Navigating the world of CBD can be an exciting journey, especially when discovering its potential health benefits. But did you know that CBD might not play nice with certain medications? Taking CBD with certain prescription medications can result in too much or too little of your medication in the body at any given time. In either case, it can be detrimental to your overall health and wellness.

But which medications should you avoid taking CBD with? In this article, we'll discuss the top medications you should be cautious about when using CBD and help you make informed decisions that will help keep you protected.

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What Is CBD?

Cannabidiol (CBD) is a naturally occurring compound found in the Cannabis sativa plant. It is one of the main active ingredients in the plant, the other being tetrahydrocannabinol (THC). Unlike THC, CBD does not produce any psychoactive effects and, if derived from hemp, is not considered a controlled substance.

CBD is available as oils, gummies, softgels, and topical creams, offering flexibility in incorporating it into your routine. Whether you prefer taking it orally, sublingually, or topically, there's a CBD product to suit your needs. 

Benefits Of CBD 

As CBD's popularity soars, so does the interest in its potential health benefits. 

According to research, CBD may help with pain, inflammation, anxiety, depression, and insomnia, making it an appealing option for people of all ages and from all walks of life.(1)

CBD's neuroprotective properties may even help shield the brain from damage caused by conditions such as Alzheimer's and Parkinson's disease.

Unlike other natural compounds, CBD carries limited side effects, does not come with a known risk of overdosing, and will produce any psychoactive effects (as long as you’re taking CBD products with limited quantities of THC).

Cons Of CBD

Though generally safe, CBD may cause side effects like nausea, diarrhea, fatigue, and changes in appetite.

It can also interact with certain medications as well as herbal and dietary supplements. 

To guarantee your safety, consult your doctor before incorporating CBD into your routine.

Drugs That Should Not Be Taken With CBD 

Because CBD is metabolized by the liver, drugs that carry the “grapefruit warning” should be avoided as these may interact negatively with CBD. However, there are some prescription medications that stand out as ones to avoid taking with CBD. Let's take a closer look at some of these riskier interactions below.

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Benzodiazepines are known for helping with anxiety and insomnia. When mixed with CBD, benzodiazepines' effects can be amplified, leading to a higher risk of side effects such as increased sleepiness, fatigue, and dizziness. 

Opioid Analgesics 

Opioid analgesics are powerful prescription painkillers, often used for chronic pain, such as that caused by arthritis, cancer, or nerve damage.

When combined with CBD, opioid analgesics can increase the risk of side effects, including drowsiness, confusion, and slowed breathing. This can sometimes lead to serious health complications, such as respiratory depression or death.(2)

CBD may also reduce the effectiveness of opioid analgesics, making the pain relief they provide less effective.

Blood Thinners 

Blood thinners, also known as anticoagulants, are prescribed to help prevent harmful blood clots from forming in the body. But when paired with CBD, there's an increased risk of bleeding.

One case report found that a patient taking CBD and warfarin needed to have their warfarin dosage reduced to 30% to decrease the risk of bleeding.(3) 


CBD can interact with antidepressants like selective serotonin reuptake inhibitors (SSRIs) and monoamine oxidase inhibitors (MAOIs). This can cause an increase in serotonin levels in the brain, leading to a condition known as serotonin syndrome. Symptoms of serotonin syndrome include confusion, agitation, increased heart rate, and restlessness.


While immunosuppressants can effectively treat autoimmune diseases and organ transplant recipients, they can also have serious side effects, including an increased risk of infection and cancer.(4)

When taken with CBD, immunosuppressants can potentially increase the risk of side effects. CBD can inhibit the enzyme activity that breaks down these medications, leading to increased levels of immunosuppressants in the body and potentially amplifying the risks.

Blood Pressure Medications

CBD may amplify the effects of certain blood pressure medications, causing a drop in blood pressure, resulting in dizziness, lightheadedness, and fainting. It can also increase the risk of other side effects, such as nausea, headaches, and fatigue.

Herbal And Dietary Supplements

Herbal and dietary supplements may be popular for promoting overall health, but mixing them with CBD can result in potentially harmful interactions.

Herbal supplements such as St. John's Wort, Ginkgo biloba, and Ginseng can interact with CBD and heighten the side effects of both substances.

Certain dietary supplements can also interact with CBD. For example, omega-3 fatty acids can reduce the effectiveness of CBD. Some dietary supplements such as calcium, magnesium, and iron can reduce the absorption of CBD in the body, making it less effective. 

CBD And Alcohol 

There's limited research on CBD and alcohol, with some studies suggesting CBD may reduce alcohol's harmful effects, while others indicate a possible increase in liver toxicity. So, it's better to err on the side of caution and avoid mixing the two.

CBD and alcohol may intensify each other's effects when consumed together, leading to increased sedation, drowsiness, and impaired cognitive and motor function.(5) 

Certain Antimicrobials

Certain antimicrobials, like erythromycin and clarithromycin, can interact with CBD and increase the amount absorbed by your body, leading to heightened side effects and potential danger. This interaction may also reduce the effectiveness of the antimicrobial, making it less efficient in treating infections.

Proton Pump Inhibitors 

Proton pump inhibitors (PPIs), commonly prescribed for acid-related conditions like heartburn and GERD, can cause serious side effects when combined with CBD. The mix can amplify PPIs' side effects, including increased headache, rash, dizziness, and gastrointestinal symptoms, including nausea, abdominal pain, flatulence, constipation, and diarrhea.(6) 

Antiepileptic Drugs

Antiepileptic drugs effectively control seizures but mixing them with CBD can increase the risk of side effects, including drowsiness, dizziness, confusion, depression, and memory loss.(2)

CBD can raise the levels of specific antiepileptic drugs, potentially leading to an overdose. 

Consult your doctor or pharmacist before taking CBD with antiepileptic drugs, as they may need to adjust your dose or monitor your blood levels more closely. 

Who Is Most Risky To CBD Interactions?

People with pre-existing medical conditions or those taking multiple medications may be more susceptible to potential side effects of CBD.

Pregnant or nursing individuals should also exercise caution when considering CBD.(7) While research on the effects of CBD on pregnant or nursing women is limited, it's always best to err on the side of caution.

Consult Your Physician

If you are considering taking CBD, it is crucial to consult with your physician first. 

Provide a list of all medications, supplements, and vitamins you're currently taking to help them determine if any of these could interact with CBD and cause adverse reactions. Also, discuss any medical conditions you have, as some could worsen by taking CBD.

Be sure to discuss your expectations for using CBD. They might suggest a specific dosage or brand of CBD or offer alternative treatments better suited to your needs.

And remember, CBD isn't a substitute for medical advice.

Final Thoughts 

CBD offers a promising natural alternative for addressing various health concerns. However, remain vigilant about potential interactions with other medications. 

Always consult a healthcare professional, such as a doctor or pharmacist, before incorporating CBD into your regimen, as they can guide you in making informed decisions. Also, closely observe your body's response and any potential side effects that may arise.

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Read Also:


  1. Rapin, L., Gamaoun, R., El Hage, C., Arboleda, M. F., & Prosk, E. (2021). Cannabidiol use and effectiveness: real-world evidence from a Canadian medical cannabis clinic. Journal of cannabis research, 3(1), 19.
  2. Balachandran, P., Elsohly, M., & Hill, K. P. (2021). Cannabidiol Interactions with Medications, Illicit Substances, and Alcohol: a Comprehensive Review. Journal of general internal medicine, 36(7), 2074–2084. 
  3. Jadoon, K. A., Tan, G. D., & O’Sullivan, S. E. (2017, June 15). A single dose of cannabidiol reduces blood pressure in healthy volunteers in a randomized crossover study. JCI insight. 
  4. D;, S. F. (n.d.). [immunosuppressive drugs - how they work, their side effects and interactions]. Therapeutische Umschau. Revue therapeutique. 
  5. Nona, C. N., Hendershot, C. S., & Le Foll, B. (2019). Effects of cannabidiol on alcohol-related outcomes: A review of preclinical and human research. Experimental and clinical psychopharmacology, 27(4), 359–369.
  6. Yibirin, M., De Oliveira, D., Valera, R., Plitt, A. E., & Lutgen, S. (2021, January 18). Adverse effects associated with proton pump inhibitor use. Cureus.,flatulence%2C%20constipation%2C%20and%20diarrhea.
  7. Dong, C., Chen, J., Harrington, A., Vinod, K. Y., Hegde, M. L., & Hegde, V. L. (2019). Cannabinoid exposure during pregnancy and its impact on immune function. Cellular and molecular life sciences : CMLS, 76(4), 729–743. 
  8. Author links open overlay panelRan Abuhasira a, a, b, c, d, e, f, AbstractBackground: Medical cannabis use is increasing rapidly in the past several years, Penner, E., Meier, M., Abuhasira, R., DeFilippis, E., Ahmed, A., Elsen, G. V. D., Fairman, BJ., Park, J., Hamilton, H., Whiting, P., Lim, K., … Korantzopoulos, P. (2021, January 20). Cannabis is associated with blood pressure reduction in older adults – a 24-hours ambulatory blood pressure monitoring study. European Journal of Internal Medicine. 
  9. Metabolomic response to coffee consumption ... - wiley online library. (n.d.).


Does CBD oil affect blood pressure?

CBD's impact on blood pressure varies between individuals. Research suggests that CBD can modestly lower blood pressure, offering potential benefits to those with hypertension.(8) 

However, CBD may increase blood pressure in some cases. If you have a history of high blood pressure, consult your doctor before using CBD.

Does caffeine affect CBD? 

While there is limited research on the specific interaction between caffeine and CBD, both substances activate some of the same pathways in the brain.(9) This can lead to a synergistic effect, where combining caffeine and CBD may enhance their overall impact on the body.

Is it okay to take vitamins with CBD?

In most cases, it's safe to combine vitamins with CBD. However, consulting your doctor before taking any vitamins or supplements alongside CBD is advisable to prevent potential interactions or side effects.

Is CBD safer than Tylenol? 

While research is still in its initial phases, growing evidence supports CBD as a viable, natural alternative to over-the-counter pain relievers. CBD not only shares similar anti-inflammatory properties but also presents significantly fewer side effects. However, it’s best to discuss this further with your doctor. 

Can CBD cause heart palpitations?

Some studies have found that CBD can increase heart rate, which may result in heart palpitations.(3) If you have a history of heart palpitations, consult your doctor before using CBD.

May 12, 2023 — Griffin Lynch

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