Wondering how to take hemp & CBD products safely while taking other medication? Click here and learn all you need to know about hemp & CBD drug interactions! CBD has an antipsychotic and anxiolytic effect, while amphetamine is a psychostimulant. Since both compounds have opposite effects, there’s a high chance of negative interactions taking place. 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.
What Drugs Should Not Be Taken With CBD?
Hemp-derived Hemp has gained notoriety for its ample range of medicinal uses and no side effects. We use Hemp oil for neurological disorders, depression, some types of cancer, even for insomnia and weight loss. But, does the lack of significant side effects mean Hemp is entirely safe when taken with other medications?
Here’s all you need to know about Hemp drug interactions.
The Cytochrome P450 System
To understand how Hemp oil may interact with other substances in your system, you must first understand what the cytochrome P450 system is and the role it plays.
The cytochrome P450 system, found within the liver, consists of enzymes that process and eliminate potentially toxic compounds. The P450 enzyme system is responsible for metabolizing over 60% of all pharmaceuticals.
Can Hemp Oil Interact with Medications I’m Taking?
Research shows that Hemp may interfere with the P450 system’s ability to metabolize other drugs. When you consume Hemp, it inhibits the system’s ability to metabolize compounds found in pharmaceutical, drugs meaning drugs can stay in your system longer. This can pose several risks especially if you are taking powerful painkillers like oxycodone and fentanyl.
Hemp and CYP3A4 Enzyme
It’s important to note that Hemp does not interact with every CYP450 enzyme. Most Hemp interactions occur via a specific CYP enzyme called CYP3A4. The way CYP3A4 metabolizes Hemp varies significantly from one person to another as a result of variations in our DNA makeup. In addition to Hemp, drugs metabolized by CYP3A4 include:
If you are taking any of these drugs, consult with a doctor before introducing Hemp products to your daily regimen.
Hemp and CYP2C19 Interactions
Research has shown that Hemp inhibits CYP2C19 enzymes in the cytochrome P450 complex. This enzyme is responsible for metabolizing many proton pump inhibitors and antiepileptic drugs such as risperidone, pantoprazole, and clobazam.
Taking high doses of Hemp can interfere with the degradation of these drugs leading to their increased bioavailability. This was shown in a two-month-long clinical study where patients were treated for epilepsy with clobazam and Hemp. The Hemp interaction with CYP3A4 and CYP2C19 led to increased clobazam bioavailability.
Researchers believe this same phenomenon can occur when taking other drugs that are metabolized by CYP2C19 enzymes. Again, if you are currently taking any medication, you should consult with a doctor first before beginning a Hemp regimen.
Hemp Oil and Blood Thinners
If you are taking Hemp, you should pay particular attention to blood thinner medications like warfarin. Mixing Hemp products with blood thinners can make the blood thinner stay in your system for too long without being broken down, increasing the risk of potentially harmful side effects.
Hemp and Adderall Interaction
Adderall is commonly prescribed for conditions like narcolepsy, attention deficit disorder (ADD), and attention deficit hyperactivity disorder (ADHD). The unregulated use of Adderall is also common among college students, who find Adderall helpful in improving their ability to concentrate and overall productivity. However, Adderall has side effects like fatigue, depression, and anxiety, especially as the impact of the drug begins to wear off.
Due to its calming effects, Hemp can reduce the effects of Adderall, creating a more balanced feeling if the effects of the drug are too strong. However, using Hemp during the comedown may cause excessive fatigue and feelings of relaxation.
Hemp Interactions with Other Drugs
Any drug that is metabolized by the cytochrome p450 system may interact with Hemp. These include:
- HMG CoA reductase inhibitors
- Calcium channel blockers
- HIV antivirals
- Immune modulators
- Angiotensin II blockers
- Oral hypoglycemic agents
How to Dose Hemp
One major factor determining how Hemp may interact with other medications in your system is the potency of your daily dose. Stronger doses of Hemp may stay in your body longer, thus interacting with the cytochrome P450 system for longer, as well. To ensure you are not taking a stronger dose than needed, start your Hemp regimen with a relatively small dose and work your up slowly until you achieve the desired results.
Seek Professional Advice
For the most effective and safest Hemp consumption practices, use pharmacist formulated Hemp from a trusted Hemp manufacturer and consult with your physician if you are taking any other medications. Using high-quality Hemp with professional guidance will help you make the most of your Hemp routine.
Does CBD Interact With Amphetamine (Adderall)?
CBD has antipsychotic and anxiolytic properties, whereas amphetamine is a psychostimulant.
If CBD (cannabidiol) is taken with psychostimulant drugs like amphetamine (Adderall), they could (theoretically) block each other’s effects.
CBD may modify or even counteract the effects of amphetamine, but to what extreme? Are they safe to use together?
Table of Contents
- Does CBD Interact With Amphetamine (Adderall)?
- 1. CBD May Decrease The Effects of Amphetamine (Antagonistic Interaction)
Does CBD Interact With Amphetamine (Adderall)?
CBD may decrease the effects of amphetamine (Adderall) and may slow down its metabolism [1,2].
Although few human studies have evaluated the interactions between CBD and amphetamines, some animal studies suggest that CBD may alter the effects of amphetamine while also attenuating the unwanted long-term side effects associated with its use .
1. CBD May Decrease The Effects of Amphetamine (Antagonistic Interaction)
CBD may interact with amphetamine (Adderall) by decreasing its effects, possibly negating its benefits, causing increased symptoms of the condition being treated.
The severity of this interaction is considered mild and unlikely to cause significant side effects.
In some cases, this effect could be viewed as a positive, as many of the effects of amphetamines CBD inhibits are considered side effects of using the medication (such as insomnia, anxiety, paranoia, and addiction).
With that said, CBD could make amphetamines ineffective for treating ADHD, which would negate the entire point of using the medication in the first place.
How This Interaction Works
The cannabinoid receptors CB1 and CB2 are distributed throughout the body in areas like the brain, organs, connective tissue, endocrine glands, and the immune system.
CBD acts through these receptors as a negative allosteric modulator. CBD also modulates neural circuits such as the dopaminergic mesocorticolimbic system, which is involved in addiction and drug-seeking behaviors .
Amphetamine (Adderall), on the other hand, is a psychostimulant drug. It increases the excitatory neurotransmitters — dopamine and norepinephrine — and causes wakefulness, euphoria, increased libido, and a better attention span.
CBD may induce molecular modifications in the dopaminergic pathways via a secondary response mechanism to its effects on the endocannabinoid system. This modification, in turn, may attenuate the effects of amphetamine, which chiefly exerts its effects through the neurotransmitter dopamine.
2. CBD May Cause Slower Elimination (Metabolic Competition)
CBD may also interfere with the metabolism of amphetamine (Adderall).
Most medications, as well as CBD, are metabolized by the liver before they’re eliminated from the body. CBD competes for the same enzymes involved with metabolizing amphetamines, which can cause the processing of both substances to become slower. This may lead to elevations in both CBD and amphetamines in the bloodstream with repeated use.
How This Interaction Works
CYP2D6 is a major liver enzyme involved in the metabolism of both CBD and amphetamine. CBD acts as a competitive inhibitor of the enzyme CYP2D6 leading to decreased metabolism of the amphetamine and increased concentration of the drug in the body .
This mechanism is relevant when amphetamine is taken in high doses with CBD. It may cause increased heart rate, arrhythmia, confusion, agitation, tremors, and muscle pain.
Other Names for Amphetamine
Amphetamine is sold under many names, all of which share the same risk and potential interactions.
The most common brand name amphetamine is sold under is Adderall — which is made by Teva Pharmaceuticals.
Other names for amphetamine include:
- Dyanavel XR
- Adzenys XR-ODT
Similar Medications: CBD & Amphetamine (Adderall)
Amphetamine (Adderall) is classified as a nervous system stimulant. CBD and stimulants all share the same risk for interaction and side effects.
Here’s a list of similar medications that share a similar level of risk when combined with CBD:
- Lisdexamfetamine Dimesylate (Vyvanse)
- Dextroamphetamine Sulfate (Zenzedi & Dexedrine)
- Methylphenidate (Ritalin)
- Atomoxetine (Strattera)
- Modafinil (Provigil & Nuvigil)
- MDMA (3,4-Methylenedioxymethamphetamine)
Is It Safe to Take CBD & Amphetamine (Adderall) Together?
CBD and amphetamine (Adderall) are generally safe at a low therapeutic dose but can be hazardous when used in high doses for recreational use (not recommended). It could also become dangerous over time if both substances are taken together on a regular basis.
You should, however, always consult your doctor if you’re on any medication before adding any other drug — even a natural one — to avoid possible interactions.
Is CBD a Viable Alternative to Amphetamine (Adderall)?
A few clinical trials show evidence of some benefits of using CBD for ADHD and its comorbidities, but the improvements were not significant enough for CBD to be an alternative to amphetamine .
These substances share very little in common and are not suitable as alternatives for one another.
What Is Amphetamine (Adderall)?
Amphetamine (Adderall) is a central nervous system (CNS) stimulant that increases the release of excitatory neurotransmitters dopamine and norepinephrine from the presynaptic terminals.
Amphetamine is prescribed for ADHD and increases attention span and focus, and helps control behavior problems. It may also help with organization and listening skills. It’s illegal to use amphetamine for recreational purposes.
Amphetamine is available in three forms:
- Oral tablets
- Extended-release orally disintegrating tablets
- Extended-release oral liquid
Drug Name Amphetamine Trade Name Adzenys XR-ODT, Dyanavel XR, Evekeo Classification CNS Stimulants CYP Metabolism Liver by enzyme CYP2D6 Interaction With CBD Antagonistic & Metabolic Competition Risk Of Interaction Mild
What Does Amphetamine (Adderall) Do?
Amphetamine (Adderall) exerts its stimulatory effects by increasing the release of dopamine and norepinephrine, and to a lesser extent, increases serotonin.
Amphetamine enters the presynaptic axon terminal by diffusion or uptake by the monoamine transporters DAT, NET, and SERT . It displaces other stored neurotransmitters through vesicular monoamine transporter 2 (VMAT2) into the cytoplasm. From the cytoplasm, neurotransmitters are transported to the synaptic cleft by a retro-transport process resulting in the release of the stored neurotransmitters.
Another mechanism of amphetamine is by inhibiting the enzyme monoamine oxidase (MAO), which is the chief enzyme responsible for the breakdown of neurotransmitters.
These mechanisms lead to increased neuronal transmission and hence stimulation.
What Are the Side Effects of Amphetamine (Adderall)?
Amphetamine (Adderall) has its benefits as well as side effects. The main factor that determines the severity of side effects is the dosage.
- Chest pain
- Shortness of breath
- Increased body temperature
- Abdominal pain
- Constipation or diarrhea
- Loss of appetite
- Dry mouth
- Difficulty in urination
- Prolonged erection
- Mood swings
When to Avoid Amphetamines (Adderall)?
Amphetamines (Adderall) can be beneficial but should be avoided in certain circumstances. Anyone with the following conditions should not use it.
- Hypersensitivity to amphetamines or their derivatives
- Cardiovascular disease
- History of certain psychiatric disorders like bipolar disorder and motor or verbal tics
- Recent use of MAO Inhibitors
Key Takeaways: Is It Safe to Take Amphetamines With CBD?
Amphetamine (Adderall) is available with a doctor’s prescription to treat ADHD and narcolepsy. Its use for any other purpose is illegal.
It is usually safe to take CBD with amphetamine within the therapeutic dose; however, it’s always best to talk to your doctor. Some animal studies have suggested that CBD may attenuate unwanted side effects of amphetamine, such as drug dependence or relapse.
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.