Will cannabis affect your other medications?
Every prescriber of medicines (your doctor or nurse practitioner) needs to check interactions between the RX you are given. Computers usually do this for them, and decisions are made to minimize risks. Cannabis is now included in RX software for clinicians; (Cannabis + RX). Drugs can interact with each other metabolically by intensifying, subduing, or prolonging effects. Some drugs are synergistic (helpers), and some are antagonistic (oppose). Overall cannabis is quite safe, but if it boosts other Rx, you may be able to use less.
The enzymes in the body that synthesize anything ingested are in the CYP, pronounced “sip” family. Cannabidiol (CBD) inhibits or slows the metabolism of the CYP enzymes when given 20 minutes before the second drug, which can potentiate effects. In the liver, CYP enzymes metabolize caffeine, melatonin, and several pharmaceuticals. To minimize drug interactions, take CBD an hour after your other Rx.
The CYP enzymes metabolize antiepileptic drugs, NSAIDS, warfarin, diazepam, phytocannabinoids (including THC and CBD), and other pharmaceuticals. Individuals with less functional CYP enzymes, due to personal genetics may experience more cannabinoid-drug interactions.
How dangerous are cannabinoid-drug interactions? Most reported adverse drug interactions have involved high doses of CBD isolates. But these can be found online, in gas stations and food markets throughout the United States. CBD isolates, unlike whole-plant extracts require higher doses to be effective, and lack the entourage effects of the other cannabinoids. Because CBD is everywhere now, there is also a lot of misinformation from vendors.
Project CBD, a California-based educational non-profit, has published an in-depth primer on Cannabinoid-Drug Interactions for health professionals and public policy-makers. The 33-page primer is a great guide and is available as a free download here; projectcbd.org
If you want to dig deeper, please join us for an upcoming class.
We’re partnering with True Farma and Radicle Health to professionalize cannabis medicine and hope you journey together with us.
It’s summertime, stay safe!
co-authored by; Ruth Hill, RN, BSN & Elisabeth Mack, RN, MBA