A comprehensive review found CBD interacts with anti-epileptic drugs, antidepressants, opioids, THC, acetaminophen, alcohol, and numerous other common medications.
Anyone taking CBD alongside other medications, healthcare providers, pharmacists, people considering adding CBD to their regimen
CBD interacts with anti-epileptics, antidepressants, opioids, acetaminophen, and alcohol
What the researchers found
CBD has confirmed or suspected drug interactions with anti-epileptic drugs, antidepressants, opioid analgesics, THC, acetaminophen, and alcohol. These interactions occur through multiple pharmacokinetic mechanisms, primarily involving cytochrome P450 enzyme inhibition.
Why it matters
With CBD products available everywhere and often used alongside prescription medications, the lack of awareness about these interactions creates real risks for adverse effects, particularly in people taking anti-seizure medications or opioids.
The numbers in context
FDA-approved CBD (Epidiolex) treats Dravet syndrome and Lennox-Gastaut syndrome; interactions identified with anti-epileptics, antidepressants, opioids, THC, acetaminophen, and alcohol
How the study worked
Systematic literature search across online databases compiling all reported CBD drug-drug interactions, with mechanisms categorized and presented in table format.
What this study cannot tell us
Many reported interactions are based on case reports or small studies. Some interactions are theorized based on metabolic pathways but not confirmed clinically. CBD doses in studies vary widely.
How to read the evidence
Comprehensive review drawing on clinical studies and pharmacokinetic data, though some interactions are based on limited evidence
When this study was published
Published in 2021. New CBD drug interactions continue to be identified as research expands.
The bigger picture
As CBD use continues to grow far beyond its FDA-approved indications, the gap between consumer awareness and the scientific evidence on drug interactions represents an underappreciated public health issue.
Questions still open
- At what CBD doses do clinically significant interactions occur? Are some CBD formulations more likely to cause interactions than others? Should routine drug interaction screening include CBD?
Common questions
Does CBD interact with other medications?
Is it safe to take CBD with prescription drugs?
Read the original research
Cannabidiol Interactions with Medications, Illicit Substances, and Alcohol: a Comprehensive Review.
Journal of general internal medicine, 36(7), 2074-2084
Citation
Balachandran, Premalatha; Elsohly, Mahmoud; Hill, Kevin P. (2021). Cannabidiol Interactions with Medications, Illicit Substances, and Alcohol: a Comprehensive Review.. Journal of general internal medicine, 36(7), 2074-2084. https://doi.org/10.1007/s11606-020-06504-8
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