CBD and Prescription Drugs

CBD and Drug Interactions

What can I do to be safe with CBD and Drugs?

  • Talk to your doctor regularly.
  • Keep track of everything (Blood sugars, Calories, Activities)
  • Get blood tests regularly if you are on opiates and blood thinners
  • Practice healthy habits, such as yoga and eating healthy foods
  • If you can't take it with Grapefruit, Don't test it with CBD either.

It is important to understand that everyone is chemically different, and that there is no solution that suits all individuals the same. What can be said, is that we all have an endocannabinoid system and it is important to explore it as an option of providing pharmacological effects through means of dietary consumption and use, much like spinach has iron, and grapefruit has compounds that interact with the body in complex ways, where mixing medication with certain foods is not the wisest idea.

Heartland Hemp Inc. does not claim to be medical professionals, we do not claim to treat, diagnose, cure, relieve, or otherwise heal any sickness, illness, disease, ailment, or otherwise a medically definable condition. 

We encourage healthy choices, education, research, and well being. 

Methods of Delivery for Drugs and Cannabinoids

When CBD was first coming out, it was previously believed that CBD had no real interactions with prescription drugs, however, this is not the case. This article addresses how CBD and other cannabinoids interact with the drug delivery system in the human body through what is known as the Cytochrome P450 Enzymes

First, we must review the methods of delivery, which are the ways humans and animals are using CBD, or Cannabidiol. 

There are many ways to take CBD , lets first go over the methods of delivery. 

Inhalation by Smoking or Vaporization

One of the most associated methods of taking medicinal marijuana is through smoking or vaporization or “vaping” cannabis extracts and cannabinoids extracted from cannabis or hemp. 

This method is currently being researched for it’s effects on the lungs with respiratory issues.

Oral

Oral Drug Delivery Method

The oral method of delivery is the most common in prescription and over the counter (OTC) drugs. 

While this method is highly popular due to the ease of compliance from consumers, it lacks benefits in realms such as bioavailablity, meaning it can be time consuming or in some cases, difficult to fully introduce a drug or chemical into the body through this method.

Oro-mucosal or Sublingual

Taking pills, oils, and drugs that are sublingual have a higher bioavailability than most methods of consumption. 

This is because the tissues in the mouth are highly vascular, meaning that there are multiple pathways into the blood vessels through this method of drug consumption.

Many CBD companies will recommend sublingual ingestion of their oils to improve bioavailability. 

Topical or Rectal Suppositories

Topical applications are increasing in popularity for the associated relief that cannabinoids are able to provide in products such as lotions, creams, gels, pastes, and more. 

Rectal suppositories do exist, however, due to the psychological stigma associated and lack of compliance from many patients, it has left this side of studies in regards to cannabinoids a little less looked into. 

Taking Hemp CBD Orally With Pills

Oral Drug Delivery Method

When looking to move into taking hemp CBD, it is important to understand that when ingesting CBD orally, there are some risks involved with about 60% of prescription drugs.

Work closely with your doctor if you are on blood thinners or opiates.

Another guideline is: If you cannot eat grapefruit with your prescription pill or OTC, don’t mix CBD with it either.

Cytochrome P450 Enzymes

THC (Tetrahydrocannabinol)  and CBD (Cannabidiol) are metabolized by CYP3A4 and CYP2C9  

CYP3A4 Inhibitors slightly increase the THC levels.

CYP3A4 Inducers slightly decrease the THC levels.

Tetrahydracannabinol (THC) is a CYP1A Inducer Theoretically, THC can decrease serum concentrations of:

  • Clozapine
  • Duloxetine
  • Naproxen
  • Cyclobenzaprine
  • Olanzapine
  • Haloperidol
  • Chlorpromazine

Cannabidiol (CBD) can inhibit the cytochrome P450 system’s ability to metabolize certain drugs, leading to an overall increase in processing times.

  • Steroids
  • HMG CoA Reductase Inhibitors
  • Calcium channel blockers
  • Antihistamines
  • Antibiotics
  • Anesthetics
  • Antipsychotics
  • Antidepressants
  • Anti-Epileptics
  • Beta blockers
  • PPIs
  • NSAIDs
  • Angiotension II blockers
  • Oral hypoglcemic agents
  • Sulfonylureas 

Other Drug Interactions

According to the named studies, these interactions ocurred with use of THC, CBD, and sometimes fulls spectrum. It is important to note that these are not the ONLY studied effects or affected items.

Wharfarin

THC and CBD increase warfarin levels
(Yamaori et al 2012).

Frequent cannabis use has been associated with increased INR.

Alcohol

Alcohol may increase THC levels
(Hartman 2015).

Theophylline

Smoked cannabis can decrease
theophylline levels
(Stout and Cimino 2014)

Indinavir or nelfinavir

Smoked cannabis had no effect
(Abrams et al 2003).

Docetaxel or irinotecan

Cannabis infusion (tea) had no effect
(Engels et al 2007).

Clobazam

In children treated with CBD for epilepsy,
CBD increased clobazam levels
(Geffrey et al 2015).

Cannabinoids and Diabetes

Cannabinoids such as CBD and THC have been undergoing studies for quite some time now, and while the complete evidence and methods of how cannabinoids interact with insulin in the body are few at this time, below are two quotes from reputable sources in regards to the studies going on with diabetes and cannabinoids.

The research included over 4,600 men and women participating in the National Health and Nutrition Examination Survey between 2005 and 2010. Among them, 48% had smoked marijuana at least once in their lives, and 12% were current cannabis smokers. The authors controlled for other factors like age, sex, income, alcohol use, cigarette smoking and physical activity that could also affect diabetes risk.

Even after these adjustments, the current marijuana users showed fasting insulin levels that were 16% lower than those of former or never users, along with a 17% reduction in another measure of insulin resistance as well. Higher levels on both tests are associated with Type 2 diabetes, which is linked with obesity. Marijuana users also had higher levels of high-density lipoprotein, the so-called good cholesterol, which can protect against heart disease. And the regular smokers also boasted smaller waistlines: on average, they were 1.5 in. (3.8 cm) slimmer than the former users and those who had never smoked cannabis.

 ~ Time – Healthland

Whether or not cannabis itself or cannabinoids contained in it may help to reduce hepatic steatosis in HIV-HCV coinfected patients remains an open question. The existing body of knowledge on the interactions between cannabis and the liver suggest a protective effect of cannabinoids on insulin resistance, diabetes, and NAFLD in the general population. Clinical research with randomized study designs is needed to evaluate the efficacy and safety of cannabis-based pharmacotherapies in HIV-HCV coinfected patients. Targeting the endocannabinoid system seems essential to differently manage several pathological conditions such as intestinal inflammation,
obesity, diabetes and fatty liver disease. However, to date, few drugs have been tested in clinical trials. CB1-antagonists and CB2-agonists appear to be viable therapeutic options that need to be explored for the management of liver diseases.

Taylor & Francis Online

Toxicity and Lethality of Cannabinoids

 Serious adverse effects are rare with cannabis or its constituents. Marijuana has low to  moderate dependence potential; the active dose is very far below the lethal dose.

Active to Lethal Dose Ratio & Dependence Potential of Psychoactive Drugs

Active Dose Potential

Moving Forward with CBD Oils and Prescription Drugs

Overall, the goal is to transition away from intoxicants that introduce a large variety of side effects, where hemp CBD oil is a promising regulator of the human body functions. 

The best way to take and use this information is to share this with your doctor and ask them about how you can get started with this holistic hemp and healthy habits lifestyle with the least risk to your health.

Alternatively, if you are not interested in using CBD for it’s regulatory properties, you will find a safer method of delivery by means of using topical lotions that are infused with full spectrum cannabinoids.

Citations

  • https://www.projectcbd.org/science/cannabis-pharmacology/cbd-drug-interactions-role-cytochrome-p450
  • https://www.ncbi.nlm.nih.gov/pubmed/12126458
  • https://doh.dc.gov/sites/default/files/dc/sites/doh/publication/attachments/Medical%20Cannabis%20Adverse%20Effects%20and%20Drug%20Interactions_0.pdf
  • https://www.cbdschool.com/cbd-and-drug-interactions-an-easy-guide/
  • https://www.sciencedirect.com/topics/pharmacology-toxicology-and-pharmaceutical-science/oral-drug-delivery
  • https://en.wikipedia.org/wiki/Oral_mucosa
  • https://en.wikipedia.org/wiki/Cytochrome_P450
  • http://healthland.time.com/2013/05/21/marijuana-the-next-diabetes-drug/
  • https://www.tandfonline.com/doi/full/10.1080/14787210.2018.1473764?scroll=top&needAccess=true