Cannabidiol is an unquestionably effective and at the same time harmless chemical compound that is a cannabis component. Although the use of hemp oils or other commercially available CBD supplements for the purpose of maintaining proper health does not cause any undesirable side effects, this is somewhat different in the case of CBD with other drugs. Researchers have been studying the influence of CBD on other pharmacological agents used simultaneously by the patient for years. What are the conclusions? Is there a risk of an unwanted body reaction to the combination of these two (or more) substances used? Do CBD inhibit the effects of drugs, reducing their effectiveness?
CBD with medicines. The role of CBD oils in the metabolism of drugs
Each medication we take passes through the metabolism process that is affected by our liver and the underlying liver enzyme (cytochrome P450). It is estimated that he is responsible for the distribution of up to 60% of drugs on the market.
“This is a very unusual enzyme. Almost all other enzymes are designed to fit into one substrate and carry out one chemical process that results in one product “(Lester Bornheim).
Studies have shown that this extremely important enzyme for the human body also metabolizes cannabidiol, absorbing a large part of the cytochrome P450 yield. It is a complex process, the action of which may (but does not have to) block the metabolization of other, simultaneously used, medicinal substances.
Factors affecting the metabolism of drugs with the simultaneous use of cannabidiol:
- CBD dosage,
- the form and manner of taking CBD,
- composition and proportions of CBD used in oils (ie the use of whole plant extract or isolated molecules),
- type of drug and dosage amount (according to Dr. Kazuhito Watanabe),
- using several combinations of medicines at the same time.
The use of an appropriately low dose of CBD should not affect the change in the metabolism of the drug used. However, none of the studies conducted so far specify a specific dose limit below which the CBD does not interact with drugs. Conflicting results in this area do not allow to clearly determine the safe dose of cannabidiol. An example is the protocol of clinical trials of 2013 carried out with the antiepileptic drug (Sativex, GW Pharmaceutical), with the simultaneous use of CBD. And so the reports from the two studies turned out to be largely divergent:
1. With the introduction of a dose of approximately 40 mg CBD in the first studies, there was no effect of CBD on the metabolism of the introduced drug.
2. Analysis of the second study revealed a significant effect on drug metabolism (inhibition) already at a dose of 25 mg CBD.
Subsequent studies have indicated that CBD can also work in the opposite pole, namely to stimulate the efficiency of cytochrome P450 enzymes. Applications arise on their own. The effects of cannabidiol on drugs can occur in two ways, increasing the metabolism (breakdown) of initiated drugs or inhibiting it.
CBD with medicines. Power of grapefruit.
In 1998, a team of Canadian scientists noted a certain relationship between the metabolism of many drugs available on the market and grapefruit. Studies have revealed that some of the compounds contained in the grapefruit fruit (bergapten) can block the dynamism of cytochrome P450 enzymes. Due to the above, specialists often inform patients not to eat this fruit before taking prescribed medicines.
So how does the acquired knowledge translate into the use of CBD with other drugs? Well, it turns out that cannabidiol is a stronger inhibitor of cytochrome P450 enzymes than the chemicals contained in the grapefruit. In practice, this means that the CBD in some cases simultaneously taking it with other drugs (eg anticoagulants) acts as a chemical substance that reduces the speed of chemical reactions, thus increasing its duration of action and sequelae.
CBD and medicines. How to make the right decision?
Each patient taking a high dose of the drug must be aware that the simultaneous use of CBD can significantly affect the ongoing metabolic process and, consequently, interfere with the overall course of treatment.
In particular, this applies to people accepting:
- medicinal preparations that save lives,
- sedatives and anti-depressants,
- medicines with a high risk of side effects,
- medicines for blood pressure,
- anticholinergic and sympathomimetic drugs (atropine),
- birth control pills.
- CBD also has positive interactions with some drugs.
Studies show that cannabis can reduce insulin resistance, improving the metabolic process of this substance, and thus controlling the level of sugar in the blood.
Specialists also indicate that the combination of CBD with opioid drugs (codeine, morphine) may have a beneficial effect on the course of the entire treatment process. The use of cannabidiol reduces the need for these types of highly addictive substances used to relieve severe pain. The interaction of both compounds allows patients to reduce the amount of opioid medication taken, significantly reducing the risk of addiction and side effects (based on research by Dr. Donald Abrams, USA, 2011). Each decision should be supported by prior consultation with a specialist who will help you take the right action.
Although CBD is a great ally in the fight against the symptoms of various diseases, its consumption may interact with other drugs. Therefore, it is important for users to know which drugs should not be mixed up, so that their reception is based on safety and efficacy.