By LeeWEpstein

March 12, 2020

In recent years, CBD has come out of the shadows thanks to its many properties in the therapeutic field.

Its effectiveness in the treatment of Dravet syndrome. Brought it out of anonymity and since then, the scientific and medical community has begun to study its properties.

CBD is effective in treating certain diseases. But you should also be aware of its effects when combined with certain drugs. As it may alter their effectiveness or increase their side effects.

Today, CBD oils and other therapeutic cannabinoid preparations have flooded the market. CBD is a compound of the cannabis plant that the body tolerates very well. Will not cause addiction and has very mild side effects. This cannabinoid, in addition to producing no psychotropic effects and having great therapeutic potential. Will be present in many treatments, which is why the scientific community has begun to research the possible reactions of CBD with certain drugs.

The action of CBD and cytochrome P450

Cytochrome P450 is a hemoprotein capable of metabolizing a large portion (approximately 60%) of the drugs consumed. Depending on the dose, CBD will inhibit the activity of these enzymes, so we could say that it temporarily deactivates them. And therefore the process of metabolizing certain drugs, and even THC-based products. That’s why you have to take that into account if you’re taking CBD with drugs because this cannabinoid could alter their effectiveness, as well as their side effects.

The dosage of CBD is fundamental for its inhibitory activity on liver enzymes. So if the dosage is too low, CBD will have no noticeable effect on the activity of the liver. And the liver will be able to metabolize other substances without concern. For the time being, no minimum or maximum dose will be marked.

Drugs effects on CBD

CBD metabolized by the enzymes CYP3A4 and CYP2C19 of the cytochrome P450 family. Administration of CBD and drugs that inhibit these enzymes may increase the plasma concentration (amount of a molecule present in the liquid phase of the blood) of this cannabinoid. Simply put, the effect of CBD increases, but so does the risk of suffering adverse effects. The list of drugs that inhibit these enzymes is long and includes antifungals, antidepressant and anxiolytic antibiotics, and many others.

Otherwise, drugs that induce CYP3A4 and CYP2C19 enzymes. Such as barbiturates and anticonvulsants, may reduce the effectiveness of CBD in the body . If so, consideration to increasing the dose of cannabidiol.

CBD effects with drugs

  • Diazepam: Cytochrome P450 is responsible for the metabolism of some anxiolytics, such as diazepam. If you are taking this medicine with CBD, you need to be careful about the dose as this may increase the risk of suffering adverse effects.
  • Clobazam: An 8-week study in 13 children treated for epilepsy with clobazam and CBD showed that the action of cannabidiol with the isoenzymes CYP3A4 and CYP2C19 may increase the bioavailability of clobazam. In other words, with a lower dose of this drug, the same effect could be obtainable, while at the same time reducing side effects.
  • Anticoagulants and anti-inflammatory drugs: Some studies indicate that CBD inhibits the hepatic enzyme CYP2C9, of the cytochrome P450 family, which is primarily responsible for the metabolism of anticoagulants. The effect of CBD is therefore believed to be a reduction in the metabolism of certain drugs such as warfarin (an anticoagulant drug) or diclofenac (an anti-inflammatory drug widely used to treat rheumatoid arthritis).
  • Barbiturates: Clinical studies indicate that the combined action of CBD and hexobarbital (a barbiturate with sedative and hypnotic effects) increases its bioavailability and facilitates its elimination.
  • Cancer drugs: Since CBD used to reduce nausea and vomiting caused by certain cancer treatments. It is important to note that some studies indicate that this cannabinoid may increase the bioavailability of these drugs. This is a factor to take into account since these products are quite aggressive.
  • Valproate: Some studies report that the administration of the anti-epileptic drug valproate and CBD may increase liver transaminase levels. Which may cause damage to the abdominal organ.
  • Central nervous system depressants and alcohol: Neuro Depressants are products that include sedatives, tranquilizers, and hypnotic drugs. Administering these types of drugs and/or alcohol with CBD may increase the risk of sedation and drowsiness.

Is an overdose of CBD possible?

No deaths from cannabinoid-related overdose have ever recorded. The body shows toleration CBD very well, even in high doses up to 1500 mg/day. However, more research needed on this molecule and its use in the treatment of certain diseases will have to be done under medical supervision.

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