CBD Oil Linked to Liver Injury in a Patient Also Taking Other Medications

A 45-year-old woman developed acute liver enzyme elevations while using therapeutic cannabis oil, with improvement after stopping the product, raising concerns about CBD-drug interactions and hepatotoxicity.

Balouch, Aiman et al.·Cureus·2025·Preliminary EvidenceCase Report
RTHC-06006Case ReportPreliminary Evidence2025RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Case Report
Evidence
Preliminary Evidence
Sample
Not reported

What This Study Found

A 45-year-old female on therapeutic cannabis oil developed an acute surge in liver transaminases. After excluding common causes including paracetamol and recent flucloxacillin (both hepatotoxic), liver parameters improved following discontinuation of the cannabis oil, suggesting a possible association with liver injury.

Key Numbers

One patient, age 45. Acute transaminase elevation during cannabis oil use. Improvement after discontinuation. Paracetamol and flucloxacillin were excluded as primary causes.

How They Did This

Single case report documenting clinical presentation, laboratory findings, workup to exclude alternative causes, and temporal relationship between cannabis oil discontinuation and liver enzyme improvement.

Why This Research Matters

As CBD products become widely available, recognizing them as potential hepatotoxins is important for clinicians investigating unexplained liver enzyme elevations, especially in patients taking other medications.

The Bigger Picture

CBD is known to interact with liver enzymes that metabolize many medications. This case adds to growing evidence that cannabis-derived products should be considered in the differential diagnosis of unexplained liver injury, particularly when patients are on multiple medications.

What This Study Doesn't Tell Us

Single case report cannot prove causation. The patient was taking other potentially hepatotoxic medications. Cannot determine whether CBD alone or a drug interaction caused the injury.

Questions This Raises

  • ?What specific CBD-drug interactions most commonly cause liver injury?
  • ?At what CBD doses does hepatotoxicity risk increase?
  • ?Should liver function monitoring be standard for therapeutic CBD users?

Trust & Context

Key Stat:
Liver enzymes improved after cannabis oil was stopped
Evidence Grade:
Preliminary: single case report that can suggest but not prove a causal relationship
Study Age:
Published in 2025
Original Title:
Unveiling the Unexpected: A Case of Synergistic Drug Reaction to Cannabidiol.
Published In:
Cureus, 17(8), e90992 (2025)
Database ID:
RTHC-06006

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / Observational
Case Report / Animal StudyOne case or non-human subjects
This study

Describes what happened to one person or a small group.

What do these levels mean? →

Frequently Asked Questions

Can CBD damage the liver?

This case report and other research suggest that CBD can contribute to liver injury, particularly in combination with other medications. FDA-approved CBD (Epidiolex) carries a warning about hepatotoxicity, and liver monitoring is recommended.

Was CBD definitely the cause?

The case report cannot prove causation. The patient was also taking paracetamol and had recently used flucloxacillin, both of which can cause liver injury. However, the temporal improvement after stopping cannabis oil supports a possible association.

Read More on RethinkTHC

Cite This Study

RTHC-06006·https://rethinkthc.com/research/RTHC-06006

APA

Balouch, Aiman; Muslim, Muhammad Osama; Akram, Muhammad; Haseeb, Syed Saad; Chaudhary, Muhammad Naqash. (2025). Unveiling the Unexpected: A Case of Synergistic Drug Reaction to Cannabidiol.. Cureus, 17(8), e90992. https://doi.org/10.7759/cureus.90992

MLA

Balouch, Aiman, et al. "Unveiling the Unexpected: A Case of Synergistic Drug Reaction to Cannabidiol.." Cureus, 2025. https://doi.org/10.7759/cureus.90992

RethinkTHC

RethinkTHC Research Database. "Unveiling the Unexpected: A Case of Synergistic Drug Reactio..." RTHC-06006. Retrieved from https://rethinkthc.com/research/balouch-2025-unveiling-the-unexpected-a

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.