is it safe to take cbd with medication

Is It Safe To Take CBD With My Medication?

Dr. Michele Ross, PhD

Safety is our number one concern here at Cloud City Supply. We make sure that every product is tested by independent labs and free of heavy metals, pesticides, and solvents that are in other CBD brands. While Cloud City CBD products meet the highest quality standards on the market, not every CBD product is safe for every consumer to use. Let’s review the different ways you can use CBD and whether are not they are potentially impacted by drug interactions with other medications you are currently taking.


CBD Topicals

Topical CBD products like lotions, creams, salves, balms, bath salts, and bath bombs are safe to use no matter what medication you are using because CBD applied to the skin is not absorbed into the bloodstream or metabolized in the liver. Applying CBD to your skin, muscles, and joints is the safest way to use CBD for relaxation and relief. The amount of CBD lip balm swallowed after application to the lips is minimal as well, so it’s safe as well!


CBD Gummies

When CBD is taken orally, in forms such as CBD gummies, capsules, softgels, pills, and drinks, it is absorbed by the gut and broken down in the liver through first-pass metabolism. This is problematic, because when CBD is in your liver, it can bind to certain enzymes that break down drugs. Over 25% of medications are broken down by a liver enzyme called p450 CYP3A4, and substances that inhibit this enzyme can cause an increase in blood levels of your medication.

CBD strongly inhibits the CYP3A4 enzyme, and this means you could experience a change in how effective your medication is, more side effects like nausea or sleepiness, and in the worst-case scenario, a possible overdose in the case of some painkillers. We recommend talking with your doctor or booking a free CBD consultation with our in-house CBD coaches if you are taking a medication that that is broken down by CYP3A4 and starting CBD for the first time.


How do you know if it safe for you to take oral CBD?

Most medications do not provide guidance on whether your medication is safe to take with CBD, especially since CBD is a relatively new supplement. There is one easy way that you tell whether your medication is metabolized by the CYP3A4 liver enzyme, and thus prone to a drug interaction with CBD. If the label on your medication or education packet provided by your pharmacy tells you not to take the medication with grapefruit, do not take it with oral CBD. Grapefruit contains compounds that also inhibit CYP3A4, making this medication warning the easiest way to tell that your medication is not safe to take with CBD gummies and other oral forms.


Are CBD oil and CBD tinctures safe to take?

When CBD oil and tinctures are used properly, they are held until the tongue for 30 seconds and then swallowed. When CBD is absorbed through the tongue, this is called sublingual administration. Sublingual administration prevents “first-pass” metabolism through the liver, and CBD goes straight into the bloodstream. This makes CBD oil and tinctures safe for most consumers to take.

A word of caution though, since some CBD liquid is swallowed, a small portion is absorbed into the gut and metabolized by the liver. If you are taking any medications with CBD oil, and feel an increase in daytime drowsiness or other unwanted side effects, discontinue use of CBD or take your medication at least 2 hours before you use CBD.


Still confused about whether CBD is safe to take?

Before starting any supplement, including CBD, it’s best to talk to your physician or health provider. Since many healthcare providers were not educated about CBD in school, you can print out this article for reference and have a productive conversation with your provider. You can book  a free educational CBD consult with Dr. Ross and ask any questions you have.


Helpful Definitions

First-pass metabolism – rapid breakdown of drugs in the liver into active and inactive metabolites.

CYP3A4 – a p450 liver enzyme that CBD inhibits when taken orally, potentially causing a drug interaction with over 25% of prescription drugs.

Sublingual – delivery of drug through the tongue so it is quickly absorbed into the bloodstream and avoids first-pass metabolism.