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Dr. Dung Trinh Answers: How does CBD interact with other medications?

How does CBD interact with other medications? 

Transcript of video:

If you’re also taking your Parkinson’s, rheumatoid, blood pressure, or your heart disease meds, how does that interact with medications? To understand medication interaction, you need to understand how CBD is metabolized in the body.

When CBD is metabolized in the body it’s broken down in your liver. Your liver filters out CBD. It filters out through a system called a Cytochrome P450 system. The Cytochrome P450 system filters out CBD. It gets rid of the CBD that you take. 

But here’s the thing, the Cytochrome P450 system doesn’t filter out, just CBD alone. It filters out other medications as well. There are medications that go through your liver and then there are medications that go through your kidneys. The Cytochrome P450 system can only filter at a specific rate. It can only go so fast.

You know how when you’re filtering water, if you have the Brita filter … you put in water and it filters through, right? That Brita filter can only filter at a certain rate. It can’t go any faster. You can throw as much water as you want on top of it, but it can only drip down at a certain rate. It’s the same thing with the Cytochrome P450 system. It can only filter so much. What you want to think about when you’re taking medications is this; there are going to be some medications that you may take that filter through your liver and there are going to be medications that filter through your Cytochrome P450 system.

So, if you’re on 10 pills and 5 of them are going through your liver, and then you have CBD going through your liver, and you have a filtration system that can only filter through so much… What does that tell you? It tells you that something’s not going to get filtered at it the time that it’s supposed to get filtered. Something’s going to back up. 

Now, for most meds it’s no big issue. Let’s say, let’s say your blood pressure medication doesn’t get filtered through as fast as it should. Okay, but if you have 5 medications going through your liver, along with CBD, you have to think twice about what’s getting filtered and what’s not.

It’s important because there are certain medications that we need to actually monitor the levels in the blood. For example, how many of you guys have heard of Coumadin or Warfarin? Those are blood thinners that require a certain level to be therapeutic. If the Coumadin level is too low, then your blood is too thick, and it’s not working. If your Coumadin level is too high, then your blood is too thin. Then you’re at risk for bleeding. So Warfarin filters through your Cytochrome P450. Would it be important to know that if you have CBD onboard and you have your blood thinners onboard, something’s going to be affected?

It’s going to most likely increase the level of your blood thinners and make your blood too thin. These are the things to keep in mind when it comes to side effects. 

Now, what’s the practical application of this? What can you do about it? 

If you’re taking CBD for pain, or you’re taking CBD for sleep or for whatever, one thing you could do is; you could go to your doctor and say, “Doc, you know, I’m on these five medications and I take CBD.” Now, your doctor may not know anything about CBD, but will probably know which one of your medications go through your liver and if it’s important or not?  

Your doctor can probably tell you; Oh, this medication goes through your liver, you know, your cholesterol medicine, your statin goes through your liver but it’s probably not a big deal. They’ll let you know that.

CBD can be given through different forms. It can be topical, right? It can be a cream, a patch, an or an oil.

It can be taken orally. There are two ways to take it orally, with a tincture under your tongue, which goes straight to the bloodstream, or it can be ingested and swallowed, right? Like a CBD gummy,  pill, or capsule. 

So why are the different modalities important? The absorption through the liver is different based on how you take it. If it’s a topical product, chances are that only a little bit probably gets to your liver. Most of it is topical. Most of it’s in the area where it hurts. If you’re rubbing CBD on your knee, because you have knee pain, it’s just going to work in that area. If you’re rubbing it on your back because you have back pain it’s mainly going to work in that area. There will be  minimal interaction with medications because it’s topical. It doesn’t go all the way through to your liver. So you worry less about medication interaction if you’re using a topical product. Topical products have less medication interactions. 

The time you worry more about medication interaction is when you’re taking it here, right?

When it’s going through. When you’re orally taking it, it goes to your stomach and your stomach digests it, it then breaks down and goes to your liver and then your liver filters it out.

There’s more of an interaction if you’re taking CBD orally than topically, as far as side effects and interactions with other medications.


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