Cannabidiol (CBD) has become popular because of its therapeutic effects that are useful for relieving symptoms of a variety of diseases. Because of this, people are using health and wellness products formulated with it as the main ingredient for treating many common day ailments and as supplements. It is one of the major cannabinoids found in the cannabis family of plants, and the primary cannabinoid found in the hemp plant, which is used for making legally available cannabidiol products. This article will discuss CBD drug interactions and the drugs that you should not be taking with it.
CBD Therapeutic And Medical Uses
CBD, also known as cannabidiol, produces its therapeutic and medical effects due to its positive effect on the endocannabinoid system (ECS). Also, it has no side effects at normal doses and does not have psychotropic effects like its isomer tetrahydrocannabinol (THC). It is useful for treating the symptoms of depression, anxiety, schizophrenia, Parkinson’s disease, neuropathic pain, inflammations, etc. This wide spectrum of therapeutic use is because cannabidiol (CBD) interacts with various systems in the body. On the flip side, this also results in adverse side effects when it is consumed with other medications, especially those with grapefruit warning.
CBD’s adverse side effects due to its interaction with drugs are closely related to our body’s metabolism of pharmaceutical drugs. Most people mistake metabolism with the metabolic rate that determines weight gain or loss. This is the basal metabolic rate, i.e. the number of calories that your body requires when it is at rest; those who are frequently involved in strenuous activities have a higher basal metabolic rate. The side effects due to CBD’s drug interaction are because it affects the metabolizing function of a group of liver enzymes cytochrome P450 (CYP450).
The food we eat is broken down into different components in the gut and the liver, and this process is known as the first-pass metabolism. For example, the liver breaks down carbohydrates into sugars, triglycerides, and fats. Likewise, proteins are broken down into their constituent amino acids. These constituents are further metabolized by chemicals called enzymes into metabolites that are used by the cells and tissues of the body as fuel, as building blocks of cells and tissues, etc. This process is similar for CBD and pharmaceutical drugs, and CBD affects the metabolizing of pharmaceutical drugs by CYP450.
The Cytochrome P450 System
The cytochrome P450 metabolizes pharmaceutical drugs into useful metabolites that are used by the body to mitigate ailments. Also, it helps to excrete these xenobiotics after they perform their therapeutic function and thereby detoxifies the body. This entire process is called the CYP450 system. These enzymes have heme as a cofactor that converts fat-soluble compounds into water-soluble compounds so that they are easily absorbed by the cells and tissues of the body.
Studies have shown that more than 60% of any drug that we consume is processed by the CYP450 system. Also, doctors and pharmaceutical researchers use this system to calculate, learn, and predict the effects, dosage, and side effects of drugs. For example, the average time it takes for the CYP450 system to metabolize one therapeutic compound can be used for calculating its accurate dosage. However, some substances affect how the CYP450 system processes or metabolizes compounds. They either increase or decrease the metabolism of specific drugs by CYP450. As a result, the normal dosage of these drugs becomes either too less, decreasing their effectiveness or too much, causing unwanted side effects.
Cytochrome P450 System And CBD
Cannabidiol (CBD) directly interacts with the CYP450 system and thereby affects its metabolizing function. Research has shown that CBD binds to the binding site of CYP450 enzymes and decreases its activity as a competitive inhibitor. As a result of this, CBD displaces chemical competitors of this enzyme; these competitors include pharmaceutical drugs. The extent to which CBD causes this competitive inhibition depends on the amount of cannabidiol consumed. On top of this, it is also affected by the physiology of the individual, the method of consuming CBD, and the type of CBD extract, i.e. CBD isolate, full-spectrum CBD, or broad-spectrum CBD. Moreover, these factors together decide how strong CBD attaches to the binding site of CYP450 enzymes.
So, when CBD is consumed while you are taking pharmaceutical medicine, cannabidiol outcompetes the therapeutic compounds of the medicine in getting metabolized by the CYP450 system. In short, CBD undoes or minimizes the therapeutic effect of the medicine. Also, keep in mind consuming large quantities of cannabidiol (CBD) reduces the metabolic capacity of the liver.
CBD And Drug Interactions
Listed below are the drugs that you must not take while consuming cannabidiol for CBD health benefits.
- Steroids and corticosteroids
- Calcium channel blockers
- HMG CoA reductase inhibitors
- Immune modulators
- HIV antivirals
- Non-steroidal anti-inflammatory drugs (NSAIDs)
- Proton-pump inhibitors (PPIs)
- Oral hypoglycaemic agents
- Angiotensin II blockers
Due to the reasons mentioned above, you must consult your physician before taking cannabidiol products for CBD health benefits.