CBD and Drug Interactions: What You Should Know

  • June 14, 2022
  • /   Dr. Robert Heinzman
  • /   Post Tags
CBD and Drug Interactions: What You Should Know

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

It is important to understand that everyone is chemically different, and that there is no one 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 always the best idea.

Before we get started, we want you to know that 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 Delivery
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 bioavailability, 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
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 THC levels.

CYP3A4 Inducers slightly decrease 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
  • Angiotensin II blockers
  • Oral hypoglycemic agents
  • Sulfonylureas 

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

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

Frequent cannabis use has been associated with increased INR.

Alcohol may increase THC levels
(Hartman 2015).

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).

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

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 its regulatory properties, you will find a safer method of delivery by means of using topical lotions that are infused with full-spectrum cannabinoids.

Bottom line regarding CBD use in conjunction with prescription drugs:
1. Talk to your doctor regularly.
2. Keep track of everything (Blood sugars, Calories, Activities) so you and your doctor can make an informed decision. 
3. Get blood tests regularly if you are on opiates and blood thinners
4. Practice healthy habits, such as yoga and eating healthy foods
5. If you can’t take it with Grapefruit, Don’t test it with CBD either.

About the Author
LDr. J. Robert Heinzman, CEO of Heartland Hemp & disabled veteran, co-founded our company in 2017 after having experienced the benefits of hemp in easing his joint & muscle pains. Dr. Heinzman, like many of his fellow vets, retained aches & pains attributed to service life. He was taking 1200 mg of Ibuprofen (Motrin) & occasional prescription of codeine to ease the shooting & localized pains.

In early 2017 his son Joseph mentioned the benefits of CBD made from Cannabis & Hemp extracts. Joseph, having spent the last few years learning extraction & formulation in Mt. Shasta, California, applied his expertise to Hemp to provide a non-psychoactive, drug-free solution to help Dr. Heinzman.

The outcome was better than expected, with Dr. Heinzman feeling as much as twenty years younger.

Today Dr. Heinzman provides strategy, operations management, and is customer “zero”. He has not taken an aspirin, Ibuprofen, or any other type of painkiller since he began using HHI Hemp CBD. His preference of 300 mg oil is all that he has taken. Dr. Heinzman continues to purchase the oil at the same prices listed in our shop for veterans.

Dr. Heinzman & Heartland Hemp hope you find the same comfort and Life Alleviation as he has.

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