Preliminary research suggests that you may have to reduce your intake of other prescription drugs if you’re planning on adding cannabidiol (CBD) to your daily treatment plan. Studies have shown that, in some cases, CBD increases the effects of pharmaceutical drugs, meaning a lower dosage is required to restore the balance – in a sense, reducing your prescription drug intake may work as a positive. The research also found that CBD could heighten the blood concentrations of some drugs.
In this post, we’ll look closely at the relationship between CBD and pharmaceutical drugs.
CBD, “first pass metabolism” and the liver
All substances that the body consumes orally must be metabolized (i.e. broken down) by the liver – cannabis is no exception. The liver is the primary detoxifier in the body and is the organ which can be seemingly responsible for reducing the potency of cannabis edibles.
After taking an edible, cannabinoids travel through the liver’s “first pass metabolism” system, which serves to filter out unwanted compounds. Unfortunately, the liver often considers THC to be unhelpful, and it’s this eradication process which explains why some find weed edibles ineffective.
The best way to counter this is to increase your dosage of CBD, which stops the liver from breaking down compounds at its normal, efficient rate. This, in turn, allows compounds like THC to stay in the body.
However, the effect CBD has on metabolism in the liver does not just affect the intensity of your highs – it also interferes with the metabolization of pharmaceutical drugs, essentially strengthening them. Repeated studies have confirmed that CBD is safe, non-psychoactive and a non-toxic substance. This special cannabis compound has a myriad of therapeutic properties and is regularly used as a treatment for mood disorders, anxiety and to cope with general stress.
The relationship between CBD and pharmaceutical drugs
Researchers have discovered that Cytochrome P450 (CYPS) enzyme proteins are in charge of breaking down up to 80 percent of pharmaceutical drugs. These enzyme proteins also facilitate the metabolization of CBD. However, further studies have shown that the appropriate dosage of CBD can inhibit these enzymes from breaking down compounds.
Therefore, when CBD is stifling Cytochrome P450 enzymes, the body must work harder to metabolize and clear out compounds present in pharmaceutical drugs. If they aren’t removed at the necessary rate, these compounds can theoretically add up to reach toxic levels in the blood. This sounds worse than it needs to be – for those who want to use CBD alongside prescription meds, ask your doctor if you should reduce the dose of your existing drugs, and if so, by how much.
In smaller dosages, CBD is a substrate for Cytochrome P450 enzymes, and can therefore be modified by them. But in 1993, a study revealed that a 120mg dose of CBD stifled almost 80 percent of activity among the 2C and 3A enzymes in the CYPS. Research also showed that 2C was particularly sensitive to CBD and was inhibited even with lower dosages of the cannabinoid.
So, what’s going on? It appears that CBD hijacks a key metabolic site found on CYPS enzymes, stopping them from interacting with and breaking down other compounds. CBD was shown to slow the breakdown of chemicals in the anti-seizure drug clobazam, increasing its blood level concentration, in a 2015 study which looked at cannabidiol and child epilepsy. Doctors responded by reducing the clobazam dose of the majority of participants which took part in the study.
How to deal with CBD’s effect on the CYPS
If you are worried about CBD interfering with your prescription medication, the first port of call should be your doctor, as they are the only person who can offer advice specifically for you. People consuming high doses of CBD with pharmaceutical meds should be more cautious than most and getting regular blood level checks is a good idea.
Recreational users don’t need to get too caught up with cytochrome P450 enzymes – simply take more THC or CBD to enhance your high. Meanwhile, medicinal users who aren’t on other meds should be just fine, too. And not all prescription medication is metabolized by CYPS enzymes, so you may find you don’t need to make any adjustments at all.