CBD oil should be avoided during pregnancy and breastfeeding. A 2018 study from the American Academy of Pediatrics warned women to avoid marijuana during pregnancy due to the potential risks to a baby’s development. Although it is unclear how CBD contributes, CBD is known to pass through the placental barrier.
Outside of these two disorders, CBD’s effectiveness in treating seizures is uncertain. Even with Epidiolex, it is uncertain whether the anti-seizure effects can be attributed to CBD or some other factor.
There is some evidence that CBD interacts with seizure medications such as Onfi (clobazam) and boosts their concentration in the blood. Further research is needed.
If you are thinking about using CBD oil to treat a health condition, be sure to speak with your healthcare provider to ensure that it is the right option for you.
CBD oil comes as full-spectrum oils or in forms that contain CBD isolates. Unlike isolates, which contain CBD only, full-spectrum oils contain a variety of compounds found naturally in the cannabis plant, including proteins, flavonoids, terpenes, and chlorophyll. Alternative practitioners believe these compounds offer more substantial health benefits, although there is no clear evidence of this.
Clinical research has shown that CBD oil can trigger side effects. Severity and type can vary from one person to the next.
Among the few human trials evaluating CBD’s anxiolytic effects was one published in the Brazilian Journal of Psychiatry in 2019. For this study, 57 men were given either CBD oil or a placebo before a public-speaking event. Anxiety was evaluated using physiological measures (such as blood pressure, heart rate, etc.) and a relatively reliable test for mood states known as the Visual Analog Mood Scale (VAMS).
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.
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.
CBD can alter the effects of other drugs
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
While generally considered safe, CBD may cause drowsiness, lightheadedness, nausea, diarrhea, dry mouth, and, in rare instances, damage to the liver. Taking CBD with other medications that have similar side effects may increase the risk of unwanted symptoms or toxicity. In other words, taking CBD at the same time with OTC or prescription medications and substances that cause sleepiness, such as opioids, benzodiazepines (such as Xanax or Ativan), antipsychotics, antidepressants, antihistamines (such as Benadryl), or alcohol may lead to increased sleepiness, fatigue, and possibly accidental falls and accidents when driving. Increased sedation and tiredness may also happen when using certain herbal supplements, such as kava, melatonin, and St. John’s wort. Taking CBD with stimulants (such as Adderall) may lead to decreased appetite, while taking it with the diabetes drug metformin or certain heartburn drugs (such as Prilosec) may increase the risk of diarrhea.
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.
Also known as “cotton mouth,” CBD can potentially cause your mouth and eyes to feel very dry, notes Dr. Brent A. Bauer via Mayo Clinic. Though this side effect is more likely to occur with THC, it can happen with CBD, as well.
It’s important to point out that CBD is not regulated by the FDA and therefore dosages might not be accurate. It’s also difficult to know what an appropriate dose is the first time you try a new product.
Because CBD supplements come in so many different forms—such as oils, gummies, tinctures, and vapors—the amount that’s actually absorbed can vary drastically. This, combined with each person, will ultimately affect which (if any) CBD side effects you might experience.
Some common side effects when using CBD include drowsiness and sedation. This is also considered a benefit, but Dr. Jas Matharu-Daley, a physician and chief medical officer for a CBD brand, notes that the effects might be too strong if you’re also taking CBD with other sedating medications.
There are several reasons why someone might want to use CBD. The substance can be found in a multitude of products ranging from pain-relieving creams to edible tinctures to skincare. Research is still underway, but over the last few decades scientists have become more aware of how CBD might prove beneficial when applied either topically or ingested.