Amlodipine And CBD Oil

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Can CBD oil help treat hypertension? And is it safe to take with existing blood pressure medications? When you take CBD alongside certain medications, it can trigger negative drug interactions. Here we explain what drugs shouldn’t be taken with CBD — and when to consult your doctor if you’re not sure about the potential interactions. CBD, or cannabidiol, is a chemical compound just like any other substance on our beautiful planet. Just like any other compound, it has the potential to interact with other compounds, such as medications that metabolize in the same part of the body.

Blood Pressure Medication and CBD Oil Interaction

A growing number of Americans are turning to cannabidiol (CBD) to address a wide range of concerns from stress and anxiety, to pain and inflammation. But, with so many people using CBD oil, questions start to arise about potential interactions with common prescriptions, including blood pressure medications.

If you rely on blood pressure medication and want to use CBD oil as an alternative or supplement to your current treatment plan, here is an overview of everything you need to know about using CBD oil while taking blood pressure medications.

CBD Oil and Blood Pressure Medication Interaction

Because there are such a wide range of pharmaceuticals prescribed for lowering blood pressure, it’s impossible to speak in broad terms about how CBD oil interacts with them all. However, if you’re taking one of the more common medications for hypertension (valsartan, metoprolol beta blocker, lisinopril, amlodipine besylate, or hydrochlorothiazide), there are a few things you should take into consideration before using cannabidiol oil.

CBD oil is generally recognized as a safe and well-tolerated compound with little to no known side effects. However, while conclusive studies have not been published, it has been suggested that CBD oil may affect the efficacy of blood pressure medication in controlling hypertension. Conversely, blood pressure medication is also believed to potentially reduce the efficacy of CBD oil.

Furthermore, because cannabidiol is an inhibitor of the cytochrome P-450 enzyme system , CBD oil should be used cautiously when combined with medications that use this pathway; in the case of high blood pressure medications, metoprolol and amlodipine besylate specifically.

The cytochrome P-450 system is comprised of liver enzymes that break down medications into smaller substances that the body can more easily process. Cannabidiol and other natural substances like grapefruit slow down this pathway. This may cause medications that rely on the P-450 system, including metoprolol and amlodipine besylate, to remain for longer periods in the system and increase the likelihood that you experience their adverse side effects.

Side Effects of Using CBD Oil and Blood Pressure Medication

While adverse interactions between CBD oil and blood pressure medication are rare, they should be combined with caution and only under doctor supervision. In some cases, blood pressure medications may delay and/or reduce the beneficial effects of CBD oil. In others, CBD oil may delay and/or reduce the effectiveness of your prescribed blood pressure medication.

For reference, this table breaks down a few of the more common blood pressure medications and the side effects you may feel if taking them in conjunction with CBD oil.

Generic Name (Brand Name) Possible Side Effects of Combining Medication + CBD Oil
Valsartan (Diovan) CBD oil may be metabolized slower when used in conjunction with Valsartan
Metoprolol (Lopressor; Toprol XL) The antihypertensive function of Metoprolol may be decreased when combined with CBD oil
Lisinopril (Prinivil; Zestril) The antihypertensive function of Lisinopril may be decreased when combined with CBD oil
Amlodipine besylate (Norvasc) CBD oil may be metabolized slower when used in conjunction with Amlodipine besylate
Hydrochlorothiazide (HCTZ) The antihypertensive function of Hydrochlorothiazide may be decreased when combined with CBD oil

Another important thing to note is that since CBD oil reduces blood pressure on its own, when it is taken in tandem with medication designed to perform the same action, you essentially have two compounds bringing down your levels. If your blood pressure is reduced too much in a short amount of time, you may feel weak and lethargic. It is for this reason that starting with a small initial dosage of CBD is key.

Avoiding the Side Effects

With the above possible side effects in mind, you may feel dissuaded from trying CBD oil while on blood pressure medication. On the other hand, you might also consider using CBD oil on its own to manage hypertension. Amongst other benefits, CBD oil has been shown to reduce blood pressure by relieving anxiety, reducing stress, and widening blood vessels.

CBD oil’s anti-anxiety and stress-relieving properties encourage a lower heart rate, which ultimately reduces blood pressure. CBD oil’s ability to dilate blood vessels allows for easier blood flow in arteries with plaque build-up, which also reduces the symptoms of hypertension. In fact, a 2017 study found that a single dose of cannabidiol significantly lowered the blood pressure of test subjects both when at rest and in stressful conditions.

In a cumulative 2017 review of numerous studies on cannabidiol’s effect on blood flow, it was concluding that “ CBD may be used as a treatment for various cardiovascular disorders, such as hypertension, myocardial infarction, and stroke.” It is important to mention that the majority of these results were found in animal studies and more clinical research is needed in humans. Still, the findings are promising.

How to Safely Use CBD Oil and Blood Pressure Medication Together

Whether your goal is to supplement your current hypertension treatment plan with CBD oil, or to completely replace your blood pressure medication with CBD oil, you should begin by speaking with your doctor . Because CBD oil can interact with your current blood pressure medications, consulting with your physician on the possible risks—and benefits—is crucial for your safety and health.

You will want to be conscientious of dosage especially since CBD oil may amplify the effects of the medications you’re taking. CBD products generally come with an information leaflet that provides a recommended dosage, but you may want to start with an amount lower than what is recommended and gradually increase your dosage over time as needed. This will allow your body to build a tolerance to CBD oil and reduce the risk of having a sudden drop in your blood pressure.

For more information on proper CBD oil dosage, check out our dosage guide here .

Over a period of time, you may even find you are able to lower the dosage of your blood pressure medication as the CBD oil becomes most effective. If you choose to do this, speak to your doctor before discontinuing or altering your prescription medication. Any changes to your treatment plan are best done under the supervision and guidance of a medical professional.

If you’re still in need of guidance or would like more information on using CBD oil as a medical supplement, consider speaking with a naturopathic doctor who specializes in natural health treatments.

Best CBD Oil to Use with Blood Pressure Medication

In order to find the best CBD oil product, you need to know what you’re looking for. With thousands of products available online and in stores, how do you know where to start?

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First, investigate the different CBD oil delivery formats to decide which one best fits your goals and lifestyle. CBD oil drops, edibles , capsules, and vapes a few of the more common options.

While the majority of people new to CBD oil opt for capsules and edibles because of their convenience and familiarity, it is worth keeping in mind that these will enter your body through the digestive system and therefore lose some potency and take longer before you feel the effects. Inhalants or sublingual drops meanwhile, allow the CBD oil to enter the bloodstream more readily, providing quick and effective results. Experiment with the different delivery methods to decide which works best for your needs and lifestyle.

Once you have decided on your preferred delivery format, look for top-rated CBD oil products that are sustainably sourced, organically grown, and third-party lab tested to ensure quality and purity. Taking these steps is the best way to ensure that your CBD oil product is free from any harmful pesticides, herbicides, and added chemicals.

And when you’re ready to shop, check out our list of the Top 10 Best CBD Products to Buy.

CBD Drug Interactions – Mixing Cannabidiol and Medications

Are you worried about potential CBD-drug interactions? In this article, we explain the mechanism behind drug metabolism and how CBD may interfere with it.

The range of therapeutic properties offered by CBD (cannabidiol) has spurred its popularity in recent years. This natural compound is known to relieve a host of symptoms, allowing for safer and more effective management of different health conditions.

And unlike THC (tetrahydrocannabinol), CBD is non-intoxicating, so it won’t get you high.

CBD can assist in the treatment of anxiety disorders and depression, inflammation and pain, neurodegeneration, seizure disorders, sleep deprivation, metabolic conditions, neuropathy, migraines, inflammatory bowel disease, and more.

Considering CBD has so many potential health benefits, you may start wondering if it can interact with certain medications used to address the same symptoms — and whether you should or shouldn’t take these drugs with CBD.

Below you’ll find the dos and don’ts of using CBD along with medications.

Let’s start with the don’ts.

What Drugs Should Not Be Taken with CBD

Studies from the Indiana University Department of Medicine have provided a list of pharmaceutical drugs and medications which shouldn’t be taken with CBD.

The list below covers all groups of drugs that can negatively interact with CBD oil.

  • Angiotension II Blockers
  • Antiarrhythmics
  • Antibiotics
  • Antidepressants
  • Anticonvulsants / Anti-Seizure Medications
  • Antihistamines
  • Antipsychotics
  • Anesthetics
  • Beta-Blockers
  • Benzodiazepines
  • Calcium Channel Blockers
  • HIV Antivirals
  • HMG CoA Reductase Inhibitors (Statins)
  • Immune Modulators
  • Non-Steroidal Anti-Inflammatory Drugs
  • Oral Hypoglycemic Agents
  • Proton-Pump Inhibitors (PPIs)
  • Prokinetics
  • Steroids and Corticosteroids
  • Sulfonylureas

There’s also a group of drugs called “prodrugs” that first need to be processed into their therapeutic compounds instead of being therapeutic compounds on their own. In plain English, the inactive compound is consumed, and once in the body, it turns into the active compound.

If this mechanism is dependant on the CYP450 system (more on that later), a drug interaction can lead to insufficient concentrations of the therapeutic agent in the bloodstream — reducing its potency.

CBD Interaction with Drugs & Medications

This section covers the most common interactions between CBD and medications. If you take any of the substances listed below, make sure to consult your doctor before buying CBD oil.

CBD and Ibuprofen Interaction

Ibuprofen is one of the Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), meaning it can produce similar benefits to CBD in terms of inflammation and pain relief. Previously we’ve mentioned that NSAIDs interact with CBD, which may raise concerns about potential negative interactions between CBD oil and Ibuprofen.

According to a study from the Journal of Neurology Research, there have been no reported interactions between CBD and ibuprofen, although it doesn’t mean they do not exist. Health experts suggest that potential interactions may be dosage-dependent. If a certain dosage threshold is breached, CBD and NSAIDs like Ibuprofen can lead to unforeseen and potentially severe nervous system pathology.

CBD and Adderall Interaction

A 2020 study found that higher doses of medical cannabis led to a decreased use of ADHD medication in adults. Products containing a higher concentration of CBD were linked to lower ADHD scores. This means that CBD can interact with ADHD meds, decreasing their efficacy while providing more pronounced benefits. The potential side effects of interactions between CBD and Adderall may lead to decreased appetite.

CBD and Lamictal Interaction

Using medical cannabis and Lamictal may increase side effects such as dizziness, confusion, drowsiness, and difficulty concentrating. Elderly consumers may also experience impairment in judgment. That being said, none of these side effects were proven to result from CBD use per se. When it comes to interactions between CBD and Lamictal, it can make the medication more or less effective, depending on the dosage.

CBD Oil and Antibiotics

There is no known interaction between CBD and antibiotics, although these interactions may occur if an antibiotic is metabolized through the cytochrome P450 enzyme system. Some studies indicate that taking CBD and antibiotics together may amplify the effects of one another without any negative side effects. However, more research is needed to confirm these findings on a larger scale.

CBD Oil and Omeprazole

CBD can inhibit the enzymes that are targeted by omeprazole and other Proton Pump Inhibitors (PPIs). Taking CBD with certain heartburn medications can increase the risk of diarrhea.

CBD and Thyroid Medications

Some people report mild nausea when taking CBD oil together with their thyroid medications. Since both substances are processed by the CYP450 enzyme system, taking CBD with a thyroid medication may cause hyperthyroidism because more thyroxine would be secreted than the body could metabolize.

CBD and Lisinopril

CBD can temporarily lower blood pressure, so taking it alongside medications like Lisinopril might reduce it even more, making you feel lethargic and weak. Always consult your doctor before adding CBD to your routine if you use anti-hypertension meds.

CBD and Prednisone

Since both CBD and corticosteroids are potent inhibitors of the CYP450 enzyme system, concomitant use may increase the risk of systemic side effects from corticosteroid use due to decreased glucocorticoid clearance. Corticosteroids like prednisolone and hydrocortisone should never be taken with CBD.

How Drugs Interact: Understanding Drug Metabolism

Metabolism can refer to how your body uses energy for weight management, or the way drugs are metabolized in your body.

The former is known as the basal metabolic rate, or in simple terms, the number of calories a person needs to maintain healthy body functions while at rest.

The latter is very different from the basal metabolic rate. Drug metabolism refers to how a substance is processed and used by the body — with the majority of this processing happening in the liver.

Scientists call it the ‘first-pass effect’ or ‘first-pass metabolism.’

Using straightforward terms, when you take a medication, it is broken down in the liver into its active compounds so that the body can use them. Just like carbohydrates are broken down into sugars, fats into triglycerides, and proteins into amino acids — drugs break down into their individual ingredients.

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From there, they are controlled by specific enzymes, which transform these compounds into metabolites. These metabolites then influence different processes in your body and are flushed with urine once used up.

How Is CBD Metabolized?

Drug metabolism determines the rate at which the body processes medications and other therapeutic compounds into their individual metabolites and how long they can stay in your system.

When you take CBD in the form of an oil, capsule, or gummy, it has to pass through your gut, where it is released into the bloodstream. From then, they travel through the bloodstream to the liver, where it absorbs through the hepatic portal. The liver breaks CBD down into its metabolites using enzymes, after which it can circulate throughout the body in the bloodstream again.

What Is the Cytochrome P450 System?

Aside from breaking compounds down into metabolites, the liver also detoxifies and excretes foreign substances and other types of toxic compounds. This can happen through a system of enzymes referred to as the Cytochrome P450 (CYP450). These enzymes contain heme as a cofactor to convert cannabinoids into more water-soluble molecules, increasing their absorption and efficacy.

Researchers estimate that the CYP450 system is responsible for metabolizing 60% of any drugs out there. And interestingly, doctors and pharmacists use this system to understand, evaluate, and predict the benefits of the drug and potential side effects based on their dosages.

However, certain compounds have the ability to compromise the CYP system’s functioning, negatively affecting the metabolism of certain medications. Once these interactions occur, the drugs can be metabolized faster or slower than normal.

CBD And the Cytochrome P450 System

As mentioned earlier, CBD can interact directly with the CYP450 system in the liver. According to preclinical studies, CBD binds to the site where the enzyme activity occurs, competing with other compounds and thus preventing this system from breaking down other substances.

This inhibitory effect on the CYP450 enzymes mainly depends on how much CBD a person takes, their unique physiology, and the type of CBD used (e.g., full-spectrum CBD vs. CBD isolate). The dosage determines the strength used by the CBD to bind to the active site of the metabolic enzymes. The tighter the bond, the more competitive inhibition.

Contraindications for Taking CBD with Medications

The mechanism behind CBD’s health benefits proves that it’s not a biologically inert compound. Instead, the pharmacokinetics and pharmacodynamics of CBD are complex and similar to any other medication. Therefore, it has the potential to compromise the metabolism of certain medications.

Any therapeutic substance that relies on the CYP450 system can be potentially affected by CBD. A common indicator for such interaction is when your medication has a grapefruit warning on the bottle. However, this is by no means a solid point of reference, and you should always check with your doctor and pharmacist before taking the two compounds together.

Why You Should Always Consult Your Doctor First

The list of drugs that we’ve mentioned above is by no means definite and doesn’t include all the pharmaceutical substances that may interact with CBD. Similarly, not all the medication from these categories will necessarily cause an interaction — as is the case for antibiotics and Ibuprofen.

A consultation with a doctor experienced in CBD and cannabis use can help you establish the right routine for your medications and supplements to avoid potentially negative interactions. Some compounds work synergistically with CBD, so asking your doctor can help you maximize the effect of your treatment.

Not to mention that the doctor can guide you on finding the optimal dosage for yourself.

Key Takeaways on CBD Drug Interactions

The safety profile of CBD has been acknowledged by major health agencies, such as the World Health Organization (WHO), showing that it’s well-tolerated by animals and humans and rarely produces any dangerous side effects.

CBD also has a profound impact on an array of systems, which explains its therapeutic versatility. That being said, this versatility is also the reason why CBD interacts with so many prescription meds and over-the-counter (OTC) PRODUCTS.

Again, if you’re not sure if CBD will interact with the medication that you might be taking, a consultation with a health professional will not harm — unlike trying to figure out these interactions on your own.

Livvy Ashton

Livvy is a registered nurse (RN) and board-certified nurse midwife (CNM) in the state of New Jersey. After giving birth to her newborn daughter, Livvy stepped down from her full-time position at the Children’s Hospital of New Jersey. This gave her the opportunity to spend more time writing articles on all topics related to pregnancy and prenatal care.

What Drugs Should Not Be Taken With CBD?

CBD, or cannabidiol, is a chemical compound just like any other substance on our beautiful planet. Just like any other compound, it has the potential to interact with other compounds, such as medications that metabolize in the same part of the body. There are a whopping 98 identified drug interactions just for caffeine, some of which stop the other drug from working completely. Even grapefruit can’t be eaten if you’re on certain prescription medications – which means it’s no surprise that CBD and some drugs just shouldn’t mix.

Fortunately, unlike caffeine and grapefruit, most of the potential interactions with CBD and other drugs have been identified as harmless or mild. In some cases, other drugs and CBD can work in combination with each other favorably instead of having adverse side effects. We always recommend speaking with a certified health professional or physician prior to taking CBD oil or adding it into your daily routine, especially if you are currently on or plan on taking prescription medications. Today, though, we’re going to cover some of the drugs that have been shown to interact with CBD in some way to look at which drugs should not be taken with CBD.

How CBD Might Interact with Other Drugs

We see a range of ways for how CBD interacts with other drugs, medications, and chemical compounds. Cannabidiol may potentially reduce the metabolism of other drugs that compete for the same enzyme as it does. Metabolized by the cytochrome enzymes CYP2C19 and CYP3A4 in the body, this can raise the blood levels of other medications that metabolize the same way, which would require your doctor to do a downward adjustment on your doses. It can inhibit CYP2D6, the enzyme targeted by risperidone and omeprazole medications. Likewise, it could reduce the metabolization of diclofenac and warfarin by inhibiting the hepatic enzyme, CYP2C9.

It was found to increase the bioavailability of Hexobarbital, a barbiturate derivative with sedative and hypnotic effects that’s often sold in both sodium salt and acid forms like Tobinal, Evipan, and Citopan. While cannabis may increase the potency or effectiveness of other drugs, close monitoring by your physician or a medical professional is important. Your dosage may need to be adjusted even if the drug interact is beneficial, so make sure you’re staying honest with your doctor if you’re interested in using CBD.

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The CYP450 Enzyme

CBD interacts with more than one cytochrome enzyme, including one located primarily in the liver and brain that’s involved in helping the body process about 60% of the pharmaceuticals on the market right now.

In short, cannabidiol has the potential to interact with a lot of medications just from this enzyme alone.

In fact, here are some of the drugs that have been shown to use the CYP450 enzyme system in our bodies:

· Oral hypoglycemic agents

· Calcium channel blockers

By interacting or saturating this enzyme system, CBD could potentially prevent other drugs from accessing the same enzyme. This causes those medications to build up in the bloodstream instead, which simply makes the drug more potent. However, it could also prevent medication from having a timely effect or releasing into the bloodstream when it’s expected to. On the bright side, just using CBD oil or another CBD product doesn’t mean that your CYP450 enzyme system is affected. Those results came from observing consistently high doses of CBD.

The lower dosages that come in a CBD oil tincture bottle will likely not cause the same extreme effects. We still need more research before we can find the exact dose of CBD required to make any significant difference for a drug interaction. As a rule of thumb, it’s safe to assume that the risk of drug interaction increases the more CBD you take in a daily sitting.

Serum Concentration Increase

CBD may cause an increase the amount of medication in your blood, otherwise known as serum concentrations, according to the District of Columbia’s Department of Health. Just like grapefruit, this means it may interact with beta blockers, calcium channel blockers, antiretrovirals, antihistamines, and antidepressants. Allergy pills, blood pressure medication, and even cholesterol drugs may absorb differently due to CBD blocking the liver enzyme it’s trying to metabolize through.

Again, this is only found in very high doses of CBD, some of which are stronger than an entire standard bottle of a CBD oil tincture. Low amounts of CBD such as standard serving sizes throughout the day don’t appear to affect how your body is processing other medicine (though a doctor’s second opinion is always recommended).

Timing Might be Everything

While you need to discuss with your physician the schedule for taking your drugs, some research suggests that the timing of when you take other medications and CBD might play a huge role in CBD’s interaction with those drugs. The goal is to reduce the workload of the liver. Medication that metabolizes in the liver enzymes are already causing the liver to perform its bodily function. However, all drugs have a half-life, and it doesn’t stay in your liver once it has been metabolized. You just have to wait long enough for the enzymes in your liver to regain a sufficient level of their function before using CBD oil. Drug interactions between CBD and other liver enzyme metabolizing medications may diminish after waiting a couple hours between taking your prescription medication and taking the cannabidiol. Your chances of a drug interaction could be lower by trying CBD throughout different times of the day.

Everyone processes CBD and other drugs differently, so you may experience different interactions than others or have little to no reaction even when you take medication in combination with cannabidiol. Heavily influenced by our body size, age, genetics, and sensitivity to chemical compounds, the effect medication will have and how our bodies will process it can vary greatly. This is just one of the reasons you want to speak with a certified health professional if you’re taking other medication to make sure it doesn’t interfere with a daily serving or more of cannabidiol.

The CBD Product You Choose Matters

There are a tremendous variety of CBD products available now – from CBD oil tinctures, to soft chews, to topicals, we see new products released every day for the industry. The way you decide to use CBD will contribute greatly to how it interacts with any medication you’re on. How much cannabidiol gets into the bloodstream varies from method to method.

For example, applying a topical CBD cream to a target area on the body, or maybe over a muscle spasm, means that the cannabidiol is only interacting with the CB receptors on the skin. The amount of CBD absorbed into the bloodstream topically is likely negligible, making it one of the safest options if you want to use CBD but don’t want it to interact with a more important prescription medication you’re taking. You can also ingest the cannabidiol directly through a CBD oil tincture, soft chew, or other edible product.

This reduces how much and how fast the CBD hits the bloodstream, taking the long route through the gastrointestinal system before heading to the liver to reach those important liver enzymes we keep talking about. Using this method to consume your CBD, you still lessen some of the CBD that’s absorbed into the enzymes in the liver. CBD oil sublingually is the second-best way to get the most effective dose possible. Swishing it around in your mouth, through your teeth, and substantially under your tongue will allow it to hit the highest surface count of capillaries. This is a direct route to your bloodstream, so you can expect the effects to hit the fastest and most effectively, lasting around the same amount of time as an edible might. While this is one of the best ways to get the most out of a CBD oil bottle, it also runs the chance of causing the CBD to interact most severely with any other medication.

The most direct route, an IV is the only way to get the CBD anymore directly into your bloodstream. However, you can also vape or smoke the product; some CBD oil formulas can even be used for both vaping and sublingual doses.

Be Smart

Don’t mix substances without receiving medical advice from a doctor first. We love seeing how many people have found the effectiveness of CBD daily, but your health is the most important factor. We use CBD to promote general wellness, so we want to be upfront about anything that substance might interact with.

Whether you’re taking your prescribed medications or you’re new to cannabidiol, speak with a certified health professional before you take your first serving. Alternatively, you can also check out our lab reports to feel more confident about the lack of contaminants and pollutants and accuracy of the cannabinoid content level we report. You can also check out the FAQ section for any other CBD related answers you are looking for.

In the meantime, we hope this answers any questions you had about how cannabidiol metabolizes in the body, how CBD interacts with other medications or prescription drugs, and, ultimately, which drugs should not be taken with CBD.

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