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CBD Drug Interactions: Avoiding Terrible Side Effects

cbd drug interactions

CBD drug interactions can be dangerous. We don’t mean to scare you, as CBD by itself is incredibly safe, but when combined with other drugs at the correct dose, it could be a life-threatening situation.

While we aim to provide comprehensive information, it’s important to note that this blog is not a substitute for professional medical advice. Always consult a healthcare provider before making any changes to your medication regimen.

As cannabidiol (CBD) gains popularity for its potential health benefits, it is crucial to understand how it interacts with other medications. Like many drugs, CBD is metabolized in the liver and can affect how other medications are processed. This blog will empower you with the knowledge of these interactions, highlight common drugs affected, and provide guidance on safely using CBD with other medications.

Understanding Drug Interactions and Liver Enzymes

Drug interactions occur when one substance affects the activity of a drug, often by influencing how the drug is metabolized. The liver plays a central role in drug metabolism through the action of enzymes, particularly those in the cytochrome P450 (CYP450) family. These enzymes help break down various substances, including medications, ensuring they are processed and eliminated from the body.

cbd drug interactions

Grapefruit and CYP450 Enzymes

Grapefruit is a commonly consumed fruit known to affect drug metabolism. Compounds in grapefruit inhibit the activity of CYP450 enzymes, particularly CYP3A4. This inhibition can lead to higher levels of certain drugs in the bloodstream, increasing the risk of side effects and toxicity. CBD similarly affects these enzymes, leading to potential interactions with medications metabolized by the same pathways.

cbd drug interactions

Drugs with Grapefruit Warnings

Several medications come with warnings to avoid grapefruit due to the risk of interactions. These warnings can also serve as a guide for identifying potential interactions with CBD. Common drugs with grapefruit warnings include:

  • Statins (e.g., atorvastatin, simvastatin): Used to lower cholesterol.
  • Calcium channel blockers (e.g., amlodipine, nifedipine): Used to treat high blood pressure.
  • Anti-anxiety medications (e.g., buspirone): Used to manage anxiety disorders.
  • Antihistamines (e.g., fexofenadine): Used to treat allergies.
  • Immunosuppressants (e.g., cyclosporine): Used to prevent organ transplant rejection.
  • Corticosteroids (e.g., budesonide): Used to reduce inflammation.
  • Antiarrhythmics (e.g., amiodarone): Used to treat irregular heartbeats.
  • Antidepressants (e.g., sertraline): Used to treat depression.

If a medication has a grapefruit warning, it is advisable to consult with a healthcare provider before combining it with CBD.

cbd drug interactions

Image Credit: Harvard Health Publishing. Harvard Medical School.

Other Potential CBD Drug Interactions

CBD may also interact with medications that do not carry a grapefruit warning. These interactions occur through different mechanisms and can affect a wide range of drugs:

  • Warfarin and other blood thinners: CBD can increase blood levels of these medications, raising the risk of bleeding.
  • Antiepileptic drugs (e.g., clobazam): CBD can increase blood levels of these drugs, potentially leading to increased side effects such as sedation.
  • Opioids (e.g., morphine, oxycodone): CBD can enhance the effects of opioids, leading to increased sedation and risk of overdose.
  • Antidepressants (e.g., SSRIs, TCAs): CBD can increase blood levels of these medications, potentially leading to enhanced side effects.

The Importance of Consulting with a Healthcare Provider

Just because something is natural does not mean it is free from causing adverse side effects. Grapefruit is a benign fruit enjoyed by billions but can cause significant interactions with medications. Similarly, other common foods and substances can interact with medications, such as:

  • Leafy green vegetables: High in vitamin K, which can interfere with blood thinners like warfarin.
  • Dairy products: Can bind to certain antibiotics, reducing their absorption and effectiveness.
  • Caffeine: Can increase side effects of stimulant medications.

Many doctors may be unfamiliar with CBD drug interactions due to its relatively recent surge in popularity and the lack of extensive research. Therefore, it is crucial to always consult with a healthcare provider before combining CBD with any medication. Their professional guidance can provide reassurance and support, ensuring your treatment plan is safe and effective.

cbd drug interactions


By understanding how CBD drug interactions, consumers can make informed decisions and avoid adverse effects. Always remember, the best way to ensure safe usage of CBD alongside other treatments is to consult with a healthcare provider. They can provide personalized advice and ensure your treatment plan is safe and effective.


1. FDA: Grapefruit Juice and Some Drugs Don’t Mix.

2. NCBI – An Update on Safety and Side Effects of Cannabidiol

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