CBD can cause side effects like dry mouth, diarrhea, reduced appetite, and drowsiness. Additionally, it can interact with certain medicines, such as blood thinners and antiseizure drugs. If you would like to start using CBD products, it’s best to first talk to your doctor.
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Because CBD products aren’t regulated by the FDA in the way that drugs are, there is huge variation in quality and, quite possibly, safety. In 2017–2018, counterfeit CBD oil was found that contained synthetic cannabinoids and led to a poisoning outbreak in Utah.
There are a lot of extravagant product claims out there about the benefits of CBD for women, but little high-quality research supports them. CBD oil and other CBD products aren’t well regulated. It’s possible what you are buying is counterfeit or contaminated. Before using CBD — especially if you plan to vape or ingest it — first talk with your doctor or healthcare provider to learn whether it could be safe and helpful for you.
Other potential benefits of CBD aren’t clear. No high-quality research shows that CBD improves sex drive, decreases pain, treats depression or mood disorders, decreases PMS symptoms like bloating and cramps, or relieves symptoms of menopause like hot flashes. This may change as more studies are done, but for now, the jury is out.
Unlike marijuana, pure CBD products don’t make you feel high. A different ingredient in marijuana called THC makes people feel high.
Testing shows purity and dosage can be unreliable in many products. One study found less than a third of the products tested had the amount of CBD shown on the label. Another study of 84 CBD products bought online showed that more than a quarter of the products contained less CBD than stated. In addition, THC (the component that can make you feel high) was found in 18 products.
Absolutely. Inhaled CBD gets into the blood the fastest, reaching high concentration within 30 minutes and increasing the risk of acute side effects. Edibles require longer time to absorb and are less likely to produce a high concentration peak, although they may eventually reach high enough levels to cause an issue or interact with other medications. Topical formulations, such as creams and lotions, may not absorb and get into the blood in sufficient amount to interact with other medications, although there is very little information on how much of CBD gets into the blood eventually. All of this is further complicated by the fact that none of these products are regulated or checked for purity, concentration, or safety.
CBD has the potential to interact with many other products, including over-the-counter medications, herbal products, and prescription medications. Some medications should never be taken with CBD; the use of other medications may need to be modified or reduced to prevent serious issues. The consequences of drug interactions also depend on many other factors, including the dose of CBD, the dose of another medication, and a person’s underlying health condition. Older adults are more susceptible to drug interactions because they often take multiple medications, and because of age-related physiological changes that affect how our bodies process medications.
Researchers from Penn State College of Medicine evaluated existing information on five prescription CBD and delta-9-tetrahydrocannabinol (THC) cannabinoid medications: antinausea medications used during cancer treatment (Marinol, Syndros, Cesamet); a medication used primarily for muscle spasms in multiple sclerosis (Sativex, which is not currently available in the US, but available in other countries); and an antiseizure medication (Epidiolex). Overall, the researchers identified 139 medications that may be affected by cannabinoids. This list was further narrowed to 57 medications, for which altered concentration can be dangerous. The list contains a variety of drugs from heart medications to antibiotics, although not all the drugs on the list may be affected by CBD-only products (some are only affected by THC). Potentially serious drug interactions with CBD included
Does the form of CBD matter?
The researchers further warned that while the list may be used as a starting point to identify potential drug interactions with marijuana or CBD oil, plant-derived cannabinoid products may deliver highly variable cannabinoid concentrations (unlike the FDA-regulated prescription cannabinoid medications previously mentioned), and may contain many other compounds that can increase the risk of unintended drug interactions.
While generally considered safe, CBD may cause drowsiness, lightheadedness, nausea, diarrhea, dry mouth, and, in rare instances, damage to the liver. Taking CBD with other medications that have similar side effects may increase the risk of unwanted symptoms or toxicity. In other words, taking CBD at the same time with OTC or prescription medications and substances that cause sleepiness, such as opioids, benzodiazepines (such as Xanax or Ativan), antipsychotics, antidepressants, antihistamines (such as Benadryl), or alcohol may lead to increased sleepiness, fatigue, and possibly accidental falls and accidents when driving. Increased sedation and tiredness may also happen when using certain herbal supplements, such as kava, melatonin, and St. John’s wort. Taking CBD with stimulants (such as Adderall) may lead to decreased appetite, while taking it with the diabetes drug metformin or certain heartburn drugs (such as Prilosec) may increase the risk of diarrhea.
Products containing cannabidiol (CBD) seem to be all the rage these days, promising relief from a wide range of maladies, from insomnia and hot flashes to chronic pain and seizures. Some of these claims have merit to them, while some of them are just hype. But it won’t hurt to try, right? Well, not so fast. CBD is a biologically active compound, and as such, it may also have unintended consequences. These include known side effects of CBD, but also unintended interactions with supplements, herbal products, and over-the-counter (OTC) and prescription medications.
People considering or taking CBD products should always mention their use to their doctor, particularly if they are taking other medications or have underlying medical conditions, such as liver disease, kidney disease, epilepsy, heart issues, a weakened immune system, or are on medications that can weaken the immune system (such as cancer medications). A pharmacist is a great resource to help you learn about a potential interaction with a supplement, an herbal product (many of which have their own drug interactions), or an over-the-counter or prescription medication. Don’t assume that just because something is natural, it is safe and trying it won’t hurt. It very well might.
While some states are slowly adopting more lenient laws regarding the recreational use of marijuana, it is a byproduct of this plant that seems to be taking the country by storm. Whether it is tinctures to manage physical pain and anxiety, or topical creams and smokeable “joints,” CBD appears to be the latest “cure-all” craze—and users are flocking to pharmacies and pop-up dispensaries in droves.
CBD is used widely in the self-management of pain and anxiety, so many patients wonder if they can ingest CBD oil drops or tinctures before their cosmetic procedure and during their recovery. CBD products should not be taken in the days before or after surgery.
What is CBD?
I encourage patients not to smoke anything before a procedure. Many patients falsely believe that smoking marijuana is a safer choice than cigarettes, which is not true—particularly when it comes to surgery. Smoke of any kind in the lungs can lead to respiratory distress, and marijuana itself can interfere with anesthesia, leading to a higher risk of pneumonia after surgery and a higher risk of airway emergencies. Much like nicotine, smoking marijuana before or after surgery delays the healing process and causes poor scarring of your surgical sites. If you live somewhere where marijuana is legal, edibles are a better choice for eliminating the respiratory problems, however, be sure not to eat past the allowed time before surgery.
I have recently had some patients ask about using CBD oil before and after elective surgery, and I want to clear a few things up to ensure that patients have a safe surgery and recovery.
CBD products also have a potent reaction with an enzyme system in the liver that can prevent other medications—such as anesthesia medications or prescription pain killers—from using the same system, leading to a build-up in your system and preventing the medications from doing their job.