The popularity of CBD is growing steadily in the Netherlands, and at Dutch Balance we are regularly asked whether CBD is safe to use alongside medicines. It is an important question, because although CBD is a natural food supplement, that does not automatically mean it has no influence on other substances you take. Research shows that as many as 81% of people who use herbal preparations combine them with medication, often without properly knowing what the possible risks are.
In this article we explain what you need to know about possible interactions between CBD and medicines, so you can make a well-considered choice. Because safety always comes first with us.
What are interactions?
An interaction arises when two substances influence one another in your body. This can mean that a medicine works less well, works more strongly than intended, or that unexpected side effects occur. As the CBG (Dutch Medicines Evaluation Board) explains: a medicine can as a result “suddenly work less or in fact more strongly” and “side effects can also arise”.
With CBD this happens mainly because the compound is broken down by the same enzymes in the liver that also process many medicines. This system is called the cytochrome P450 system. Just as grapefruit juice is known to influence certain medicines, CBD can inhibit these enzymes too. As a result, medicines can stay in your body longer or be broken down faster than normal.
Medicines that need extra attention
Blood thinners
Blood thinners such as warfarin are among the riskiest combinations with CBD. Researchers at Harvard Medical School warn specifically about this combination. CBD can cause blood thinners to stay in your body longer, which increases the chance of bleeding.
Signs to look out for are unexplained bruising, having a nosebleed more often than normal, bleeding for a long time from small cuts, or bleeding gums. Do you notice any of these? Then contact your doctor straight away.
Heart and blood pressure medication
CBD can strengthen the effects of blood pressure lowering medicines. Research shows that the heart rhythm medicine amiodarone and thyroid medication such as levothyroxine in particular can cause problems.
This can lead to a sudden drop in your blood pressure, dizziness or fainting. Do you take heart or blood pressure medication? Then it is extra important to check your blood pressure regularly, especially in the first weeks after you start with CBD.
Sleeping pills and sedatives
Harvard researchers state that CBD combined with benzodiazepines (such as Xanax), antidepressants, antihistamines or alcohol “can lead to increased sleepiness, fatigue and possibly accidents while driving”. This combination can be very dangerous, especially because both substances have a sedative effect that reinforces the other.
Jellinek warns that “CBD oil can strengthen their action” and advises “taking extra care in traffic”. Natural sleep aids such as valerian and melatonin can, in combination with CBD, lead to too much sleepiness too. If you have trouble sleeping, it is extra important to be careful with combinations.
Epilepsy medication and antidepressants
Certain epilepsy medicines such as clobazam, lamotrigine and valproate can have both positive and negative interactions with CBD. The CBG confirms that herbal preparations with cannabis “influence anti-epileptics and antidepressants”.
Interestingly, this can sometimes work out well: research shows that in some cases CBD can improve how epilepsy medication works. This always requires strict medical supervision, though.
With antidepressants, especially SSRIs such as fluoxetine (Prozac), CBD can cause the concentration in the blood to rise. This can lead to what is known as serotonin syndrome, a dangerous condition with symptoms such as confusion, tremors and a fast heartbeat. Want to know more? Read more about the possible side effects of CBD.
Using CBD and medicines safely: practical tips
Being honest with your doctor is very important. Research by the CBG shows that “72% of users of herbal preparations have not informed their GP of this use”. That is worrying, because your doctor can only get a complete picture if you are open about all the substances you use.
Always start with a low dose of CBD, such as the CBD oil 5% we offer at Dutch Balance. We recommend starting with 2 to 3 drops a day. Pay close attention to signals from your body, such as unusual tiredness, dizziness or other changes you cannot explain.
Keep a diary of your CBD use and possible effects. This helps your doctor give good advice. Also think about the form in which you use CBD: CBD capsules or oil under the tongue give a more gradual absorption and are often safer alongside medication than forms you inhale. Are you curious about which CBD oil suits you best? Then our overview article will help you further.
Plan your CBD intake carefully. Do not take CBD at the same time as important medication, but try to leave at least 2 hours between them. Make sure you have regular check-ups with your doctor, especially when you start with CBD.
Important information before you combine CBD and medicines
CBD is a food supplement and not a medicine. Dutch Balance does not give medical advice. Do you have medical complaints? Then always consult your doctor and discuss using CBD before you start. Never simply stop taking medicines without medical advice.
At Dutch Balance we work with brands that have their products tested by external laboratories for purity and content. The reports are available on request.
