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.
CBD users, clinicians evaluating liver enzyme elevations, pharmacists monitoring drug interactions
Liver enzymes improved after cannabis oil was stopped
What the researchers 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.
Why it 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 numbers in context
One patient, age 45. Acute transaminase elevation during cannabis oil use. Improvement after discontinuation. Paracetamol and flucloxacillin were excluded as primary causes.
How the study worked
Single case report documenting clinical presentation, laboratory findings, workup to exclude alternative causes, and temporal relationship between cannabis oil discontinuation and liver enzyme improvement.
What this study cannot 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.
How to read the evidence
Preliminary: single case report that can suggest but not prove a causal relationship
When this study was published
Published in 2025
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.
Questions still open
- 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?
Common questions
Can CBD damage the liver?
Was CBD definitely the cause?
Read the original research
Unveiling the Unexpected: A Case of Synergistic Drug Reaction to Cannabidiol.
Cureus, 17(8), e90992
Citation
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
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