Continued as Epilepsy & Behavior ReportsEpilepsy & Behavior Case Reports (EBCR) was an online, Open Access journal devoted to the rapid publication of unique … Learn the risks, benefits, and possible side effects of taking CBD oil while on blood thinner medication. WebMD provides information about interactions between Coumadin and antipsychotics-sibutramine.
An Interaction between warfarin and cannabidiol, a case report
Cannabis products are compounds derived from the cannabis plant. These products are being used with increasing frequency in the treatment of epilepsy and other chronic diseases. While generally felt to be safe due to their natural origin, data reveals interactions with other pharmaceuticals. This case outlines one such example in a patient taking warfarin (a commonly used blood thinner). Following the addition of cannabidiol, the patient’s INR (international normalized ratio, a marker of the blood-thinning effect of warfarin) exceeded the therapeutic range. This case underscores the importance of proper monitoring in patients taking warfarin and cannabis derivatives.
Blood Thinners and CBD Oil Interaction
CBD oil has been making headlines for potentially being able to treat hypertension and heart disease, so naturally, if you suffer from a hemostasis disorder, you may be wondering if CBD could be of any help in treating your condition.
Although CBD oil has been shown to be relatively safe, it should be used cautiously with some blood thinning medications, including some commonly prescribed anticoagulants.
If you are considering combining CBD oil and blood thinners, or simply want to explore if it’s a safe option, here is everything you need to know.
Effects of CBD on Blood Clotting
The effects of CBD oil on blood clotting are not well understood, but it is thought that a few factors may be involved. First is CBD oil’s impact on blood flow.
CBD oil can aid the circulatory system by dilating blood vessels. This allows the blood to flow quicker, and in turn, can make the occurrence of blood clots less likely. A 2017 study found that just a single dose of CBD significantly reduced the blood pressure of subjects both at rest and in stressful situations.
Broad spectrum CBD, or full spectrum CBD oil in particular, may be a useful tool in preventing thrombosis, or the formation of blood clots. A study on the anticoagulant effects of cannabis found the cannabinoids tetrahydrocannabinol (THC) and cannabinol (CBN) to be effective anti-thrombotics, doubling the amount of time it took for blood clots to form in obese and lean rat test subjects compared to the control group.
Both CBN and THC are present in full spectrum CBD oil, along with all the other cannabinoids and terpenes present in cannabis. CBD oil derived from the industrial or agricultural hemp variety of the cannabis plant contains less than 0.3% THC, which is in line with federal regulations.
If you’d rather not have any THC in your CBD product, but still want the anticoagulant effects of CBN and CBD, a broad spectrum CBD oil would be ideal. Broad-spectrum CBD products contain all the cannabinoids and terpenes of the hemp plant except THC. If you aren’t sure whether you’d like a full- or broad-spectrum product, a good place to start is researching your state’s laws on cannabis, THC, and CBD, as well as seeking advice from a medical professional.
Interactions Between CBD and Blood Thinners
Although CBD oil has been found to be generally well-tolerated and without any significant side effects in studies , it can interact negatively with some medications. Often referred to as the ‘grapefruit effect,’ CBD oil is one of a number of natural substances that can slow down systems the body uses to metabolize and break down toxins.
One of the main metabolic systems in the body is the cytochrome P-450 enzyme system , which is made up of liver enzymes that break down certain drugs in the body, with removal of potentially harmful byproducts. If the P-450 enzyme system is inhibited by a compound like CBD, medications typically broken down by the liver enzymes remain in the system for longer than desirable, making it more likely you will experience side effects from the medication.
As you’ll see in the table below, not all pharmaceuticals are processed by the cytochrome P-450 enzyme system. So while you may need to take care when taking CBD oil with a blood thinner like warfarin, for example, people taking heparin face fewer risks.
Ultimately, it’s important to consult with a doctor before using CBD oil if you take any blood thinning medication. Your doctor will make adjustments to your medication, taking into account any effects that CBD oil may have in any potential interactions with it.
As a starting point, here is a list of some of the most commonly prescribed blood thinners and what we currently know about their interaction with CBD oil.
|Anticoagulant Type||Brand Name||Common Drug Side Effects||Possible Side Effects of Combining Medication + CBD Oil|
|Rivaroxaban||Xarelto||Prolonged bleeding; bruising easily; nosebleeds; bleeding gums||Rivaroxaban may remain in the system longer and increase the likelihood you’ll experience its side effects|
|Dabigatran||Pradaxa||Prolonged bleeding; bruising easily; nosebleeds; bleeding gums||No known interaction|
|Apixaban||Eliquis||Prolonged bleeding; bruising easily; nosebleeds; bleeding gums||Combine with caution; apixaban may remain in the system longer and make side effects more likely|
|Edoxaban||Lixiana||Prolonged bleeding; bruising easily; skin rash; reduced liver function; anemia||No known interaction|
|Warfarin||Coumadin; Jantoven||Unusual bruising; bleeding gums; nosebleeds; prolonged bleeding||Combine with caution; Warfarin may remain in the system longer and side effects could become more likely|
|Heparin||Various||Prolonged bleeding; bruising easily; nosebleeds; bleeding gums; skin irritation; allergic reaction||No known interaction|
How to Safely Take CBD and Blood Thinners Together
When combining CBD oil and blood thinners, there are a variety of factors that come into play. Your health, weight, and general tolerance can all influence how likely you are to experience possible drug-drug interactions. Because there are so many variables to consider, you should first speak to your doctor about the possibility of adding CBD oil to your medication regimen. Together, you can create a plan to ensure there is minimal disruption to your system.
In order to further minimize the risks of an adverse reaction between CBD oil and your anticoagulant, it’s suggested that you start with a lower dose than what is recommended for your chosen CBD product, and slowly increase the dosage over time if needed. This not only allows you to build a tolerance to CBD oil, but also provides your doctor with the time and flexibility to monitor changes and decrease the dosage of your blood thinners if necessary.
Safest CBD Oils to Take with Blood Thinners
With so many varieties of CBD oil available to you, how do you know where to start? If you’re looking for a safe CBD oil to combine with blood thinners, or are turning to CBD oil as a preventative measure against blood clots, there are a few things to consider to ensure you’re making the smartest and safest choice possible.
First, choose your CBD delivery method. You can buy CBD oil in a wide variety of forms including capsules, vapes , edibles , and drops . While vaping CBD will deliver the fastest results, drops are more discreet with longer-lasting effects, and capsules offer a user-friendly, familiar option for people who are new to CBD. When deciding on a method, it is worth noting that any format that’s processed through the digestive system will take longer to show effects and as such, may lose some of its potency.
After you have chosen your preferred method for CBD administration, look for a high quality CBD product that has been organically grown, sustainably sourced, and third-party lab tested. Reading the lab reports (called Certificates of Analysis) will ensure the product you purchase is in fact the safest CBD oil to take with blood thinners. A Certificate of Analysis should tell you if the CBD product you have contains herbicides, pesticides, heavy metals, or chemical additives.
When you have your CBD oil product, figuring out your ideal dosage is the final step to making sure you’re using CBD safely. The safest way to take CBD oil with blood thinners is to start with a small dose and gradually increase it over a period of time if needed. For additional guidance on CBD dosage, consider speaking with a naturopathic doctor who specializes in using CBD oil to treat medical conditions.
If you’ve spoken to your physician and are ready to choose a CBD oil, check out the Best CBD Oil Products to Buy .
This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.
Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.
How the interaction occurs:
Products that contain active ingredients from cannabis such as THC or CBD may slow down how quickly your body processes warfarin.
What might happen:
You may experience an increased chance for bleeding including bleeding from your gums, nosebleeds, unusual bruising, or dark stools.
What you should do about this interaction:
Make sure your healthcare professionals (e.g. doctor or pharmacist) know that you are taking dronabinol, using cannabis products such as CBD oil, or using marijuana. You may need to have your bleeding tests (e.g. INR) checked more often, especially when you first start taking these products, if the dose changes, or if you increase or decrease use of cannabis products and marijuana. If you have any signs of bleeding, such as bleeding from your gums, nosebleeds, unusual bruising, or dark stools, contact your doctor right away.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.