There’s reason to believe that, as safe as CBD has been shown when used alone, it may have the potential to negatively react with other medications to create some unintended side effects. Can You Take CBD Oil With Levothyroxine? Drug interaction is defined as the changes in a drug’s effects due to recent or concurrent use of another drug or drugs (drug-drug interactions), Can You Take Thyroid Medicine With CBD Oil “Can I vape cbd or take less amount of cbd oil so it does not inteferes with my medicine because of the P450 enzyme?” Yes, you can vape CBD oil.
What Kind of Drug Interactions Can Happen with CBD?
Many consumers are increasingly turning to CBD products as a natural alternative to everything from chronic pain relief to the treatment of ADHD, anxiety, and more. While CBD, one of the many compounds inherent to the cannabis sativa plant, may offer a nice alternative to current treatments, including prescription drugs, it’s important to be smart about how CBD could potentially interact with any other medications you’re taking.
7 Common CBD Oil Drug Interactions
- Antidepressants, such as Fluoxetine or Prozac
- Any drug that causes drowsiness, including antipsychotics and benzodiazepines
- Macrolide antibiotics like Erythromycin and Clarithromycin
- Seizure Medications Like Clobazam, Lamotrigine and Vaproate
CBD has many exciting possibilities when it comes to therapeutic treatment, but it’s important to remember that the research around is in the very early stages. Because researchers haven’t fully explored CBD’s mechanism of action (yet), it can be sometimes be hard to predict whether it will have interactions with other medications, both over-the-counter and prescriptions. What behaves as a safe and natural remedy for one patient could have unintended negative interactions with another patient, depending on the other compounds in the patient’s system.
While we’ll outline some of the most common CBD oil drug interactions, it’s always important to visit with your doctor or consult with a pharmacist if you have any concerns about potential negative side effects.
Does CBD Interact with Medications?
There’s reason to believe that, as safe as CBD has been shown when used alone, it may have the potential to negatively react with other medications to create some unintended side effects.
CBD may at times react with over-the-counter medications, herbal products, and some prescription medications, which underscores the necessity of talking with a doctor or pharmacist before trying CBD products if you’re regularly taking a drug for a heart condition, pain or another medical condition. Some medications should never be taken with CBD, while others can be modified or reduced in order to decrease the chance of a negative CBD drug interaction. And while CBD information for medical professionals is in early phases, your doctor is still the best equipped to provide sound advice about how to safely use CBD for your particular medical condition.
According to Nina M. Bemben, PharmD, BCPS —a specialist in drug interactions—CBD, along with many other medications and compounds, are broken down for the body’s use by the liver enzyme family known as Cytochrome p450. Because CBD acts as an inhibitor to certain CYP enzymes, it could cause other medications in the body to be broken down more slowly—which, unless your doctor lowers your dosage, could lead to increased side effects. On the other hand, CBD can induce other CYP enzymes, which may lead to a faster drug metabolism, resulting in reduced efficacy unless the dosage is increased.
While much research is needed on exactly how CBD behaves within our bodies and how it interacts with various other medications, here’s a good general rule to remember: if you take a drug with a label that features a grapefruit juice warning, it’s a good idea to steer clear of any CBD product while you take that drug. Why? According to the U.S. Food and Drug Administration , a medication with this warning, taken together with grapefruit or grapefruit juice, can manifest at a higher than intended concentration within the blood, potentially causing adverse events.
What does this have to do with CBD? A class of chemicals present in grapefruit juice, known as furanocoumarins, inhibit the enzyme CYP3A4—in much the same way CBD does, resulting in a slower metabolization of medications. So, if you’re taking a medication that features a grapefruit warning, there’s a good chance CBD may cause a few issues with that drug as well. More than 85 different drugs react negatively with grapefruit, including many of the following—you’ll notice a distinct overlap between this list and the list of drugs that commonly have a CBD drug interaction:
- Antibiotics and antimicrobials
- Anticancer medications
- Antiepileptic drugs
- Blood pressure medications
- Blood thinners
- Cholesterol medications
- Erectile dysfunction medications
- GI medications, such as those used to treat nausea and GERD
- Heart rhythm medications
- Mental health medications, such as to treat anxiety, depression, or mood disorders
- Pain management medications
- Prostate medications
The good news? Based on what we know about how CBD is metabolized, there doesn’t seem to be much concern over potential reactions to nonsteroidal anti-inflammatory drugs and/or other prescription medications used to treat the symptoms of arthritis. More good news: there are no reports of any life-threatening interactions that over-the-counter CBD products have had with any herbal, OTC, or prescription drug. Commonly reported side effects have included drowsiness, nausea, diarrhea, dry mouth, a decrease in medication efficacy and changes in appetite or weight.
With the help of your doctor, it’s possible to add CBD to your therapeutic regimen, even if you’re taking another prescription medication that could interact negatively with CBD. It may just be a question of adjusting dosage, monitoring liver function and/or carefully watching for side effects.
We also want to stress that you should never forego your current medication to try CBD without talking with your doctor first. Some medications will need the dosage slowly tapered down in order to safely discontinue use, while others may require careful monitoring.
7 Common CBD Oil Drug Interactions
Let’s take a closer look at common medications CBD oil may negatively interact with:
1. Antidepressants, such as Fluoxetine or Prozac
Some common medications prescribed for depression, such as Fluoxetine and Prozac, when combined with CBD, may increase drowsiness or dizziness. This can be dangerous for patients who are older or who otherwise experience mobility issues, as it may increase the chances for a dangerous or even life-threatening fall.
2. Any drug that causes drowsiness, including antipsychotics and benzodiazepines
Any drug that causes drowsiness, which is a surprisingly large collection, has the potential to combine with CBD for an intensified effect. Anyone who is taking these types of medications combined with CBD is at an increased risk for impaired judgment, falls, and other dangerous situations that result from excessive drowsiness.
3. Warfarin and Clopidogrel
Warfarin is a fairly common drug prescribed as a blood thinner. The most reliable information we have about CBD’s potential interaction with Warfarin comes from studies of the only FDA-approved CBD product, Epidiolex, which is a prescription treatment for rare forms of epilepsy. Epidiolex has been shown to increase blood levels of Warfarin by approximately 30 percent. With this increase comes a higher risk of excessive bleeding. Clopidogrel also interacts with CBD.
4. Macrolide antibiotics like Erythromycin and Clarithromycin
These types of antibiotics are widely prescribed for the treatment of bacterial infections. Because CBD has the ability to slow down or speed up the metabolism of antibiotics by our CPY450 enzymes, taking antibiotics in conjunction with CBD may mean you end up with a higher dose of drugs in your system than is either safe or effective.
Amiodarone is often prescribed to address irregular heart rhythm. CBD metabolism often is slowed down when taken in combination with Amiodarone, resulting in elevated levels of both medications in your system if they’re used together. In addition, both CBD and amiodarone can cause an elevation in liver enzymes, and the effect is exacerbated when the two are taken together.
Levothyroxine is a commonly prescribed thyroid medication. In fact, it is likely the most popular drug prescribed for thyroid issues. When CBD and levothyroxine are taken together, they are forced to compete within the CPY450 enzyme pathways for effective drug metabolism. This kind of drug interaction could cause thyroxine to accumulate, which could result in hyperthyroidism. In addition, when thyroid medications and CBD products are taken too closely together, some patients may experience short-term anxiety and mild nausea.
Seizure medications, like Clobazam, Lamotrigine and Vaproate
Clobazam, Lamotrigine, and Vaproate often are prescribed for patients experiencing seizures, either due to epilepsy or other health conditions. In some cases, CBD has increased the Clobazam levels of children treated with both Clobazam and CBD for epilepsy.
Does CBD Consumption Method Matter?
The manner in which you consume CBD absolutely has an effect on its potential to negatively react with other medications you take. Inhaling CBD, for example, deposits the compound almost immediately into your bloodstream, which allows it to reach peak concentration within 30 minutes. This delivery method avoids the liver’s metabolism, but may still increase the chances that CBD will negatively react with other medications already in your system.
Edible CBD vehicles, like soft chews, CBD gummies, etc., take longer to absorb and reach peak concentration, but they also have the potential to reach a highly concentrated enough level that negative interactions are possible. The same is true for a CBD oil or emulsion tincture .
CBD topicals, such as balms, creams, CBD lotion, etc., are the least likely to react negatively with other medications in your bloodstream because absorption through the skin decreases the amount of CBD that may eventually make its way into your bloodstream.
Other factors that influence both the occurrence and severity of a CBD interaction with other pharmaceutical drugs may include the age of the patient, the dosage amount of both CBD, and the interacting drug, plus any existing underlying medical conditions. Older patients may be at higher risk of potential negative drug interaction for a couple of reasons: first, as we age, the time our bodies take to process compounds like CBD and other medications increases, and second, older patients are more likely to take multiple medications on a regular basis.
Your doctor can help you figure out what type of CBD and dosage may be right for you, considering your medical profile and any medications you already take on a regular basis.
Create a CBD Treatment Plan with Your Medical Team Today!
CBD shows great promise in being able to offer patients relief from a wide variety of medical conditions, but it’s still in the early stages of research. If you want to try CBD, but are already taking a medication to treat your condition, make sure to confer with your doctor before adding CBD to your treatment plan or before using CBD to replace any of your current medications.
Your doctor can help you develop a plan that will let you enjoy the highest therapeutic effect of CBD with the fewest possible side effects. And when you’re ready to purchase high quality, responsible CBD products, our team at Farmer & Chemist is here to help—we have a broad variety of CBD oils, creams, gummies, and more. Our team of pharmacists and pharmacy technicians are also available to answer any questions you may have about the appropriate use of CBD, as well as any potential drug interaction you need to speak to your doctor about.
Can You Take CBD Oil With Levothyroxine?
Drug interaction is defined as the changes in a drug’s effects due to recent or concurrent use of another drug or drugs (drug-drug interactions), ingestion of food (drug-nutrient interactions), or ingestion of dietary supplements (dietary supplement-drug interactions).
Drug-drug interactions result when two or more drugs react with each other. Such drugs can be from a combination of prescription drugs and/or over-the-counter (OTC) medications. Drugs with a narrow therapeutic range (little difference between therapeutic and lethal dose) are more likely to face incidents of serious drug interactions.
What is levothyroxine?
Levothyroxine is a prescription medicine used to treat an underactive thyroid gland (hypothyroidism). The thyroid gland makes thyroid hormones that help to control energy levels and growth. Levothyroxine is taken to replace the missing thyroid hormone thyroxine.
Levothyroxine belongs to a class of drugs called hormones. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions. About 40-60% of orally administered levothyroxine is absorbed; the majority from the jejunum and upper ileum of the gastrointestinal tract. Absorption is increased when levothyroxine is taken on an empty stomach. Levothyroxine works by providing the thyroid hormone that your thyroid gland would produce if it were working normally.
About 1 to 2 weeks after you start treatment with levothyroxine, you will likely notice that your levels of fatigue have improved. It is important that you take your medication exactly as prescribed and not miss any doses as well as maintain routine checkups with your primary health care provider.
What is CBD oil?
Cannabidiol (CBD) oil is a product that’s derived from cannabis. It’s a type of cannabinoid, which are the chemicals naturally found in marijuana plants. Even though it comes from marijuana plants, CBD doesn’t create a “high” effect or any form of intoxication — that’s caused by another cannabinoid, known as THC. This quality makes CBD an appealing option for those who are looking for relief from pain and other symptoms without the mind-altering effects of cannabis or other side effects related to some pharmaceutical drugs.
CBD oil is made by extracting CBD from the cannabis plant and then diluting it with a carrier oil like coconut oil or hemp seed oil. CBD can be found in a variety of products online and in stores, including dietary supplements, bath soaks, drinks, and food.
It continues to gain momentum in the health and wellness world, with some scientific studies finding that it may ease symptoms of several conditions. A high-quality CBD oil may address a variety of thyroid dysfunctions. This underperformance includes hypothyroidism, hyperthyroidism, goiter, thyroiditis, and thyroid storm. All of the above conditions are triggered by chronic inflammation of the thyroid gland due to the body’s autoaggressive actions on this organ.
We know that endogenous cannabinoids (the ones produced by our bodies) help regulate our appetite, energy, homeostasis, and influence endocrine glands, including the pituitary gland and thyroid gland. Research does not yet know how external cannabinoids (like CBD oil) affect these glands and your serum thyroid hormones concentrations like TSH and T4.
A 2015 study found significant concentrations of CB1 and CB2 cannabinoid receptors in the thyroid glands. These receptors were associated with the shrinkage of thyroid tumors, showing promise as potential blockers of the spread of malignant cells on the gland.
Can you take CBD oil with levothyroxine?
No, you should never take CBD oil with levothyroxine together, because taking CBD oil with other medications that have similar effects like levothyroxine may increase the risk of unwanted symptoms or toxicity.
In addition, taking CBD oil while on levothyroxine treatment can lead to hyperthyroidism, a condition where your thyroid makes and releases high levels of thyroid hormone. This condition can speed up your metabolism. Symptoms of hyperthyroidism include a rapid heartbeat, weight loss, increased appetite, and anxiety.
Researchers are working to determine the specific interactions between CBD and various medications. Studies have been done on animals for certain medications, but in many cases, scientists are still determining how those results translate to humans.
Can You Take Thyroid Medicine With CBD Oil
“Can I vape cbd or take less amount of cbd oil so it does not inteferes with my medicine because of the P450 enzyme?”
Yes, you can vape CBD oil.
Does vaping get processed through the liver also?
The interaction of cannabinoids and levothyroxine competing for metabolism in the cytochrome p450 pathway would most likely be a hyPERthyroid state, as more thyroxine would accumulate before breakdown. It may be that ingesting a CBD oil or similar preparation is impairing the absorption of the thyroid medicine from the GI tract, which could cause you to become hypothyroid by just not absorbing enough. Vaping CBD is an excellent way to take it, and would have the same metabolic consequences as ingesting it but eliminates problems from non-absorption. By the way, although cytochrome enzyme metabolism is relevant in cannabis, the difference between real world clinical effects and laboratory effects is more relevant. There is little or no clinical data re: significant effects on blood levels of common medications in ambulatory patients. I suspect unless extremes of dosage or other conditions are happening the competition for metabolic breakdown between cannabis and those medications is of marginal significance for most patients.
I use Armour Thyroid and I smoke a CBD oil, ratio: 55% CBD, 15% THC and 1% CBN. I use it often for my arthritis pain and heart palpatations. I have had to cut my thyroid med by half as my TSH was .5. I hope my next blood test will show it at around 1.5. You shouldn’t go Hypo with the combination. You should go to a more hyper state, if there is a bit of a conflict. Different Gender can make a big difference as other body hormones will affect the Armour’s absorbtion.
One of the other responses mentioned Levothyroxine, which is quite different than Armour. I would think that the interactions would be different. In my case it seems as though the Cannabis is causing better absorbtion. I have no way of verifying my reactions to the combination as we just don’t have enough research to point us in a useful direction, nor can you get a lab to test you for both….they wouldn’t have any guidelines.
I was on sythroid for many years. I had a total TT and been on NDT and cytomel. My digestion is better and appetite. But still have a lot of issue with bloating . I also have OA, DDD , gastropareis. I take CBD oil and an indica flower high THC at night. I am doing better since started on Natural thyroid meds. My TSH is finally stabilize. I also take digstive supplement and other herbs therapy.