Many patients wonder whether taking CBD oil (also known as hemp oil) in parallel with their medications can cause negative drug interactions. Luckily, studies have been done in the past, and are currently ongoing, concerning how CBD affects the body in conjunction with other medications. While CBD oil is normally safe, it can cause some side effects, especially if taken in large amounts or improper dosages. Since CBD oil can interact with certain foods and beverages (such as mangos and coffee), it can also interact either positively or negatively with certain medications – such as blood thinners. Therefore, it is important to know how CBD oil can interact with your medicines before taking them together. This article will share useful information about CBD oil and drug interactions so you can make the best decisions for your health. It is essential to consult with your doctor for personalized medical advice about every drug you use, including any over the counter medications, when starting new prescription medications.

How does CBD work in your body?

Cannabidiol, CBD, and hemp are all different names for essentially the same thing. CBD is a type of chemical (known as a cannabinoid) that is extracted from the hemp plant. CBD products act on the endocannabinoid systems in the body – which regulate sleep, mood, appetite, memory, immune responses, reproduction and fertility. The endocannabinoid system is a network of receptors in our bodies that researchers still do not fully understand. These receptors create natural endocannabinoid substances to keep our bodies in homeostasis. This system is fully functional in all humans, even people who have never tried cannabinoids before. The system is only named after the cannabis plant that led to its discovery. The effects of CBD on your body vary based on dosage, frequency of usage, weight, as well as a variety of other factors. CBD may be an effective treatment for many different problems such as back pain, multiple sclerosis, anxiety, neurological conditions, gut disorders and many more conditions.

How does hemp oil affect your blood?

Studies show that CBD oil acts as an antithrombotic agent – meaning it reduces the formation of blood clots. Additionally, CBD itself has been shown to have mild anticoagulating effects – meaning it can act somewhat like a blood thinner as well. However, in other studies, hemp oil was found to affect platelets and anticoagulants by suppressing their production and thereby potentially increasing bleeding tendencies. More studies need to be completed to fully understand the way that CBD affects the human body.

There is scientifically sound evidence, clinical trials, and case studies concerning how CBD works with the endocannabinoid systems in the body. However, it was only in 2018 that the Agriculture Improvement Act (also known as the Farm Bill) allowed farmers across 46 of the United States to grow hemp that contains less than .3% of THC. Additional studies and clinical trials are developing every day as scientists now have greater access to study the potential healing properties of CBD.

What are the different types of blood thinners?

While there are many medications prescribed as “blood thinners” or “blood thinning medications,” these are terms that use common vernacular to describe the effects of the medications. There are two main types of blood thinners: anticoagulants and antiplatelets. The different types of medication work differently in your body. Anticoagulants, such as heparin, warfarin or coumadin, help your blood flow smoothly in your bloodstream by decreasing the number of clotting proteins in your blood. It makes the blood more liquid and thus limits its ability to coagulate. Antiplatelet drugs, such as aspirin, prevent blood cells (called platelets) from clumping together to form a clot. The goal of these medications is to make the blood clotting functions of the body less effective, hence the vernacular “blood thinner.”

How does CBD oil interact with anticoagulant drugs?

While there are many different types of anticoagulants, Warfarin is the most commonly prescribed. Warfarin is metabolized (processed through your body) by the hepatic P450 enzyme system. CBD and Warfarin both act on similar proteins in this enzyme system which can cause the warfarin to not be processed as effectively by the body. CBD is not a strong blood thinner, however, it acts on the same systems that blood thinners do. This means that CBD may contribute to additional blood thinning when taken in conjunction with other anticoagulants such as Warfarin. As such, taking both medications can increase the risk of bleeding complications. While Warfarin normally decreases the risk of blood clots, too much of an anticoagulant can cause serious bleeding. Your blood can not clot effectively enough leading to an increased risk of excessive bleeding.

How does CBD oil interact with antiplatelet drugs?

Aspirin is an incredibly common antiplatelet drug. Once again, CBD acts on the cytochrome P450 enzyme system in your body. This system, found within the liver, is responsible for metabolizing (breaking down) potentially toxic compounds, including over 60% of any drugs consumed. When this system is processing more than it is used to, it can metabolize substances differently than it normally would. As such, taking CBD with other medications that act on this system can cause unexpected effects.

In a study published by the American Society for Clinical Pharmacology and Therapeutics, researchers found that low-dose aspirin administration affected only certain enzymes in the P450 system in healthy human subjects. However, there has not yet been any long-term studies, conducted on humans, that examine the interaction effects of combining CBD with aspirin.  The researchers noted that doses of the substances would likely need to be adjusted to ensure their efficacy. Read on to learn about how to take these medications together safely.

How do you safely take both CBD and blood thinners?

Taking blood thinners and CBD without proper research into the side effects can be dangerous. However, CBD can make medications, like warfarin, more effective. Therefore, in some cases, taking CBD in conjunction with warfarin may be one option for reducing the dosage of the drug consumed and limiting the side effects. It is important to consult with a doctor about the health benefits or consequential interaction of taking two or more medications like warfarin and CBD oil. When combining the two, it is important to monitor your international normalized ratio (INR). This standard number is determined in the lab from a simple blood draw. It is used to monitor the effectiveness of anticoagulants. Your doctor can order monitoring tests of your INR to ensure your blood is clotting effectively.

However, there has not yet been studies comparing the congruent interaction of antiplatelet drugs and CBD. It is important to talk to your doctor and proceed with caution before combining two or more medications in your body.

How do you safely take both CBD and other medications?

However, there is another way to determine if CBD oil and your other prescription will likely interact negatively in your body – the grapefruit test. One of the components of grapefruit interferes with the cytochrome p450 enzymes – and so does CBD oil. If your doctor recommends you avoid grapefruit or grapefruit juice during your treatment, you should likely avoid hemp oil as well.

This is important especially if your doctor is uninformed about cannabis. Be honest and talk to your doctor if you use CBD and any medication you take or intend to take. This rule of thumb applies even if your doctor does not normally prescribe cannabis. CBD is legal in all 50 states because it contains less than 0.3% of THC, therefore it is perfectly safe to talk to your doctor. You are the patient and your doctor is there to make sure you are safely taking all of the medication you need.

 

If your doctor knows that you using CBD products, you will be able to get tips and information about the possible drug interactions or side effects. They may decide to monitor your blood closely or advise against taking CBD oil at the same time as your other medication.

Does the form of CBD matter?

Absolutely. You can smoke or vape CBD oil or flower, and smoking CBD is one of the most effective ways to experience its benefits. However, this method also allows the CBD to reach your blood the fastest. This can increase the risk of acute side effects due to drug interaction. Because the onset of edibles is about one to two hours, the risk is lessened. CBD in edibles is absorbed through the gut before reaching the liver, however, edibles can still produce a high enough concentration peak to cause a dangerous drug interaction. CBD oil from tinctures is absorbed into the bloodstream through the mouth, with a faster onset than edibles but a slower onset than inhalation. However, it is important to know that there are very few scientific studies proving how much CBD gets into the blood eventually via any of these methods.

It is also always very important to get your CBD from a reliable, safe and pure source as the FDA does not regulate the purity, concentration, or safety of CBD products in the U.S. The additional chemicals in commercial CBD oil can also interact with your body or other medications in unexpected ways.

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