CBD interacts with a surprisingly wide range of medications, from anti-epileptics to common pain relievers
A comprehensive review found CBD interacts with anti-epileptic drugs, antidepressants, opioids, THC, acetaminophen, alcohol, and numerous other common medications.
Quick Facts
What This Study 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.
Key Numbers
FDA-approved CBD (Epidiolex) treats Dravet syndrome and Lennox-Gastaut syndrome; interactions identified with anti-epileptics, antidepressants, opioids, THC, acetaminophen, and alcohol
How They Did This
Systematic literature search across online databases compiling all reported CBD drug-drug interactions, with mechanisms categorized and presented in table format.
Why This Research 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 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.
What This Study Doesn't 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.
Questions This Raises
- ?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?
Trust & Context
- Key Stat:
- CBD interacts with anti-epileptics, antidepressants, opioids, acetaminophen, and alcohol
- Evidence Grade:
- Comprehensive review drawing on clinical studies and pharmacokinetic data, though some interactions are based on limited evidence
- Study Age:
- Published in 2021. New CBD drug interactions continue to be identified as research expands.
- Original Title:
- Cannabidiol Interactions with Medications, Illicit Substances, and Alcohol: a Comprehensive Review.
- Published In:
- Journal of general internal medicine, 36(7), 2074-2084 (2021)
- Authors:
- Balachandran, Premalatha, Elsohly, Mahmoud(2), Hill, Kevin P(9)
- Database ID:
- RTHC-02989
Evidence Hierarchy
Summarizes existing research on a topic.
What do these levels mean? →Frequently Asked Questions
Does CBD interact with other medications?
Yes. This review found CBD interacts with anti-epileptic drugs, antidepressants, opioids, THC, acetaminophen, alcohol, and other common medications, primarily by affecting liver enzymes that break down these drugs.
Is it safe to take CBD with prescription drugs?
CBD can alter how the body processes many medications, potentially increasing side effects or reducing efficacy. The review emphasizes the importance of understanding these interactions, especially for people on multiple medications.
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Cite This Study
https://rethinkthc.com/research/RTHC-02989APA
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
MLA
Balachandran, Premalatha, et al. "Cannabidiol Interactions with Medications, Illicit Substances, and Alcohol: a Comprehensive Review.." Journal of general internal medicine, 2021. https://doi.org/10.1007/s11606-020-06504-8
RethinkTHC
RethinkTHC Research Database. "Cannabidiol Interactions with Medications, Illicit Substance..." RTHC-02989. Retrieved from https://rethinkthc.com/research/balachandran-2021-cannabidiol-interactions-with-medications
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.