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How Are CBD and Grapefruit Similar? – Drug Interactions with Cannabinoids

cbd drug interactions
Written by Alexandra Hicks

The theory that CBD can possibly interact with various medications has been thrown around for a while now, but as it turns out, some recently completed studies indicate this may actually be true.

It’s a commonly held belief that because CBD is natural, it doesn’t have side effects or any negative drug interactions, but that’s a dangerous belief to have. Take the grapefruit for example, a delicious fruit with numerous benefits including weight loss and a reduced risk of heart disease. Despite how healthy it is, eating grapefruit or drinking grapefruit juice can be very risky if you’re on certain medications.

This is because grapefruit contains compounds known as furanocoumarins, which bind to and neutralize various gut enzymes, the most important being the Cytochrome P450 enzymes. CYP450 is a group of liver enzymes that help break down and eliminate drugs from the body.

Just like the furanocoumarins in grapefruit, CBD binds to the CYP450 enzymes as well, but research suggests that it may be even more potent because it attaches in multiple parts of the gut and liver, whereas grapefruit mainly affects just the small intestine. Because of this, CBD can raise levels of certain drugs in the blood stream.

Of particular concern is the combination of CBD with anticoagulants like coumadin and Eliquis, and chemotherapy medication such as Abraxane and Cytoxan. For both of these classes of drugs, the dosage must be precise, and they’re formulated with the understanding that they will be metabolized at a certain rate. It can be detrimental if the body is getting more than what’s recommended.

What’s more, the enzymes don’t immediately go back to normal after being inhibited. It can take days, even weeks, for enzyme function to regulate after it’s been affected. It’s also worth noting that when observed in rats, CBD only inhibited CPY450 for a short period of time, but induced them after repeated use. How that plays out in the long-term remains to be seen.

There is a silver lining to this study, however, which is CBD’s affect on CYP1A1. Cannabidiol induces this enzyme, which is responsible for the degradation of carcinogenic substances. As per the publication, “CYP1A1 can be found in the intestine and CBD-induced higher activity could therefore prevent absorption of cancerogenic substances into the bloodstream and thereby help to protect DNA.”

So, this is clearly a new area of research, but it really drives home the point that CBD – being a health supplement or medication – will NOT have the same effects on everyone. It can work flawlessly for some, and for others, well, not so much. Side effects and drug interactions are possible with CBD. 

Before making any changes to your health regimen, make sure to speak to a health care professional that you trust and one who knows your medical history.

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About the author

Alexandra Hicks

Managing editor at Cannadelics and U.S based journalist, helping spread the word about the many benefits of using cannabis and psychedelics.