Metformin is a medication prescribed to adults with type 2 diabetes to help control blood sugar levels. Side effects of metformin include low blood sugar, nausea, diarrhea, vomiting, and muscle pain.
Acetaminophen and CBD both are metabolized by CYP450, which lowers the effectiveness of both chemicals as they’re processed in the body. One controversial 2019 study, conducted by the University of Arkansas on mice and published in the journal Molecules, claimed that high doses of CBD contributed to liver toxicity, which could compound acetaminophen’s liver damage potential. However, the study’s authors have been accused of cherry-picking research and designing experiments to showcase potential CBD toxicity. The one study they cited with human test subjects did not show liver toxicity from CBD.
Patients taking metoprolol or other beta-blockers should consult their doctor as to whether to consume CBD.
Should I take CBD with Xanax?
Statins are a classification of drugs designed to lower cholesterol and protect against heart attack and stroke. Common side effects of statins are muscle soreness, blood sugar increase, headaches, and nausea.
Further, a 1993 study conducted by pharmacology researchers at the University of California, San Francisco, and published in the journal Biochemical Pharmacology, discovered that CBD, much like grapefruit, disrupts the normal function of cytochrome P450 enzymes in mice. The study postulated that while the blockage could allow patients to take lower doses of their prescriptions, it could also cause a toxic buildup of chemicals in the body. Since this study’s publication, several scientific and medical journals have published evidence of the grapefruit-like effects of CBD in humans.
Patients should consult with their healthcare provider before taking ibuprofen with CBD.
Potentially, CBD can increase the duration and strength of ibuprofen, thereby increasing the risk of adverse side effects. No human studies to date examine CBD’s interaction with NSAIDs specifically. Still, two studies conducted on animal models in 2006 and 2008 and published respectively in the journals, Pain and Pharmacology, suggest that other cannabinoids may work synergistically with NSAIDs like ibuprofen to reduce pain.
As a doctor who considers prescribing cannabis or a patient wishing to try CBD or medicinal cannabis, you need to be aware of how the cannabinoids might interact with other medications in the body.
Delta-9-tetrahydrocannabinol, also known as THC, may inhibit cytochrome P450 enzyme CYP2C9, which is responsible for metabolising Warfarin, a blood thinner used for people who receive new heart valves, among others. This can cause the INR (elevated international normalisation ratio), a measurement of the time it takes the blood to clot to go up, which in turn can cause internal bleeding(1).
Cannabis Drug Interactions – How Does THC and CBD Interact with Other Medicines?
Caution is also advised when prescribing cannabis to people who are in therapy with sedative-hypnotics like barbiturates or benzodiazepines. This also includes other psychoactive drugs with an effect on the central nervous system. Cannabis has the potential to have an additive or synergistic effect with these drugs which can cause severe drowsiness, dizziness and other unwanted side-effects(3).
Since some cannabinoids can inhibit enzymes like cytochrome P450 liver enzymes (CYP) as well as P-glycoprotein and UDP-glucuronosyltransferases it has the potential to interact with medications that are metabolised by these enzymes. One of the major patient groups to consider is the one with cardiovascular disease using blood thinners, so-called anticoagulant or antiplatelet treatment.
Cannabidiol (CBD) has been shown to inhibit the CYP2C19, which is responsible for converting clopidogrel to its active thiol metabolite. Clopidogrel is often given to people who had a heart attack (myocardial infarction) or a cerebral stroke. Since CBD can block the activity of CYP2C19, it has the potential to lead to sub-therapeutic levels of the active metabolite and consequently an elevated risk of stroke(2).
"To date, there is no evidence of public health related problems associated with the use of pure CBD."
CBD oil in all forms is regulated as a medical supplement, because this is typically how it is advertised. As a result, only five states currently have no significant restrictions on its sale and consumption. Every other state has either restricted it through marijuana laws or limits the sale of CBD oil in some form, whether through food and drink regulation, medical regulation or other forms of restriction.
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Like most supplements, CBD oil rarely does what it promises. It does have some early medical potential, and doctors may prescribe it for patients at risk of seizure or with inflammatory issues. However, as an over-the-counter oil or when infused into a snack cake it probably won't do you much good. You may see some benefits in connection with CBD oil's anti-anxiety or sleep aid properties, but the odds are that any real improvements are largely psychosomatic.
• It can make Parkinson's disease worse.
It can also interact with medications through "the exact same mechanism that grapefruit juice does," according to an article on the Harvard health blog. While rarely a significant concern, on certain medications these interactions can be harmful or even deadly, according to the FDA. If you have blood pressure issues, are taking prescription drugs or have ever been warned about ingesting fruit juice, citrus or fermented products, consult your doctor before touching CBD oil.