Why Does CBD Interact with Certain Drugs?

CBD drug interaction

Some things just don’t mix…. oil and water, toothpaste and orange juice, alcohol and online shopping, and CBD with certain medications.  When adding CBD to your daily regimen, there are a lot of things to consider.  Which is why you should always consult with your physician about making any changes to your lifestyle and drug regimen.  Of course, you may say “CBD is natural so it should be fine.”  Well, arsenic and poison ivy are also very natural, and I don’t see you guys out there rolling around in poison ivy drinking arsenic lemonade. 

To start, all things we put into our bodies, must eventually come out one way or another.  There are several ways the body eliminates waste.  One of the most common ways we break down medications and other chemicals and compounds is with our liver.  The liver really is an amazing organ.  It uses special enzymes to break down compounds into simpler chemicals that the body can easily remove.  This enzyme system is called Cytochrome P450 metabolism or cyp450 for short.  

Any guesses where our body metabolizes and eliminates CBD?  You guessed it, the liver.  However, CBD is not the only drug or chemical that is processed by the liver.   Here’s a list of some common medications and compounds metabolized by the liver: Alcohol, Macrolide Antibiotics, Calcium Channel Blockers, Antivirals, Steroids, Warfarin, Antifungals, Benzodiazepines, Caffeine, and many, many more. 

As wonderful as our liver may be, it can only process so much at once.  You can’t put 10 pounds of manure in a 5lb bag so to speak, or; there are only so many seats on the liver train.  To make matters more interesting, there are some drugs that inhibit or induce (slow down or speed up the train) metabolism by cyp450 enzymes.  For instance, you may have heard don’t drink grapefruit juice when taking Lipitor (atorvastatin).  The reason is a chemical in grapefruit juice acts as an inhibitor of the cyp450 that breaks down atorvastatin.  It doesn’t allow your body to eliminate atorvastatin as quickly as it is supposed to which can lead to a buildup of atorvastatin in your body which may have detrimental effects.  Basically, grapefruit took atorvastatin hostage on the liver train and isn’t letting him off until he gets off.  

CBD is not only metabolized by cyp450, it is also a strong inhibitor of one of the enzymes.  Therefore, it is very important to speak with your doctor and your pharmacist to go over the possible interactions between your current medications and CBD.  Most of the time it only requires a change in the dosing of CBD, but occasionally, it may require the avoidance of CBD or changing your pharmaceutical regimen.   You can always visit our website and request a consultation.  

Dr. Kathy Jo Brocious

Dr. Kathy Jo Brocious

Dr. Brocious earned a Doctorate in Pharmacy from the University of Mississippi. Kathy has helped numerous patients make important decisions about their healthcare from choosing the best vitamins and supplements to advice on medications and lifestyle choices.