Is CBD (Cannabidiol) Safe With Heart Medication?

In our latest question and answer, the pharmacist discusses whether or not CBD (cannabidiol) interacts with heart medication.

Jul 08, 2018

Lauren asked

Could you tell me if CBD oil affects heart medication and what the risks would be if any?

Answer

It is possible that CDB (cannabidiol) could interact with your heart medication, but it is difficult to definitively say as you don't mention the specific heart medication you are taking. Heart medications could potentially include:

  • Anticoagulants (e.g. warfarin)
  • ACE-Inhibitors (e.g. lisinopril)
  • Anti-platelets (e.g. Plavix)
  • ARBs (e.g. losartan)
  • Beta-blockers (e.g. metoprolol)
  • Cholesterol lowering drugs (e.g. Lipitor)
  • Calcium Channel Blockers (Diltiazem)
  • Phenytoin

Unfortunately, there is a lack of information regarding CBD drug interactions as there simply isn't a lot of data available yet.

Nevertheless, we have written extensively on potential CBD drug interactions with a variety of drugs, such as this one: Does CBD (Cannabidiol) Interact With Zoloft (Sertraline)?

Below is a summary of a few points from that article:

  • CBD is a major constituent of the cannabis plant and is not thought to have euphoric effects (i.e. won't make you "high").
  • Preliminary evidence suggests that CBD can be an effective treatment for a variety of indications including pain, inflammatory and muscle spasticity. In fact, CBD as an active ingredient was recently approved as a prescription product (Epidolex) for the treatment of epilepsy.
  • There is a lack of data available regarding whether or not CBD interacts with prescription medication. It is known that CBD can inhibit certain liver metabolizing enzymes, and could therefore affect both the rate and extent of how drugs are metabolized.
  • Even in situations where CBD does affect the metabolism of a drug you are taking, there is some controversy whether or not the interactions are clinically relevant.

As mentioned in one of the points above, a newly approved prescription product, known as Epidiolex, contains CBD and is used for the treatment of epilepsy. The prescribing information for the drug discusses potential drug interactions but is fairly broad in scope. Per the prescribing information:

"In vitro data predict drug-drug interactions with CYP1A2 substrates (e.g., theophylline, caffeine), CYP2B6 substrates (e.g., bupropion, efavirenz), uridine 5' diphospho-glucuronosyltransferase 1A9 (UGT1A9) (e.g., diflunisal, propofol, fenofibrate), and UGT2B7 (e.g., gemfibrozil, lamotrigine, morphine, lorazepam) when coadministered with EPIDIOLEX. Coadministration of EPIDIOLEX is also predicted to cause clinically significant interactions with CYP2C8 and CYP2C9 (e.g., phenytoin) substrates..."

As there clearly are potential drug interactions, be sure to discuss with your local pharmacist or doctor the heart medication you take and whether or not it is safe to take CBD with it.

Ready for a more personal experience with your meds?