Researchers from Penn State College of Medicine evaluated existing information on five prescription CBD and delta-9-tetrahydrocannabinol (THC) cannabinoid medications: antinausea medications used during cancer treatment (Marinol, Syndros, Cesamet); a medication used primarily for muscle spasms in multiple sclerosis (Sativex, which is not currently available in the US, but available in other countries); and an antiseizure medication (Epidiolex). Overall, the researchers identified 139 medications that may be affected by cannabinoids. This list was further narrowed to 57 medications, for which altered concentration can be dangerous. The list contains a variety of drugs from heart medications to antibiotics, although not all the drugs on the list may be affected by CBD-only products (some are only affected by THC). Potentially serious drug interactions with CBD included
Products containing cannabidiol (CBD) seem to be all the rage these days, promising relief from a wide range of maladies, from insomnia and hot flashes to chronic pain and seizures. Some of these claims have merit to them, while some of them are just hype. But it won’t hurt to try, right? Well, not so fast. CBD is a biologically active compound, and as such, it may also have unintended consequences. These include known side effects of CBD, but also unintended interactions with supplements, herbal products, and over-the-counter (OTC) and prescription medications.
CBD can alter the effects of other drugs
Many drugs are broken down by enzymes in the liver, and CBD may compete for or interfere with these enzymes, leading to too much or not enough of the drug in the body, called altered concentration. The altered concentration, in turn, may lead to the medication not working, or an increased risk of side effects. Such drug interactions are usually hard to predict but can cause unpleasant and sometimes serious problems.
Absolutely. Inhaled CBD gets into the blood the fastest, reaching high concentration within 30 minutes and increasing the risk of acute side effects. Edibles require longer time to absorb and are less likely to produce a high concentration peak, although they may eventually reach high enough levels to cause an issue or interact with other medications. Topical formulations, such as creams and lotions, may not absorb and get into the blood in sufficient amount to interact with other medications, although there is very little information on how much of CBD gets into the blood eventually. All of this is further complicated by the fact that none of these products are regulated or checked for purity, concentration, or safety.
People considering or taking CBD products should always mention their use to their doctor, particularly if they are taking other medications or have underlying medical conditions, such as liver disease, kidney disease, epilepsy, heart issues, a weakened immune system, or are on medications that can weaken the immune system (such as cancer medications). A pharmacist is a great resource to help you learn about a potential interaction with a supplement, an herbal product (many of which have their own drug interactions), or an over-the-counter or prescription medication. Don’t assume that just because something is natural, it is safe and trying it won’t hurt. It very well might.
The patient should stop taking the drug if they experience seizures, painful skin rashes, symptoms of allergic reaction, difficulty breathing, and symptoms of serotonin syndrome that include experiencing confusion, restlessness, sweating, shivering, shaking, hallucinations, rapid heartbeat, and sudden muscle jerking.
This medication carries with it several important drug interactions of which to be aware. If you are prescribed this medication, please consult your doctor and/or pharmacist on the following drug interactions:
While taking this drug, you should be aware of the following important warnings:
Possible Side Effects
In August 2004, the U.S. Food and Drug Administration (FDA) approved duloxetine for the treatment of depression under the brand name Cymbalta. Shortly afterward, Cymbalta became the first and only officially indicated drug in the United States for the management of pain from diabetic peripheral neuropathy. In February 2007, Cymbalta got approval from the FDA for the treatment of generalized anxiety.
Cymbalta (duloxetine) is commonly used to treat depression and generalized anxiety. The drug belongs to a class of antidepressant medicines known as serotonin and norepinephrine reuptake inhibitors (SNRIs). In some cases Cymbalta may be prescribed to treat pain due to diabetic neuropathy and fibromyalgia.
The most frequent adverse effects of this medication include, but are not limited to the following:
Cymbalta inhibits the reuptake of serotonin and norepinephrine in the central nervous system. It also increases dopamine by acting on dopamine reuptake pumps, thus increasing the diffusion of dopamine in the brain. It also decreases pro-inflammatory cytokines and increases the anti-inflammatory ones, which assist in relieving depression symptoms. The pain-relieving properties of this drug are thought to be due to the blocking of sodium channels.
Side effects of Cymbalta range from mild to severe. Common and minor side effects include aches, frequent urination, excessive sweating, sleep issues and weight loss. Rarer side effects include digestive issues and sexual problems.
Drugs.com classifies the interaction between Cymbalta and marijuana as moderate. According to the site’s guide, doctors should only recommend the combination in special circumstances.
Overview of Cymbalta
The problems that can occur when the two drugs interact tend to be related to cognitive and motor function. Cognitive side effects include concentration problems, confusion, impaired judgment and difficulty thinking. Motor side effects include impaired coordination and dizziness. These side effects can become even worse when you use alcohol.
Marijuana may relieve depression symptoms, for example. Research has shown that patients who use medical marijuana experience less depression than patients who don’t use it.
Cannabis can ease anxiety as well. One of the major components of marijuana, cannabidiol (CBD), was found to reduce anxiety in clinical trial subjects. Since marijuana can also heighten anxiety, monitor your symptoms closely if you medicate with cannabis.