No products in the cart.
If you’ve ever researched a drug online or viewed a television ad for a prescription medication, you’ve probably heard some variation of the phrase “talk to your doctor before starting a regimen”. Consultation with a medical professional prior to the adoption of a new drug is necessary for several reasons. Perhaps most important is the concern over contraindications, the presence of which can be life-threatening for the patient involved.
A contraindication is essentially a red flag that a drug should be closely monitored or not taken at all due to certain conditions. These range from physiological and psychological symptoms in the patient to external factors, such as the chemical interactions between drugs that, while safe to consume on their own, can be deadly in combination with each other.
As CBD products continue to flood the consumer market in increasing volume, many are left wondering whether cannabidiol will interact negatively with their other medications. While CBD is generally well-tolerated with mild to no side effects, it has been known to interact with certain enzymes in the body – in particular, CYP3A4.
Located in the liver, CYP3A4 is an enzyme that is responsible for metabolizing approximately 60% of all drugs, including CBD. Research has shown that CBD can inhibit CYP3A4 in repeated dosages, slowing down the metabolization of other drugs and thus prolonging their concentration in the body. Likewise, other drugs that also inhibit CYP3A4 can increase levels and effective duration of CBD in the same way. A notable example is ketoconazole, an antifungal that nearly doubles CBD peak plasma concentration by inhibiting CBD breakdown.
In some cases, CBD’s inhibition of CYP3A4 can have practical medical applications, as demonstrated by one study involving clobazam, used to treat epilepsy. When 13 juvenile subjects were treated with both clobazam and CBD, CBD inhibited the breakdown of clobazam, increasing its bioavailability and thus reducing both required dosage amounts and the presence of side effects.
Conversely, there are also times when this “enhancing” effect is undesirable. According to the Washington, DC Department of Health, enzyme inhibition via CBD can increase concentrations of many types of drugs, from antidepressants to antihistamines, causing an increase in side effects. In rare cases, it can result in toxic concentration levels and interfere with bodily functions such as respiration.
While some drugs inhibit the breakdown of CBD, others induce it, speeding up metabolization and causing reduced bioavailability and effectiveness. Several anticonvulsant (seizure-preventative) medications such as phenobarbital, carbamazepine, and phenytoin are known for this. People who take these medications may find that they require substantially higher doses of CBD than others to achieve the same desired effect.
Although there is clear evidence that CBD is contraindicated in other drugs, there is little reason for concern; most instances require a much-higher-than-usual dosage amount to have an effect. Despite this, it’s always recommended that you speak with your doctor before beginning a new routine.
It’s important to note that much more research is needed regarding CBD’s contraindications. The sheer volume of drugs it can potentially interact with, coupled with a hazy legal status that has thus far hindered further study, are currently the biggest barriers to such research. This and other mysteries surrounding CBD will be solved as the demand and market potential for CBD continue to rise.