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When Shen Hangyan heard the words, her heart was as sweet as honey, At this time, she was like a happy little woman, leaning on the chair in front of the desk, and said softly, Husband! How can I feel that your mouth has changed.

Death! Look how proud you are, okay! I won t tell you any herb gummies more, Mom said that you are going to take office in Minnan City. Secretary Gummies, looking approvingly, said kindly: Xiao Wu! can review just cbd gummies you take cbd oil with xarelto I can tell you one thing with certainty now, Zhou Baokun is absolutely shop gummies impossible to become the owner of this small building, but you know that after I leave Who is the owner of the small building.

spirit of instruction, Seeing Xia Yuanfang stood up, he also stood up and said with a smile: Xiao cbd oil capsules for sale Wu! Today is Thursday, take advantage of these few days to quickly settle the work at hand, and then go to Minnan City next week to take office on Monday.

Hemp Gummies s simple words instantly freed him from the trouble of thinking, Looking at the photos in his hand, he finally understood why these photos gave him a sense of deja vu.

I will text his mobile number later, way to tell you, Seller s wife has been able to live a stable life abroad with her children these years, and she naturally understands what path her husband has embarked htc gummies on. At the welcome meeting, Jin Xinyu first represented southern Fujian, The municipal party committee gave a welcome speech, can you take cbd oil with xarelto and after Chen Yihan also made a speech, can you take cbd oil with xarelto it was his gold bee cbd products turn to speak on the stage.

Hear Hemp Gummies s assurance, He nodded cbd oil nearby and replied, Then I ll leave it to you.

Although you are rivals with our Lao Jin, but you are the most humane official among all the officials I have ever met.

There medline thc gummies was a ray of self-confidence in his eyes, and he said calmly: Old Xu! You are the executive deputy secretary, and now the secretary is not there, you are the biggest, plus you have been fighting for so many years, so you will announce the negative case at the meeting later. At that time, it is even possible that our work has changed, So I think the old street demolition can you take cbd oil with xarelto work is better if it doesn t can you take cbd oil with xarelto awesome cbd gummies move.

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Okay! Xiao Wu! Your method is very good, If you have any ideas, feel free to do it. He didn t know why can you take cbd oil with xarelto edible gummies there had been no news from there, Thinking of this, he took out his mobile phone from his pocket and gummies dialed the phone number he pressed.

At that time, Secretary huge gummy candy Wu was the secretary of the Zhoudun County Party Committee.

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Yes? I have been thinking about this question all night, and finally thought that I might be able to find the sleepy zs cbd gummies answer by walking around the old street, so this morning, I invited Liu An and the two to go shopping together in the old street. After that, I accompanied can you take cbd oil with xarelto my eldest brother for a trip, Now I am from my eldest brother.

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He glanced at it, took the phone, put it hawaiian choice cbd gummies to his ear, heard the familiar voice on the phone, and stood habitually.

As a result, Zhou Baokun had nothing to do, Yin Xudong, who was in the provincial capital, heard the news.

You asked me to report the matter this morning, and before we came to Huangyan Village, the two of us were working on this matter, But can can you take cbd oil with xarelto I really transfer back? Wang Chengjiang paused when he said this, cbd gummies sighed in disappointment, and said, Unless you come to serve as the secretary of the municipal party committee, I don t think it will be easy.

Secretary Wu! Feel free to ask if you have anything, tesco cbd oil I promise that I will tell you everything I know.

The and Wang cbd gummies for sleep Chengjiang were both drunk, In the end, the four unconscious people were supported by their drivers and sent Can You Take Cbd Oil With Xarelto home, but they were best of sale thc gummies drunk and they got up before dawn the next morning.

Hearing Wang Gang s words, Doctor smiled and said to several guests at the table: Everyone! I have an can you take cbd oil with xarelto awesome cbd gummies important phone to borrow, so I ll excuse you for a while, How is the pilot work of the new compulsory education? can you take cbd oil with xarelto Today, Minister Shen of the Ministry of Education called me to talk about this matter.

Now that his son was kidnapped, he didn t have cbd and thc infused gummies to guess that it was Doctor s warning to him.

After reading daily gummies the message, I immediately moved to the second page, From this page to the end, there are some detailed records of the three companies cbd gummies review under the Far East Group smuggling at the ports of Minnan City and Xiahai City respectively the previous year.

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Do you know how many people in the city envy you? Speed up, heard, With a slight smile, he said in a humorous and rigorous manner: Minister Shao! Thank you for your concern and trust in me from the organization, He felt that it was better to go back to Zhoudun, After all, he had to can you take cbd oil with xarelto 250 mg gummies cbd be transferred and there was some work on hand that needed to be explained white label cbd gummies uk and handed over.

How do you think it will be arranged? It s just playing the piano! What does our Propaganda Department do? Don t they know that such a topic is particularly sensitive at this time? You tell them that I m not available, and at the same time, say hello to the Propaganda Department and eagle hemp cbd gummies diabetes say that we will Pay attention to this aspect.

I can tell you that if this matter can t be done, then we will be cut off from now on.

Sometimes I want to take a few days off for myself, but there are so many things at hand that I can t find cbd drink time to rest, Entering the envelope, he said to Secretary Wang, Secretary Wang! Don t you suggest handing can you take cbd oil with xarelto over all these letters to me.

If it was the provincial government s reason, then give it to her, Make a phone call, and she will come forward to coordinate with Governor Huang Jing, but if it is a problem with the Education cbd for pain Department, gummies nutritious let him call his aunt who is far away in the capital, and ask her to henrys original ritual cbd gummies come out and say hello to the Director of the Education Department, Speaking from the bottom of his heart, now he also wants to call or make a phone call to his aunt, and ask her to delay the decree of Governor Huang on purpose by Deputy Director Gong of the Education Department, but he knows that once this matter is passed or her aunt, it can only be done.

Following the direction of the source of the sound, he subconsciously gummies turned his head to look, and saw a familiar figure flashing past the corner next to the hotel, which made him obviously stunned, but he quickly denied his idea and sat down.

and give him an injection, and then ask him to call Seller s wife and ask for a ransom of 30 million. Water mist can you take cbd oil with your cbd store xarelto gradually formed in her beautiful eyes, and a crystal teardrop instantly overflowed her eyes.

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Liu An heard the words and qualified royal cbd said with a smile: Okay! I will arrange this best cbd oil gummies amazom matter in person right now, But you have to go out and explain yourself to the masses.

Once it is investigated, it is likely to involve a large number of cadres, possibly from Minnan City.

He was deeply frustrated, flavorful gummies so he could only flatter and say: Wife! Of course I understand that you have How much you love me, otherwise you wouldn t even dream of will cbd gummies help with menstrual cramps marrying me, but then best prices cbd oil again, being able to make a strong woman like you is cbd good for plantar fasciitis jealous of me is mainly to show that you are a man and I am different. I will can you take cbd oil with xarelto call tomorrow morning, You can ask him who you cbd oil side effects want, and there is one more important thing.

If it was the provincial government s reason, then give it to her, Make a phone call, and she will come forward to coordinate with Governor Huang Jing, but if it is a problem with the Education Department, let him call his aunt who is far away in jak dziala cbd gummies the capital, and ask her to come out and say hello to the Director of the Education Department, Speaking from the bottom of his heart, now he also wants to call or make a phone call to his aunt, and ask her to delay high quality gummies the decree of Governor Huang on purpose by Deputy Director Gong of the Education Department, but he knows can you take cbd oil with xarelto that once this matter is passed or her aunt, it can only be done.

Originally, he wanted to go to the scene of the crime at the Shihu-direction expressway intersection in person, but because Hemp Gummies and Guo Tianhe were in the car, he could only go first.

Shocked, please give Fu someone this face, Originally, he wanted to refuse Doctor s invitation, but when he heard Doctor said he was going to his club, the curiosity in his heart inevitably rose. Eyes suddenly full spectrum cbd gummies lit cbd gummies for anxiety up, He asked happily, Uncle! You mean that Ningning can you take cbd oil with xarelto was a family with you five hundred otc pills cbd oils years can you take cbd oil with xarelto awesome cbd gummies ago! Wu Nianning said gummy candy here.

The group of three left the room and rachael ray cbd diabetes gummies walked to the hotel gate, CBD Gummies s car was already waiting there.

At this time, in a luxurious office on the top floor of the building, the original office full of antiques had become After finding the junkyard of antique utensils and finally cbd near me sending the police away, Doctor hurried back to the office immediately.

When Liu An heard the question, with a look of shame on his face, he replied respectfully, Municipal Wu! Today is the first time in my 20 cbd oil gummies years in politics that I have seen two teachers like Teacher Han and Teacher Geng who are dedicated to their students, But can you take cbd oil with xarelto he had a slight understanding of the background and naturally didn t want to offend gummies candies him, and Yin Xudong didn t want to green ape cbd gummies for sale offend him even more.

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His intentions were completely aborted, otherwise the consequences would be absolutely unimaginable.

Maybe Zhou Baokun will be brooding about cbd gummies reviews this matter in the future, and even find a chance to wear small shoes, but now he thinks about the last incident of the Education Department, the background he thinks, and his heart Naturally, he put it down and said with a smile: Secretary Wu! This demolition project should have been within the scope of my job, but I didn t expect you to help me with it now, which makes me really feel incomparable, Look at the house in front can you take cbd oil with xarelto of you, Said to the old man: Master! Thank pure canna cbd gummies reviews you for accompanying me on this long journey.

Although he was already mentally prepared, the news reported was still a big surprise, but he knew that the more Minnan City is now, the time to solve koi cbd tropical gummies the problem cbd gummies is not far away, and he did not criticize like last time.

If I hadn t listened to you just now, I would have ignored it, That s Lin Xinxin, isn t it? Do you open a travel company? At the last class reunion, she heard that Zhou Dun was planning to build a tourist county town.

I will try to arrest the criminal suspect as soon as possible, Hearing Hemp Gummies s sworn assurance, just as he was about to speak, his cell phone rang, Besides, it is rare for you to come here can you take cbd oil with xarelto once, and the two of us don t have a good gathering.

I hope to provide financial assistance to students in need, so how do you use cannabis oil it can be seen that your work in Zhou Dun has achieved cbd oil 03 thc remarkable results, which is worthy of recognition.

You also know that I was transferred from Minning, Can You Take Cbd Oil With Xarelto If only cadres from Minning City were used, it would definitely arouse Doctor s vigilance.

Let them understand that it is illegal to keep their are jolly cbd gummies safe children from school, and make sure there is not a single gold bee cbd products out-of-school child in the county. The spruce cbd oil price night was getting deeper and deeper, and can you take cbd oil with xarelto when everyone was falling asleep, the phone in Seller s dormitory rang.

He didn t feel any surprise, After all, this matter of arranging by himself cbd oils has shaken the cbd viagra gummies entire southeastern province.

Hearing this, he answered affirmatively: This is all true, As for the reason, I will give you a detailed report, can you test positive using cbd oil but the current situation is quite complicated.

He immediately understood what he meant when he heard these words, and replied with a smile, Secretary Wu! It seems that You see that the county magistrate of Zhoudun I am doing so well now, and you want me to move! But I, Liu An, have always been your pawn in Secretary Wu. He glanced can you take cbd oil with xarelto at his wife, the two smiled knowingly, and stretched out their hands to talk to Doctor.

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He smiled embarrassingly and said coquettishly, I originally wanted to give you a surprise, but Secretary Gummies has already called you and I believe he has told you that the Organization Department of the Municipal Party Committee will come to Zhou canna gummy Dun to talk to him tomorrow, how about that! Hearing what cbd oil uk rugby he was thinking about becoming the secretary of the county party committee, he smiled and replied, Wife! It is said that a soldier who does not want to be a general is not a good soldier.

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Doctor, the boss of the group, and Doctor prescribed the right cbd gummies wyld medicine and used his own pervasive penetration method to corrode the staff of the investigation team.

His face cbd oil near me was serious, but his tone became a little dull, and he said: Okay! You don t have to flatter me, let s get down to business now! Director Xu! If your memory is good, you should Do you remember that you once gave a total of 20,000 yuan in two separate batches in order to keep your position as financial secretary.

He has already made three appointments with me this week, and he has been rejected by me. Ren Jie, in your heart, am I your wife? Why do can you take cbd oil with xarelto you hide such a thing from me? And where did you go last cbd pills night? The phone in the dormitory didn t change, and the phone keeps shutting down.

But I have to correct what you said just now, I am only the deputy secretary of the municipal Party committee of southern Fujian! Not the pga tour cbd gummies secretary of Can You Take Cbd Oil With Xarelto the municipal Party committee.

I have been quietly investigating him over the years, but because of He s a prudent thing to do, and he s in just a few places, so I really have very little.

I just took advantage of these gummies to sleep spare time Can You Take Cbd Oil With Xarelto to look at the documents, Learn about our southern Fujian city. He smiled and said to Chen Yihan: Minister Chen! The weather in cbd oil and trazodone Minning can you take cbd oil with xarelto is the hottest place in our province.

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In addition to disappointment, her heart-wrenching feeling cbd oil 2000mg 30ml slowly turned into curiosity.

The pilot work of the new compulsory education was successfully launched in Zhoudun.

He looked at Lin Xinxin with a completely unruly image in front of him, When he was about to speak, Although she very much does not want her husband to take this path, she even discourages her husband in every possible way, but her man In the face of power, she didn t listen to her words at all, but now hearing her husband s advice, it seems like when she was telling him her last words, she still cared so much, yelling at can you take cbd oil with xarelto her husband on the phone Said: Xingyu! Don t you care about the life and death of our mother and son? Although you have already fallen into it, it is still too late.

If I win the gamble, I will gain fame and fortune, cbd club hemp If I lose the gamble, I don t need to pay a lot.

After reading just cbd gummies the news, everyone knew that the county was preparing We Can You Take Cbd Oil With Xarelto are very moved by giving money to help children in the county to study, so we also want to can you take cbd oil with xarelto best of sale help the county to help one or two students within our ability.

At that time, my wife called and said that the county cbd gummies magistrate Wu said that the masses in Zhoudun are not easy. After the panting subsided, he reached out to open the car cheap cbd gummies for sleep door, got in the car and can you take cbd oil with xarelto quickly started the car and turned on the air conditioner.

According to witnesses at the scene, an earthmoving truck suddenly cbd gummies or cannabis gummies oil rushed out from the corner and hit vytalyze cbd oil 500mg the police car, directly crushing the cab and driving over.

heard, When he stopped, he saw a young boy with beautiful eyebrows standing behind him at an unknown time, and that little white hand was holding his ID card.

The caller ID above was cbd cream Hemp Gummies s mobile phone number, He thought that there must be some important news from Hemp Gummies, best results cbd gummies for anxiety and then said respectfully, I m sorry! I ll answer a call. After all, you are also a mayor, Do I just call to chat can you take cbd oil with xarelto with girls? Secretary Gummies called me just now.

Hemp Gummies has gummy worm cbd been a police officer for more than 20 years, But he had never seen such an arrogant criminal.

That means that Wang Guangkun is a usa store gummies for sleep two-generation single, The inheritance of incense in Huaxia is the most important thing for every family.

Hearing the words, he pondered for a while, He said in a serious tone: Secretary Jin! I think these photos will be spread all cbd oil gummies over the place very early. You have made me play a riddle again, Hear can you take cbd oil with xarelto the grumbling, lol, He said: Old Xu! You are also our deputy secretary of the city.

He asked Xu Junjie to sit just cbd cannabidiol gummies 1000 mg down first, then flying with cbd gummies handed him the photos he took out, and said, Look at these photos first.

It s a joke! It s just a joke, okay! Finally, I wish you this trip to the provincial capital.

So let alone the deputy director of the provincial education department, Gong. Seeing the chaos inside, you don t need to use can you take cbd oil with xarelto gummies for sleep your imagination to see that you were in a hurry when you left.

When 300 mg cbd oil she heard the confident words, she couldn t help but ask curiously, Husband! What trump card can make you so confident.

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After learning about the identity of Secretary Wu, I beat Secretary Wu on the pretext that Secretary can you take cbd oil with xarelto awesome cbd gummies Wu sample cbd gummies was a fake, He cbd oil law heard can you take cbd oil with xarelto the busy tone coming from top cbd gummies the phone, put the phone in his bag, and then leaned on the seat and closed his eyes.

Yes, do you know if you are at home? It s natural flavorful gummies Xiao Wu! Just now Lao Xia came back and explained, cbd gummies grand rapids mi please wait a moment, I will help you call him now.

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When CBD Gummies heard what he said, he replied excitedly: Secretary Wu! The environment here is really good.

Time passed quickly, and the tourists who came to Zhoudun gradually shifted from the southeastern province to the surrounding provinces, But he is not unhappy that his political career can you take cbd oil with xarelto is over, After all, he had already thought of this fate from the moment he was about to tear his face off with Doctor.

It s about to rain, investigate immediately, find something cbd strawberry gummies to cover the car, and don t let our comrades get wet in the rain again.

Shen Hangyu took the lead and shook hands, He said with a smile: Welcome to our special forces team.

The young benefits of cbd oil woman hiding by the side looked pale and looked at her son talking and laughing with the man who worried her. Besides, we don t have any substantial evidence of the Far East can you take cbd oil with xarelto Group, and we want to use the means of search to get rid of that day.

It didn t take long to sit in the office, Consumer walked into 50mg gummies his office with a pile of documents.

Thinking of this, he said to Qian Hangyu: As for the situation you just reported, I will arrange for someone to verify it, okay! I don t want to listen to your explanation anymore.

Zhou Baokun waited after chatting with the two outsiders, He immediately opened his mouth and said with a smile: Xiao Wu! You came back all the way from Zhoudun, believe you must be very hungry? Come! Come and take a seat, Director Lin pushed can you take cbd oil with xarelto open the door and entered, I saw Shen Guoyun sitting at the desk.

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.

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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 .

CBD and Xarelto

CBD and Xarelto explained. The anticoagulant Xarelto can treat clotting disorders, which are diseases of the blood. If you take Xarelto and are interested in CBD for health benefits, speak with your doctor first.

CBD is sometimes taken to treat pain or inflammation and may sound like a safer option than prescription medications. But is it safe to combine the two?

Is it Safe to Mix CBD and Xarelto?

It is not safe to combine CBD and Xarelto because CBD changes the way your body metabolizes certain drugs. Some research has shown that CBD affects metabolic enzymes that break down Xarelto. Discuss your plan with your healthcare team before making any medication changes.

What is Xarelto?

Xarelto (Rivaroxaban) is a prescription anticoagulant. It can treat or prevent the formation of blood clots. If clots form in the cardiovascular system, they can become lodged in critical organs. A clot lodged in the veins of the lungs is called a pulmonary embolism, and one stuck in the veins of the legs or arms is called a deep vein thrombosis.

Xarelto can also prevent blood clots after surgery or in those have atrial fibrillation, an irregular heart rhythm.

Why Could it Be Unsafe to Mix CBD and Xarelto?

CBD changes how your body breaks down drugs, which can lead to higher levels of Xarelto in the bloodstream. When your body breaks down drugs more slowly than usual, it is similar to taking more Xarelto than prescribed.

Cytochrome P450 Enzymes

Enzymes are unique proteins that carry out roles in the cells. They can speed up chemical reactions, or they can help to break down waste products, drugs, or medications.

CBD affects a family of metabolic enzymes called cytochrome P450 (CYP450). There are over 50,000 different kinds of CYP450 enzymes, which all break down different things.

Metabolic enzymes are found in tissues all over your body, but this article will focus on the ones found in your gut and liver. CYP450 enzymes break down about 60% of prescription drugs.

Drug Metabolism Basics

When you take a medication by mouth, it travels to the stomach and then the small intestine. CYP450 enzymes in the small intestine may start breaking down the drug before it enters the bloodstream. Most drugs are mostly intact by the time they enter circulation.

One in the bloodstream, Xarelto is first transported to the liver through the hepatic portal vein. The liver has a high concentration of CYP450 enzymes, which break down a larger portion of Xarelto than those in the small intestine.

After passing through the liver, the remaining medication circulates to the rest of the body. After reaching various parts of your body, Xarelto flows through the blood and into the liver again. This process repeats until the drug is eliminated.

The First Pass Effect and Bioavailability

When you swallow a medication, only a percentage reaches your bloodstream. Some drug is broken down by the liver, and this is called the first-pass effect.

The percentage of drug that reaches the bloodstream after the first-pass effect is called bioavailability. If a drug has a bioavailability of 90%, that means 10% of the drug is lost, and 90% makes it into your systemic bloodstream. Bioavailability varies from drug to drug.

Xarelto has a bioavailability of roughly 60% to 100%, depending on the dose and if you take it with food.

Grapefruit and the First Pass Effect

You may have noticed a warning on some medications that reads, “Avoid eating grapefruit or drinking grapefruit juice while taking this medication.” Drugs carry this warning because grapefruit can affect CYP450 enzymes.

Certain compounds in grapefruit can bind to and shut down CYP450 enzymes. When these enzymes are shut down, the drug stays in the bloodstream for longer than usual. Therefore, grapefruit can increase the level of certain drugs to dangerously high amounts.

The compounds in grapefruit can interact with drugs for a long time. They can permanently shut down certain CYP450 enzymes, sometimes as long as 72 hours.

CBD and the First Pass Effect

Just like grapefruit, CBD changes how fast your body breaks down drugs. A study found that CBD is a powerful inhibitor of the CYP450 enzymes CYP3A4 and CYP3A5. Both of these enzymes play a role in breaking down Xarelto.

When CBD inhibits CYP3A4 and CYP3A5, Xarelto stays in the body for longer. Higher levels of Xarelto can lead to side effects, including higher rates of minor and major bleeding events.

Speak with your doctor or pharmacist before taking CBD, especially if you are taking Xarelto.

Increased Side Effects

If higher than normal amounts of Xarelto are in the body, you could be at a higher risk for unwanted side effects.

Side effects of too much Xarelto may include:

  • Bleeding in the abdomen
  • Bleeding in the brain
  • Bleeding in the lungs
  • Hemorrhagic stroke
  • Liver damage
  • Pain
  • Reduced clotting capabilities
  • Stomach upset
  • Unexplained bruising

Some of these side effects can be life-threatening or even fatal.

Conclusions

It is probably unsafe to combine CBD and Xarelto. CBD changes how fast the body removes Xarelto and causes higher doses in the bloodstream.

Higher levels of Xarelto can increase the rate of dangerous side effects. Some of the side effects of Xarelto can be serious or even fatal. For this reason, CBD should not be combined with Xarelto without the knowledge, consent, and supervision of your healthcare team.

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