CBD and Medication – Potential Interactions

Ingesting CBD?  Proceed With Caution

CBD is popping up in everything as it gains popularity – including CBD infused edibles and beverages. CBD is in food, gummies and even burgers. You can even find it in beverages, such as water, beer, and energy drinks. These new products bring precaution and potential interaction with medication.

BEFORE ingesting CBD (in food or beverages), I strongly advise you to consult with your doctor or pharmacist, if you are on medication.

I am not a doctor, however, I am passionate about health and wellness. Although CBD has its benefits, there is no “one size fits all” category. There are precautions to consider when trying anything new. CBD should be included on the list. You may be wondering why the CEO of a CBD company that sells gummies would say this right? Because I want you to be your own health advocate! Knowledge is power and no one knows your body better than you!

With that, let’s dive in.

In The Beginning….For Me

When I started researching CBD for my own use to manage my Fibromyalgia symptoms, my first concern was what, if any, were the potential drug interactions with my medications. Part of my education journey included my daughter, who at the time was working at the National Institute of Health (NIH) as a researcher.  She spent countless hours explaining to me how the body metabolizes medication. With her support, I learned what to look for with my medications and potential interactions with CBD.

Below is a basic guide on how the body metabolizes CBD and some medications. It’s not all inclusive and is provided merely to help you determine for yourself before taking ingestible CBD, or whether further research and discussion with your doctor should be taken.

CBD + Medications – The Basics

  • What does it mean to metabolize medication or CBD?
    Metabolism is the term used to describe the alteration of a substance within the body so that it can be eliminated more easily.
  • How are prescriptions and CBD metabolized in the body?
    Most prescriptions must pass through the liver, which is the primary site for drug metabolism. Once in the liver, enzymes convert prodrugs to active metabolites or convert active drugs to inactive forms.
  • Cytochrome P450 enzyme is a class that has more than 50 enzymes, in which six of them metabolize 90 percent of drugs, with the two most significant enzymes being CYP3A4 and CYP2D6. These enzymes are predominantly expressed in the liver, but they also occur in the small intestine (reducing drug bioavailability), lungs, placenta, and kidneys. According to NIH research, approximately 60 percent of clinically prescribed drugs are metabolized via the CYP3A4 enzyme.
  • CBD when ingested, metabolizes through the liver using the Cytochrome P450 family, more specifically, via the CYP3A4 enzyme.
  • Because of their genetic makeup, some people may process (metabolize) medication slowly. As a result, a medication may accumulate in the body, causing toxicity. Other people may metabolize medication too quickly, meaning after taking a usual dose, drug levels in the blood never become high enough for the medication to be effective.
  • When there are two substances that are metabolized using the same enzymes, interactions can occur, thus inhibiting (slowing down) or activating (speeding up) one or the other substance. This is the area of concern when ingesting CBD and other medications using Cytochrome P450, CYP3A4 metabolizing enzymes in the liver.

How to Avoid Potential Interaction

How can you use CBD to avoid potential interactions with medication?

  1. CBD Tinctures. When taking CBD Oil under the tongue, most CBD is absorbed through the capillaries under the tongue. However, you may still end up swallowing CBD not absorbed using this method, although it would be minimal. My advice is “if in doubt, spit it out”. Meaning, spit out any remaining residual CBD oil that may be left after holding the oil under the tongue.
  2. Inhaling CBD. When inhaled, CBD absorbs into the blood stream through blood vessels and capillaries in the mouth. I inhale CBD, especially if I need fast relief. However, I do not recommend inhaling CBD into the lungs. Although others may disagree with me (which is fine) our inhaler cartridges are effective inhaling into the mouth. Why go into my lungs if I don’t have to? Also, make sure CBD pre-filled cartridges are not thinned down with any glycols. Look for cartridges with CBD only.
  3.  Topicals that you rub onto your skin are safe as they do not interact with the liver.

What Did I Do?

When I started, I chose to not take CBD in an edible form. Some of my medications metabolized using the same enzyme as CBD. Because I was in a fibro flare up, I used the 2500 mg/60 mL Extra Strength oil and both the max balm and the soothing lotion (it really depended on my symptoms). I also added the CBD inhaler to help with sleep and for fast relief.  Now that I’m off those medications, I added CBD gummies into my regime, especially when I’m traveling as they are easy to toss in my purse.

Final Thoughts

Remember to speak with your doctor or pharmacist first before ingesting CBD. It is important to note that at the time of writing this blog, there are no FDA regulatory guidelines for edibles in the CBD market. Be smart about what you put into your body and remember your body is unique to you. You are your own health advocate.

 

In health and wellness,

Lisa Baskfield, CEO & Certified Pilates Instructor

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