If you are considering taking CBD alongside prescription medication, then there are a few things that you should bear in mind. Preliminary research indicates that some pharmaceutical drugs are enhanced by the presence of CBD, which brings a positive and a reason to be wary.
The advantage of this would be that you would need less of your prescription medication to receive the same effects, however if you were unaware of the effect that the CBD was having, you may end up dosing too much. Studies also suggest that CBD products may boost the blood concentrations of some prescribed meds.
Let’s take a detailed look at these issues.
Does CBD increase the effects of pharmaceutical drugs?
Any substance that is orally consumed must be metabolized by the liver – the same goes for the cannabinoids in cannabis. The liver is the organ responsible for detoxifying, and the way it breaks down substances has been blamed for some people not finding cannabis edibles effective.
The “first pass metabolism” process of the liver helps to remove any typically unwanted compounds and molecules from the body. Unfortunately, when operating at maximum efficiency, the liver may even remove THC – if you don’t notice the effects of your edible, it’s likely because this psychoactive cannabinoid has been sifted out.
To counteract a speedy metabolism, higher dosages of cannabidiol (CBD) are needed, as the liver will be much harder pushed to break down all these molecules.
Therefore, if the metabolism is having to work harder to metabolize substances, it’s possible that it won’t break down the substances in your prescription medication as effectively as it should, thereby enhancing these meds. For medicating, CBD is generally preferred over its psychoactive relative THC. While THC makes the user “high” and can induce anxiety and paranoia, CBD is non-intoxicating and actively quells those two side effects. Many find CBD to be a great, natural mood lifter.
How CBD influences pharmaceutical drugs
The Cytochrome P450 (CYPS) enzyme proteins are charged with breaking down the vast majority of pharmaceutical drugs when they enter the liver. The same enzymes also help to break down CBD. But when CBD is administered in high dosages, research has found that the cannabinoid may stifle CYPS from working at its full potential.
This can make it harder for the body to clean out unwanted substances and metabolize pharmaceutical drugs. With the wrong concoction, it is possible that pharmaceuticals can concentrate in the blood at unsafe, toxic levels. If your dosage of CBD and prescribed meds is having this impact, you may want to reduce the dose of your medication to redress this imbalance.
CBD is a substrate for the CYPS enzymes when given in low doses, and when the two interact, the enzymes can alter the effects of the CBD. However, in 1993, researchers discovered that CBD dosages of 120mg and upwards inhibits the activity of two important enzymes in the CYPS group – the P450s 2C and 3A enzymes, with the former being most affected by low CBD doses.
It appears that CBD hijacks a key metabolic site of the 2C enzyme, which prevents other chemical compounds from being broken down as they should. In 2015, a small study found evidence that blood levels of clobazam, an anti-epilepsy drug often prescribed to children, were increased when CBD was present. This is particularly noteworthy as CBD has become a prominent antidote for treatment-resistant epilepsy in recent years.
Doctors’ response to the heightened clobazam levels was to reduce the dosage of the drug in almost 80 percent of participants.
What to do if you’re concerned about taking CBD with other meds
It’s only natural to have concerns about taking CBD with other medication if you’re new to the marijuana compound. You may want to discuss the possible reactions CBD may have with your meds with a doctor, especially if you plan on taking large dosages of cannabidiol. Having your blood levels checked regularly is also a prudent move.
Feel free to ask your doctor how much CBD you should take, whether regular blood tests are necessary, if your current medication is metabolized by cytochrome P450 and what the side effects may be of drug toxicity for your situation.