- CBD can be used in place of many common medications, but when used together, these combinations can cause issues.
- Medications that interact negatively with CBD include opioids, SSRIs, Warfarin, antihistamines, and melatonin, among others. These interactions trigger concerning symptoms such as intense drowsiness and altered concentrations of medications.
- Always speak with a physician before making any changes to your current treatment plan.
The first question your doctor will ask before recommending you a new medication is, “What medications do you currently take?” A drug may be able to treat your symptoms, but if it interacts negatively with another one you take, you may have to rethink your treatment plan.
What does this mean for holistic healing options like CBD?
Patients currently use CBD to safely and effectively manage chronic pain, mental health, inflammation, and more. Like most other medications, though, it may cause harm when combined with other drugs.
From prescription drugs like opioids and antidepressants to over-the-counter (OTC) medications like antihistamines and melatonin, find out what to avoid while using CBD. And if, after reading, you want more personalized advice, TeleLeaf can connect you with an expert medical marijuana clinician.
What Is CBD?
CBD is the abbreviated name for cannabidiol, one of the most well-known cannabinoids derived from the cannabis plant.
Like all cannabinoids, CBD interacts with your body’s endocannabinoid system (ECS). The ECS regulates some of your most important internal functions; activating it with cannabinoids can benefit people living with a wide range of physical and mental health conditions.
Specifically, CBD can:
- Relieve chronic pain
- Relax and uplift mood
- Soothe muscles
- Promote sleep
- Protect neurological functions
- Reduce inflammation
- Lower blood pressure
Patients also love CBD for what it doesn’t do: CBD has no psychoactive properties, so you can’t get high by taking CBD alone. Broad-spectrum CBD and CBD-isolate products contain little to no tetrahydrocannabinol (THC)—the famous psychoactive cannabinoid—ensuring you won’t feel intoxicated.
Products come in a variety of forms from edibles and gummies to oils, capsules, and tinctures.
CBD Access
CBD access has increased significantly thanks to the 2018 Farm Bill. The bill federally legalized the production of hemp, a variant of the cannabis plant that contains negligible amounts of THC.
Growers use hemp to manufacture a variety of finished goods. They also extract CBD from it, which they can then make into edibles, oils, tinctures, and more.
The FDA classifies CBD products as dietary supplements; therefore, it does not approve any CBD products on the market.
Don’t worry—you can still trust CBD products purchased from quality dispensaries. While dispensaries-grade products are lab-tested and labeled, these labels likely won’t include a detailed list of all the medications they interact with.
What Medications Interact with CBD?
Most medications interact with others in some way. This isn’t limited to prescription drugs, either. Over-the-counter medications, dietary supplements, and herbal remedies can all potentially cause adverse reactions when combined—including with CBD.
CBD interacts with several common medications; reactions may vary depending on the combination and dose.
Before making any medication changes, learn about the potential consequences. And remember—always discuss your thoughts with your healthcare provider before making any final decisions.
#1 Opioids
Doctors prescribe opioids to relieve pain, especially for patients with chronic pain conditions. Some unintended side effects of opioid use include fatigue and a euphoric “high.”
Because opioids increase your dopamine levels, misuse can quickly lead to dependence and overdose. To avoid this, many patients now turn to a safer, more holistic pain reliever: CBD.
Under a healthcare provider’s supervision, patients can use CBD to supplement and wean off of opioids and other prescription painkillers. CBD offers potent pain relief without the high risks. Compared to opioids, CBD:
However, because opioids and CBD can both make you drowsy, using them at the same time may elevate fatigue to an unpleasant—and potentially unsafe—degree.
If you want to reduce or halt opioid use by using CBD, work closely with your provider to develop a safe treatment schedule that relieves your symptoms without over-sedating you.
#2 Antidepressants
CBD also interacts negatively with a group of prescription medications called selective serotonin reuptake inhibitors (SSRIs), also known as antidepressants. Brand name SSRIs that may interact with CBD include:
Both CBD and SSRIs can relieve symptoms of depression and anxiety. They also share similar side effects; when taken together, this may cause you to experience more intense side effects, including sleep troubles and stomach pain. Doctors refer to this as “doubling.”
Researchers need to study these doubled interactions more closely, though they have a few potential explanations for them:
- Altered metabolism – CBD may impact your body’s ability to break down SSRIs normally. This causes excess amounts of SSRI compounds to build up and increases the risks of adverse side effects.
- Lowered blood-sodium levels – CBD may also significantly lower your blood-sodium levels when taking sertraline (Zoloft). This can dangerously impair your thinking.
We still know very little about the compounded effects of CBD and antidepressants. If you currently take an SSRI and are curious to explore the mental health benefits of CBD, speak with your healthcare provider to learn how to safely make the switch.
#3 Warfarin
In one study, researchers tested the drug interactions between cannabis-derived medications such as Epidolex with other common prescription medications. They found that many of these combinations cause altered concentrations—when the amount of medication in your body decreases or increases abnormally.
They found that CBD altered concentrations of Warfarin, a common blood thinner, to a concerning degree.
Other medications that CBD can dangerously alter concentrations of include:
- Amiodarone
- Levothyroxine
- Clobazam
- Lamotrigine
- Valproate
If you take any of these drugs, talk to a healthcare provider before using CBD or other cannabis products. Always speak with your provider before adjusting or quitting your current treatment plan.
#4 Antihistamines
Antihistamines suppress your body’s reaction to allergens. They combat mild allergy symptoms, including:
- Congestion
- Coughing
- Sneezing
- Itchy eyes
Additionally, some antihistamines can treat insomnia, nausea, and certain movement disorders like Parkinson’s disease.
Many first-generation antihistamines, such as diphenhydramine (Benadryl) cause drowsiness. Mixing Benadryl with CBD, which can also make you sleepy, may leave you feeling overly tired as well as dizzy, confused, and unfocused.
CBD can also treat many symptoms that antihistamines target, including inflammation, sleep troubles, nausea, and tremors. If you want to use CBD instead of antihistamines, discuss your thoughts with your provider.
#5 Melatonin
Melatonin supplements are intended to aid sleep: that’s all melatonin does. Combining it with CBD may aid sleep a little too much.
Few (if any) studies have tested the interaction between melatonin and CBD, so we don’t know the exact results. However, since both substances share some of the same properties, combining them may increase the risks of their side effects, such as:
- Drowsiness
- Confusion
- Dizziness
- Difficulty concentrating
Other sedating supplements, substances, and herbal remedies that can interact similarly with CBD include:
- Kava
- St. John’s Wort
- Valerian
- L-tryptophan
- Alcohol
While combining CBD and melatonin intensifies drowsiness, it won’t cause serious harm. With CBD, many people achieve enhanced, satisfying sleep. Some companies even sell combined CBD-melatonin supplements.
Talk with your provider to discover which sleep aid options can best serve your unique needs.
Navigate the World of Medical Marijuana with TeleLeaf as Your Guide
This article serves as a general outline for CBD medication interactions. Individual factors can also impact your medication interactions. How do you know which treatment is right for you? Gain cannabis clarity with TeleLeaf.
During your virtual appointment, you’ll meet with an experienced, state-certified medical marijuana clinician. Not only will they assess your qualifying conditions, but they’ll also advise you on the best path forward for managing your symptoms safely and effectively.
With TeleLeaf, your healing journey belongs to you. We seek to personalize your experience every step of the way, offering individualized medical marijuana guidance whenever you need it.
Schedule your appointment now or reach out for more information online and by phone at (504) 264-3123.
Sources:
Healthline. 6 Health Benefits of CBD Oil — and a Look at Side Effects.
https://www.healthline.com/nutrition/cbd-oil-benefits
Brookings. The Farm Bill, hemp legalization and the status of CBD: An explainer.
https://www.brookings.edu/articles/the-farm-bill-hemp-and-cbd-explainer/
Harvard Health Publishing. CBD and other medications: Proceed with caution.
https://www.health.harvard.edu/blog/cbd-and-other-medications-proceed-with-caution-2021011121743/
National Institute on Drug Abuse. Prescription Opioids DrugFacts.
https://nida.nih.gov/publications/drugfacts/prescription-opioids
Neurogan. Can You Overdose On CBD?
https://neurogan.com/
Drugwatch. CBD and Antidepressants.
https://www.drugwatch.com/mental-health/depression/cbd/
Cleveland Clinic. Antihistamines.
https://my.clevelandclinic.org/
Drugs.com. Drug Interactions between Benadryl and cannabidiol.
https://www.drugs.com/drug-interactions/benadryl-with-cannabidiol-896-1617-3919-0.html
Drugs.com. Drug Interactions between Epidiolex and melatonin.
https://www.drugs.com/drug-interactions/epidiolex-with-melatonin-3919-18874-1548-0.html
Dr. Chance Miller 
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