Skip to main content

What CBD And Grapefruit Have In Common When It Comes To Drug Interactions: Risks You Should Know

Hand holding bottle of CBD oil in pipette isolated

Getty

Interest in cannabidiol (CBD) is exploding. Now that major retailers are carrying CBD products, plus an enormous selection online, curiosity is only going up. But along with the enthusiasm, we also need healthy skepticism and caution. CBD research is still in the early stages, and marketing is predictably outpacing facts. Concerns about safety, among others, are getting lost in the hype.

Apart from a short list of possible side-effects, bigger concerns revolve around how CBD interacts with other drugs. Here’s a brief breakdown of possible risks if you’re thinking of trying it out.

What CBD and grapefruit have in common

You’re probably familiar with “grapefruit warnings” that appear on a variety of medications, or maybe your doctor or pharmacist has told you to avoid grapefruit or grapefruit juice when taking a particular med.

The reason for the warning is that grapefruit contains compounds called furanocoumarins that bind with and effectively neutralize enzymes in the gut (specifically CYP450 enzymes), which help break down and eliminate drugs. When these enzymes can’t do their job, too much of the drug enters the liver and flows unprocessed into the bloodstream. That elevates risk of having dangerously high levels of the drug in your system.

CBD is similar to grapefruit in that it also binds with those enzymes, but research suggests that it’s possibly even more potent because it binds in multiple parts of the gut and liver (grapefruit seems to mainly affect enzymes within the small intestine).  Once an enzyme has been inhibited, the effect isn’t immediately reversed. It can take days for enzyme function to return to baseline and start the process again.

In particular, research has found that CBD is a “potent inhibitor” of two enzymes (CYP3A4 and CYP2D6) that affect many common drugs, including antihistamines, benzodiazepines, certain antidepressants and statins.

What’s the risk?

The enzymes that both grapefruit and CBD inhibit are thought to break down a significant percentage of prescription medications, so the potential for problems could be high. 

A low dose of a med could become a high dose if it’s not properly broken down and eliminated. A high dose of a med could become a dangerously high dose, or even an overdose. Drugs with a narrow “therapeutic window” (they must stay within a certain blood-concentration range) are especially susceptible.

One of the big problems with CBD at the moment is we don’t really know yet which drugs are affected the most, and it’s difficult to identify exact levels of risk because the research has a lot of catching up to do after decades of science-blocking illegality. But since the compound appears to exert a similar effect as grapefruit, caution is needed.

What’s the best path forward?

At a minimum, the evidence at this point suggests that grapefruit warnings on medications carrying them should also apply to CBD. And it’s important to check with your doctor before taking CBD, especially if you’re taking other medications.  

The market for CBD products is predicted to pass $22 billion over the next four years, and that’s coming with the expected hurricane of fact-obscuring hype. With so much fanfare, it’s easy to ignore the fact that CBD is a potent compound that’s far from exhaustively understood. Research is uncovering upsides of taking it for a variety of conditions, and we’ll likely see more to come, but it’s also on us to recognize that this is an unfolding story and move forward with caution.

Original Article Source: https://www.forbes.com/sites/daviddisalvo/2019/06/30/what-cbd-and-grapefruit-have-in-common-when-it-comes-to-drug-interactions-risks-you-should-know/

Comments

Post a Comment

Popular posts from this blog

New York City Adds More Exceptions To Pre-Employment Marijuana Testing Ban

An ambitious campaign to decriminalize psychedelics in Washington, D.C., is one step closer to placing their measure on the November ballot with the formal submission of tens of thousands of voter signatures. Organizers have been scrambling for weeks to collect enough signatures from D.C. voters by Monday’s deadline amid historically difficult circumstances: a global pandemic, months of stay-at-home orders and protests over racism and police violence that filled the streets of the nation’s capital. But with the help of innovative signature-gathering techniques and allies flown in from across the country, advocates said they had successfully submitted upwards of 35,000 signatures—more than enough to qualify the initiative. If approved by voters, Initiative 81 would make enforcement of laws against plant- and fungus-based psychedelics among the “lowest law enforcement priorities” for the Metropolitan Police Department. It would not, however, legalize or reduce penalties for the subs
Post a Comment
Read more

Charlotte Figi The Girl Who Inspired A CBD Movement Has Died At Age 13

Charlotte had recently been hospitalized due to pneumonia, breathing problems and seizures. She was treated as a likely case of Covid-19, her mother, Paige Figi, said Wednesday, although she tested negative for the virus. “Charlotte is no longer suffering. She is seizure-free forever,” a family friend wrote on Paige Figi’s Facebook page, announcing Charlotte’s death. “Thank you so much for all of your love.” Charlotte became a symbol of the possibilities of CBD after CNN Chief Medical Correspondent Dr. Sanjay Gupta told her story in the documentary “Weed.” In the film, Charlotte was shown to be a playful child who was overcome by horrific seizures, which were quelled with Charlotte’s Web, a marijuana strain named in her honor. Charlotte had Dravet syndrome, a rare form of epilepsy which was not controlled by medication. The Stanley brothers, marijuana growers in Colorado, were crossbreeding a strain of marijuana high in CBD and low in THC, its psychoactive ingredient. After Charlo
Post a Comment
Read more

Virginia CBD Program Criticized As Multistate Medical Cannabis Operators Gain Edge

Seven companies are challenging a CBD licensing process in Virginia that resulted in multistate medical marijuana operators getting a majority of available licenses. The appeals called the process “wildly prejudicial.” Out of 51 applicants for five vertically integrated CBD and THC-A licenses, multistate operators received three, a situation that spurred the appeals, The Virginian-Pilot reported. Applicants filing the appeals complained the closed-meeting review process lacked fairness and transparency. One consultant to an applicant said the selections felt “predetermined.” The Virginia Board of Pharmacy reportedly sent information to the applicants in December explaining its selections, but some applicants weren’t satisfied. A board spokeswoman wrote in an email to the Pilot that the board “does not comment on pending litigation.” The five winning applicants , called “pharmaceutical processors,” have a year from winning the licenses to become operational. The multistate
Post a Comment
Read more