Interactions

CBD oil can interact with certain medications, including some drugs used to treat epilepsy. CBD inhibits an enzyme called cytochrome P450 (CYP450), which certain drugs use for metabolization. By interfering with CYP450, CBD may either increase the toxicity or decrease the effectiveness of these drugs.

Potential drug-drug interactions with CBD include:

• Anti-arrhythmia drugs like quinidine
• Anticonvulsants like Tegretol (carbamazepine) and Trileptal (oxcarbazepine)
• Antifungal drugs like Nizoral (ketoconazole) and Vfend (voriconazole)
• Antipsychotic drugs like Orap (pimozide)
• Atypical antidepressants like Remeron (mirtazapine)
• Benzodiazepine sedatives like Klonopin (clonazepam) and Halcion (triazolam)
• Immune-suppressive drugs like Sandimmune (cyclosporine)
• Macrolide antibiotics like clarithromycin and telithromycin
• Migraine medications like Ergomar (ergotamine)
• Opioid painkillers like Duragesic (fentanyl) and alfentanil
• Rifampin-based drugs used to treat tuberculosis

Many of these interactions are mild and require no adjustment to treatment. Others may require a drug substitution or the separation of doses by several hours.

To avoid interactions, advise your doctor and pharmacist about any drugs you are taking, whether they are prescription, over-the-counter, herbal, or recreational.