A daily dose of baby aspirin can help reduce the risk of heart attack, but how does this NSAID drug interact with CBD? Learn more about the potential side effects on Remedy Review. When you take CBD alongside certain medications, it can trigger negative drug interactions. Here we explain what drugs shouldn’t be taken with CBD — and when to consult your doctor if you’re not sure about the potential interactions. In our latest question and answer, the pharmacist discusses whether or not CBD Oil interacts with aspirin or Zyrtec.
CBD and Baby Aspirin—What You Need to Know
Aspirin is a non-steroidal anti-inflammatory drug (NSAID) that has many different uses, including reduced fever, pain, and risk of blood clots. Baby aspirin has the same effects but comes in smaller doses, which helps reduce the potential for negative side effects of excessive NSAID use.
Cannabidiol (CBD) has been touted for its many wellness benefits, some of which are described as having similar pain relieving properties as baby aspirin. But you should know these come with side effects, too. More clinical research is needed to determine the full therapeutic potential of CBD.
Given the current knowledge on this cannabinoid, it’s also uncertain how baby aspirin and CBD may interact with one another. To help answer this question, we dug a little deeper to assess the similarities and difference between the two, and what to avoid.
Why do people take baby aspirin?
For people with diabetes, high cholesterol, and other heart disease risk factors, aspirin is one of the best ways to prevent against heart attacks. Aspirin does so by stopping the formation of blood clots, which are the primary cause of heart attacks. These clots block the flow of oxygen-rich blood to a section of the heart, and may cause serious damage if not treated quickly enough.
While aspirin presents some advantages when it comes to reducing a person’s risk of heart attack, it also has some negative effects. The blood thinning properties of this drug can cause severe nausea, vomiting, or stomach pain, just to name a few of the most common side effects. Because of this, baby aspirin has become a safer option for many patients since it offers the same preventative advantages, but reduces the chance of serious internal bleeding.
Can CBD lower your risk of heart attack?
CBD is perhaps best known for its anti-inflammatory and analgesic properties, which contributes to the many soothing qualities that people often report experiencing when they use CBD oil. In terms of heart health, it can be difficult to measure the success of a wellness supplement like CBD, although some scientific evidence has helped uncover the effects CBD may have on cardiovascular health.
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In a review published by the British Journal of Clinical Pharmacology, the authors analyzed several studies and preclinical data to conclude that CBD might positively affect the cardiovascular system. These observations were most frequently observed in rats, where CBD exhibited the ability to reduce the cardiovascular response to stress, decrease myocardial inflammation, and provide some cardioprotective benefits. However, it’s unclear the exact mechanisms that CBD acts upon to facilitate these results, and the full extent of how this cannabis compound may affect humans.
CBD has also demonstrated anti-arrhythmic advantages, which are not directly correlated to the prevention of heart attacks, but are worth mentioning given the various causes of heart arrhythmias. These irregular heartbeats can happen as a result of high blood pressure, blocked arteries, heart scar tissue, stress, diabetes, and heart attacks when they are happening in the moment.
Some evidence supports the use of CBD for positive heart health benefits, but CBD is not a proven treatment option in the same way that baby aspirin is. The blood thinning properties of aspirin are linked directly to blood clot reduction and heart attack prevention. In addition, more research is needed to analyze and assess the therapeutic potential of CBD for heart attacks and heart related diseases.
Potential Risks of Mixing CBD with Baby Aspirin
CBD has become a popular wellness supplement for a wide range of ailments, but there is still much that we don’t know about this cannabinoid. The World Health Organization notes that cannabidiol is “generally well tolerated with a good safety profile,” but this does not account for potential drug interactions between CBD and other medications. For instance, CBD might increase the level of certain medications in your blood, which could interfere with the efficacy or side effects of the drug.
Because of the many unknowns that surround CBD, we don’t recommend mixing CBD supplements and baby aspirin together. They may interact with the heart in different ways or CBD might increase the blood thinning properties of baby aspirin, which could have potentially dangerous side effects, such as:
- Intestinal bleeding
- Gastrointestinal ulcers
- Bleeding in the brain
- Stomach ache
- Nose bleeds
Before taking CBD, it’s best to check with your doctor, especially if you have a medical condition that you are currently seeking treatment for.
CBD Drug Interactions – Mixing Cannabidiol and Medications
Are you worried about potential CBD-drug interactions? In this article, we explain the mechanism behind drug metabolism and how CBD may interfere with it.
The range of therapeutic properties offered by CBD (cannabidiol) has spurred its popularity in recent years. This natural compound is known to relieve a host of symptoms, allowing for safer and more effective management of different health conditions.
And unlike THC (tetrahydrocannabinol), CBD is non-intoxicating, so it won’t get you high.
CBD can assist in the treatment of anxiety disorders and depression, inflammation and pain, neurodegeneration, seizure disorders, sleep deprivation, metabolic conditions, neuropathy, migraines, inflammatory bowel disease, and more.
Considering CBD has so many potential health benefits, you may start wondering if it can interact with certain medications used to address the same symptoms — and whether you should or shouldn’t take these drugs with CBD.
Below you’ll find the dos and don’ts of using CBD along with medications.
Let’s start with the don’ts.
What Drugs Should Not Be Taken with CBD
Studies from the Indiana University Department of Medicine have provided a list of pharmaceutical drugs and medications which shouldn’t be taken with CBD.
The list below covers all groups of drugs that can negatively interact with CBD oil.
- Angiotension II Blockers
- Anticonvulsants / Anti-Seizure Medications
- Calcium Channel Blockers
- HIV Antivirals
- HMG CoA Reductase Inhibitors (Statins)
- Immune Modulators
- Non-Steroidal Anti-Inflammatory Drugs
- Oral Hypoglycemic Agents
- Proton-Pump Inhibitors (PPIs)
- Steroids and Corticosteroids
There’s also a group of drugs called “prodrugs” that first need to be processed into their therapeutic compounds instead of being therapeutic compounds on their own. In plain English, the inactive compound is consumed, and once in the body, it turns into the active compound.
If this mechanism is dependant on the CYP450 system (more on that later), a drug interaction can lead to insufficient concentrations of the therapeutic agent in the bloodstream — reducing its potency.
CBD Interaction with Drugs & Medications
This section covers the most common interactions between CBD and medications. If you take any of the substances listed below, make sure to consult your doctor before buying CBD oil.
CBD and Ibuprofen Interaction
Ibuprofen is one of the Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), meaning it can produce similar benefits to CBD in terms of inflammation and pain relief. Previously we’ve mentioned that NSAIDs interact with CBD, which may raise concerns about potential negative interactions between CBD oil and Ibuprofen.
According to a study from the Journal of Neurology Research, there have been no reported interactions between CBD and ibuprofen, although it doesn’t mean they do not exist. Health experts suggest that potential interactions may be dosage-dependent. If a certain dosage threshold is breached, CBD and NSAIDs like Ibuprofen can lead to unforeseen and potentially severe nervous system pathology.
CBD and Adderall Interaction
A 2020 study found that higher doses of medical cannabis led to a decreased use of ADHD medication in adults. Products containing a higher concentration of CBD were linked to lower ADHD scores. This means that CBD can interact with ADHD meds, decreasing their efficacy while providing more pronounced benefits. The potential side effects of interactions between CBD and Adderall may lead to decreased appetite.
CBD and Lamictal Interaction
Using medical cannabis and Lamictal may increase side effects such as dizziness, confusion, drowsiness, and difficulty concentrating. Elderly consumers may also experience impairment in judgment. That being said, none of these side effects were proven to result from CBD use per se. When it comes to interactions between CBD and Lamictal, it can make the medication more or less effective, depending on the dosage.
CBD Oil and Antibiotics
There is no known interaction between CBD and antibiotics, although these interactions may occur if an antibiotic is metabolized through the cytochrome P450 enzyme system. Some studies indicate that taking CBD and antibiotics together may amplify the effects of one another without any negative side effects. However, more research is needed to confirm these findings on a larger scale.
CBD Oil and Omeprazole
CBD can inhibit the enzymes that are targeted by omeprazole and other Proton Pump Inhibitors (PPIs). Taking CBD with certain heartburn medications can increase the risk of diarrhea.
CBD and Thyroid Medications
Some people report mild nausea when taking CBD oil together with their thyroid medications. Since both substances are processed by the CYP450 enzyme system, taking CBD with a thyroid medication may cause hyperthyroidism because more thyroxine would be secreted than the body could metabolize.
CBD and Lisinopril
CBD can temporarily lower blood pressure, so taking it alongside medications like Lisinopril might reduce it even more, making you feel lethargic and weak. Always consult your doctor before adding CBD to your routine if you use anti-hypertension meds.
CBD and Prednisone
Since both CBD and corticosteroids are potent inhibitors of the CYP450 enzyme system, concomitant use may increase the risk of systemic side effects from corticosteroid use due to decreased glucocorticoid clearance. Corticosteroids like prednisolone and hydrocortisone should never be taken with CBD.
How Drugs Interact: Understanding Drug Metabolism
Metabolism can refer to how your body uses energy for weight management, or the way drugs are metabolized in your body.
The former is known as the basal metabolic rate, or in simple terms, the number of calories a person needs to maintain healthy body functions while at rest.
The latter is very different from the basal metabolic rate. Drug metabolism refers to how a substance is processed and used by the body — with the majority of this processing happening in the liver.
Scientists call it the ‘first-pass effect’ or ‘first-pass metabolism.’
Using straightforward terms, when you take a medication, it is broken down in the liver into its active compounds so that the body can use them. Just like carbohydrates are broken down into sugars, fats into triglycerides, and proteins into amino acids — drugs break down into their individual ingredients.
From there, they are controlled by specific enzymes, which transform these compounds into metabolites. These metabolites then influence different processes in your body and are flushed with urine once used up.
How Is CBD Metabolized?
Drug metabolism determines the rate at which the body processes medications and other therapeutic compounds into their individual metabolites and how long they can stay in your system.
When you take CBD in the form of an oil, capsule, or gummy, it has to pass through your gut, where it is released into the bloodstream. From then, they travel through the bloodstream to the liver, where it absorbs through the hepatic portal. The liver breaks CBD down into its metabolites using enzymes, after which it can circulate throughout the body in the bloodstream again.
What Is the Cytochrome P450 System?
Aside from breaking compounds down into metabolites, the liver also detoxifies and excretes foreign substances and other types of toxic compounds. This can happen through a system of enzymes referred to as the Cytochrome P450 (CYP450). These enzymes contain heme as a cofactor to convert cannabinoids into more water-soluble molecules, increasing their absorption and efficacy.
Researchers estimate that the CYP450 system is responsible for metabolizing 60% of any drugs out there. And interestingly, doctors and pharmacists use this system to understand, evaluate, and predict the benefits of the drug and potential side effects based on their dosages.
However, certain compounds have the ability to compromise the CYP system’s functioning, negatively affecting the metabolism of certain medications. Once these interactions occur, the drugs can be metabolized faster or slower than normal.
CBD And the Cytochrome P450 System
As mentioned earlier, CBD can interact directly with the CYP450 system in the liver. According to preclinical studies, CBD binds to the site where the enzyme activity occurs, competing with other compounds and thus preventing this system from breaking down other substances.
This inhibitory effect on the CYP450 enzymes mainly depends on how much CBD a person takes, their unique physiology, and the type of CBD used (e.g., full-spectrum CBD vs. CBD isolate). The dosage determines the strength used by the CBD to bind to the active site of the metabolic enzymes. The tighter the bond, the more competitive inhibition.
Contraindications for Taking CBD with Medications
The mechanism behind CBD’s health benefits proves that it’s not a biologically inert compound. Instead, the pharmacokinetics and pharmacodynamics of CBD are complex and similar to any other medication. Therefore, it has the potential to compromise the metabolism of certain medications.
Any therapeutic substance that relies on the CYP450 system can be potentially affected by CBD. A common indicator for such interaction is when your medication has a grapefruit warning on the bottle. However, this is by no means a solid point of reference, and you should always check with your doctor and pharmacist before taking the two compounds together.
Why You Should Always Consult Your Doctor First
The list of drugs that we’ve mentioned above is by no means definite and doesn’t include all the pharmaceutical substances that may interact with CBD. Similarly, not all the medication from these categories will necessarily cause an interaction — as is the case for antibiotics and Ibuprofen.
A consultation with a doctor experienced in CBD and cannabis use can help you establish the right routine for your medications and supplements to avoid potentially negative interactions. Some compounds work synergistically with CBD, so asking your doctor can help you maximize the effect of your treatment.
Not to mention that the doctor can guide you on finding the optimal dosage for yourself.
Key Takeaways on CBD Drug Interactions
The safety profile of CBD has been acknowledged by major health agencies, such as the World Health Organization (WHO), showing that it’s well-tolerated by animals and humans and rarely produces any dangerous side effects.
CBD also has a profound impact on an array of systems, which explains its therapeutic versatility. That being said, this versatility is also the reason why CBD interacts with so many prescription meds and over-the-counter (OTC) PRODUCTS.
Again, if you’re not sure if CBD will interact with the medication that you might be taking, a consultation with a health professional will not harm — unlike trying to figure out these interactions on your own.
Livvy is a registered nurse (RN) and board-certified nurse midwife (CNM) in the state of New Jersey. After giving birth to her newborn daughter, Livvy stepped down from her full-time position at the Children’s Hospital of New Jersey. This gave her the opportunity to spend more time writing articles on all topics related to pregnancy and prenatal care.
Do Aspirin Or Zyrtec Interact With CBD (Cannabidiol)?
In our latest question and answer, the pharmacist discusses whether or not CBD Oil interacts with aspirin or Zyrtec.
I have started CBD oil level 2 from CWHEMP. I take Hydrocodone twice a day and I’m trying to stop taking them. I read that there shouldn’t be interactions with that medicine. What about taking Aspirin and Zyrtec?? Will those interact with CBD OIL? I just want to be sure. Thank you,
CBD (cannabidiol) is one the major constituents of cannabis. In fact, depending on the chemovar of cannabis in question, CBD can make up nearly 40% of cannabis extracts.
CBD has a wide range of medicinal effects on the body and its use is growing at a rapid pace. It has been used medicinally for:
- Bipolar disorder
- Muscle spasm
- Multiple sclerosis
- Parkinson’s disease
Safety Of CBD (Cannabidiol)
While there is still a considerable amount we do not know about CBD, including complete actions on the body, side effects and drug interactions, research has shown it to be relatively safe for most individuals.
Studies have used CBD doses up to 300 mg daily, for up to 6 months, safely. Some studies have even used doses exceeding 1200 mg daily, and reported them to be safe up to 4 weeks.
Toxicity studies in monkeys have shown extremely large doses of CBD (over 200 mg per kg IV and perhaps 20 times more than that for oral doses) are needed to elicit toxic/deadly effects.
CBD (Cannabidiol) Drug Interactions With Zyrtec And Aspirin
Drug interaction studies with CBD are lacking and there have been no studies evaluating the use of CBD with either Zyrtec or aspirin. Nevertheless, based on available data regarding the pharmacokinetic profile of CBD, interactions with Zyrtec or aspirin seem unlikely.
The big concern with drug interactions in this case is whether or not CBD affects metabolizing enzymes, which could in turn affect how other medications are processed in the body.
Many recent studies do indicate that CBD potentially affects many different metabolizing enzymes in the body. In fact, studies have shown that CBD may inhibit the following liver metabolizing enzymes:
Metabolizing enzyme inhibition often leads to increased concentrations of drugs that are typical substrates for a particular enzyme.
Aspirin may be partially metabolized by CYP2C19, but not extensively. There is a chance that CBD may prolong elimination time of aspirin, which may prolong the effects of the medication. This doesn’t appear as though it is clinically significant however, at least at this time.
The metabolism of Zyrtec isn’t thought to be mediated by CYP enzymes and therefore isn’t thought to interact with CBD.
Whether or not CBD actually does cause metabolism inhibition is up for some debate. Most studies that show CBD inhibition of metabolizing enzymes do so only in a lab setting. Often times, when humans are evaluated in regard to CBD inhibition of metabolizing enzymes, the effects aren’t significant.
However, one 2017 study did report clinically significant interactions between high doses of CBD (5mg/kg/day to 50mg/kg/day) and certain anti-epileptic drugs. However, the doses used in the study far exceed what most individuals would be taking.