandoz)
  • Ofloxacin (Tarivid, Exocin)
  • Rifampicin (Rimapen)

CBD AND OTHER INTERACTION MEDICINES

Cholesterol: lovastatin (Mevacor, Lovastatin)
Antimicrobials: ketoconazole (Nizoral) & itraconazole (Sporanox)
Cortisone preparation: methylprednisolone (Solu-Medrol, Solomet)
Antihistamines: fexofenadine (R Fexorin) & terfenadine (Telfast)
Erectile Dysfunction Drug: Sildenafil (Viagra)
Cholesterol lowering drug: simvastatin (Simvastatin, Zocor)
Barbiturate: Hexobarbital

Read more about the effects and side effects of CBD oil .

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