CBD has the potential to interact with many other products, including over-the-counter drugs, herbal products, and prescription drugs. Some medications should never be taken together with CBD; it may be necessary to modify or reduce the use of other medications to prevent serious problems. A pharmacokinetic interaction between CBD and clobazam was reported, and a decrease in serum clobazam levels was observed after increasing doses of CDB40. But what if we could consume CBD without using our liver? CBD would work safely regardless of the other prescription or over-the-counter medications used.
Similarly, when CBD was administered together with ethanol to rats, CBD was able to attenuate alcohol-induced brain damage to the hippocampal and entorhinal cortices. In addition to more traditional ways of consuming cannabis, such as smoking, there is growing interest in CBD oil, which only contains CBD and not the psychoactive component of cannabis, delta-9-tetrahydrocannabinol (THC). It is known that CBD interacts with the metabolizing enzymes of cytochrome P450 drugs, and this affects the co-administration of CBD with other drugs that are also inhibited or metabolized by these enzymes. Although the effects of CBD on alcohol consumption are not well understood, it is known that CBD acts as an agonist of 5-HT1A receptors and the results suggest that CBD may attenuate alcohol consumption and, potentially, protect against certain harmful effects of alcohol, such as liver and brain damage.
67 However, CBD inhibits CYP3A4, which means that taking CBD and sertraline at the same time could be dangerous. Given the increasing use of CBD and its wide availability to the general public, it is important to examine and report on potential pharmacological interactions between CBD and other therapeutic agents, as well as with addictive substances such as alcohol and tobacco. Despite the growing popularity of CBD as a drug for countless medical conditions, the limited availability of applicable pharmacokinetic and pharmacodynamic information highlights the need to start prescribing CBD with a “start small and go slow” approach, carefully watching the patient for desired and adverse effects. Although CBD did not affect the anticonvulsant activity of lacosamide, pharmacokinetic interactions between these two drugs cannot be excluded, since CBD increased the concentration of lacosamide in the brain and vice versa.
The increase in the anticonvulsant activity of AEDs was partly related to pharmacokinetic interactions with CBD, since CBD increased the serum and brain concentrations of these AEDs. The interaction of these drugs with CYP3A4 causes a slower degradation of CBD and, consequently, can cause higher levels of CBD that are pharmaceutically active for long periods of time. Rather than distributing CBD throughout the body, these external CBD products concentrate their therapeutic effects on a specific area.
