Meta Information
ID:cbd
Name:
Schema Version:AIM-2.0
Interactions
Target id:
/class/cyp3a4-substrates
Target name:
CYP3A4 Substrates
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
CBD is a potent inhibitor of the CYP3A4 enzyme, which can significantly increase the concentration and risk of side effects from many common medications, including certain statins, calcium channel blockers, and immunosuppressants.
Actionable advice:
Consult a physician before combining with any medication metabolized by CYP3A4, as dose adjustments or alternative therapies may be required.
Target id:
/class/cyp2c19-substrates
Target name:
CYP2C19 Substrates
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
CBD strongly inhibits the CYP2C19 enzyme, increasing levels of drugs like the anticonvulsant clobazam, proton pump inhibitors (omeprazole), and some antidepressants (citalopram), which can lead to toxicity.
Actionable advice:
Avoid or use with extreme caution and medical supervision alongside medications metabolized by CYP2C19.
Target id:
/intervention/warfarin
Target name:
Warfarin
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
CBD inhibits the CYP2C9 enzyme responsible for metabolizing warfarin, which can dangerously increase warfarin levels and elevate the risk of severe bleeding.
Actionable advice:
Avoid concurrent use; if necessary, frequent INR monitoring and dose adjustments under strict medical supervision are required.
Target id:
/condition/hepatic-impairment
Target name:
Hepatic Impairment
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
CBD is metabolized by the liver, and impaired liver function can lead to higher CBD concentrations and an increased risk of side effects, including further liver injury (elevated transaminases).
Actionable advice:
Avoid use or consult a specialist for significant dose reduction in cases of moderate to severe liver disease.
Target id:
/intervention/valproate
Target name:
Valproate / Valproic Acid
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Concurrent use of CBD and valproate, an anti-seizure medication, is associated with a significantly higher incidence of liver enzyme elevation than with either drug alone.
Actionable advice:
Avoid this combination or proceed only with very close liver function monitoring under specialist care.
Target id:
/condition/pregnancy
Target name:
Pregnancy
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
The effects of CBD on fetal development are unknown, and it may cross the placental barrier. The FDA strongly advises against its use during pregnancy due to potential risks.
Actionable advice:
Avoid completely during pregnancy.
Target id:
/condition/lactation
Target name:
Breastfeeding (Lactation)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
CBD is transferred into breast milk, and its effects on a nursing infant are unknown and potentially harmful. The FDA strongly advises against its use while breastfeeding.
Actionable advice:
Avoid completely while breastfeeding.
Target id:
/class/immunosuppressants
Target name:
Calcineurin Inhibitors (e.g., Tacrolimus, Cyclosporine)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
CBD's inhibition of CYP3A4 can lead to dangerously high levels of immunosuppressants like tacrolimus, increasing the risk of kidney damage and other severe toxicities.
Actionable advice:
Avoid this combination unless managed by a specialist with frequent therapeutic drug monitoring.
Target id:
/dietary/high-fat-meal
Target name:
High-Fat Meal
Severity:
moderate
Interaction type:
synergistic
Nature:
temporal
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
A high-fat meal can increase the absorption and total concentration of CBD by four to five times compared to taking it on an empty stomach, leading to more consistent effects.
Actionable advice:
Take CBD with a meal containing healthy fats to enhance absorption and ensure consistent dosing.
Target id:
/class/cns-depressants
Target name:
Central Nervous System Depressants (e.g., Alcohol, Benzodiazepines, Opioids)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
CBD can cause drowsiness and sedation. These effects are additive with other CNS depressants, potentially leading to excessive sleepiness, dizziness, and impaired coordination.
Actionable advice:
Avoid combining with alcohol and use with caution alongside other sedating medications, especially when driving.
Target id:
/class/cyp2d6-substrates
Target name:
CYP2D6 Substrates
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
CBD is a moderate inhibitor of the CYP2D6 enzyme, which can increase levels of many antidepressants (e.g., SSRIs, tricyclics), antipsychotics, and beta-blockers.
Actionable advice:
Use with caution and be aware of potential for increased side effects from medications metabolized by CYP2D6.
Target id:
/class/cyp2c9-substrates
Target name:
Drugs Metabolized by CYP2C9
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
CBD inhibits the CYP2C9 enzyme, which can increase levels of certain medications like some NSAIDs (ibuprofen, celecoxib) and antidiabetic drugs (glipizide), potentially increasing their side effects.
Actionable advice:
Use with caution when combining with medications metabolized by CYP2C9, and avoid completely with warfarin.
Target id:
/class/anticoagulants-antiplatelets
Target name:
Anticoagulants and Antiplatelets
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Beyond the major interaction with warfarin via CYP2C9 inhibition, CBD may have additive blood-thinning effects with other anticoagulants and antiplatelets, theoretically increasing the overall risk of bleeding.
Actionable advice:
Use with caution and consult a healthcare provider before combining with any blood-thinning medications or supplements.
Target id:
/class/broad-spectrum-inducers
Target name:
Strong Enzyme Inducers (e.g., Rifampin, St. John's Wort)
Severity:
moderate
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
null
Description:
Drugs that strongly induce CYP3A4 and CYP2C19 enzymes can significantly accelerate the breakdown of CBD, reducing its blood concentration and effectiveness.
Actionable advice:
Avoid combination or anticipate the need for a higher CBD dose under medical guidance.
Target id:
/dietary/grapefruit-pomelo
Target name:
Grapefruit or Grapefruit Juice
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Both CBD and grapefruit are inhibitors of the CYP3A4 enzyme. Consuming them together can amplify this effect, increasing the risk and severity of interactions with other medications metabolized by this pathway.
Actionable advice:
Avoid consuming grapefruit products when taking CBD, especially if you are on other medications.
Target id:
/biomarker/alanine-aminotransferase
Target name:
Liver Enzymes (ALT/AST)
Severity:
moderate
Interaction type:
assay_interference
Nature:
absolute
Temporal spacing:
null
Description:
High doses of CBD can cause a dose-dependent elevation in liver enzymes (transaminases), indicating potential liver stress. This risk is higher when combined with other drugs affecting the liver.
Actionable advice:
Regularly monitor liver function tests when taking high doses of CBD or using it with other potentially hepatotoxic medications.
Target id:
/class/antihypertensives
Target name:
Antihypertensive Medications
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
CBD may cause a modest decrease in blood pressure, which could have an additive effect with blood pressure-lowering medications, potentially causing dizziness or lightheadedness.
Actionable advice:
Monitor blood pressure when starting or adjusting CBD dosage if you are taking antihypertensive drugs.
Target id:
/class/antidiabetic-medications
Target name:
Diabetes Medications
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Some evidence suggests CBD may influence glucose metabolism and insulin sensitivity. This could theoretically alter the effects of antidiabetic medications, requiring dose adjustments.
Actionable advice:
Monitor blood glucose levels closely when initiating or changing your CBD dose if you are being treated for diabetes.
Target id:
/intervention/caffeine
Target name:
Caffeine
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
CBD may weakly inhibit the CYP1A2 enzyme that metabolizes caffeine, potentially slowing its clearance and prolonging its effects, which could lead to jitteriness or insomnia in sensitive individuals.
Actionable advice:
Consider reducing caffeine intake if you experience increased side effects after starting CBD.
Target id:
/intervention/theophylline
Target name:
Theophylline
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
High doses of CBD may weakly inhibit CYP1A2, the enzyme that metabolizes theophylline. This could potentially increase levels of theophylline, a drug with a narrow therapeutic window.
Actionable advice:
Use with caution and monitor for theophylline side effects if using high-dose CBD.
Target id:
/condition/seizure-disorder
Target name:
Seizure Disorder / Epilepsy
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
While used to treat certain seizures, CBD can also alter the blood concentrations of other anti-seizure medications through metabolic enzyme inhibition, requiring careful dose management by a neurologist.
Actionable advice:
Only use for epilepsy under the direct supervision of a physician who can manage drug interactions.