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cbd and lipitor

Cbd and lipitor

The researchers further warned that while the list may be used as a starting point to identify potential drug interactions with marijuana or CBD oil, plant-derived cannabinoid products may deliver highly variable cannabinoid concentrations (unlike the FDA-regulated prescription cannabinoid medications previously mentioned), and may contain many other compounds that can increase the risk of unintended drug interactions.

Many drugs are broken down by enzymes in the liver, and CBD may compete for or interfere with these enzymes, leading to too much or not enough of the drug in the body, called altered concentration. The altered concentration, in turn, may lead to the medication not working, or an increased risk of side effects. Such drug interactions are usually hard to predict but can cause unpleasant and sometimes serious problems.

CBD has the potential to interact with many other products, including over-the-counter medications, herbal products, and prescription medications. Some medications should never be taken with CBD; the use of other medications may need to be modified or reduced to prevent serious issues. The consequences of drug interactions also depend on many other factors, including the dose of CBD, the dose of another medication, and a person’s underlying health condition. Older adults are more susceptible to drug interactions because they often take multiple medications, and because of age-related physiological changes that affect how our bodies process medications.

CBD can alter the effects of other drugs

Products containing cannabidiol (CBD) seem to be all the rage these days, promising relief from a wide range of maladies, from insomnia and hot flashes to chronic pain and seizures. Some of these claims have merit to them, while some of them are just hype. But it won’t hurt to try, right? Well, not so fast. CBD is a biologically active compound, and as such, it may also have unintended consequences. These include known side effects of CBD, but also unintended interactions with supplements, herbal products, and over-the-counter (OTC) and prescription medications.

Absolutely. Inhaled CBD gets into the blood the fastest, reaching high concentration within 30 minutes and increasing the risk of acute side effects. Edibles require longer time to absorb and are less likely to produce a high concentration peak, although they may eventually reach high enough levels to cause an issue or interact with other medications. Topical formulations, such as creams and lotions, may not absorb and get into the blood in sufficient amount to interact with other medications, although there is very little information on how much of CBD gets into the blood eventually. All of this is further complicated by the fact that none of these products are regulated or checked for purity, concentration, or safety.

Doubling up on side effects

While generally considered safe, CBD may cause drowsiness, lightheadedness, nausea, diarrhea, dry mouth, and, in rare instances, damage to the liver. Taking CBD with other medications that have similar side effects may increase the risk of unwanted symptoms or toxicity. In other words, taking CBD at the same time with OTC or prescription medications and substances that cause sleepiness, such as opioids, benzodiazepines (such as Xanax or Ativan), antipsychotics, antidepressants, antihistamines (such as Benadryl), or alcohol may lead to increased sleepiness, fatigue, and possibly accidental falls and accidents when driving. Increased sedation and tiredness may also happen when using certain herbal supplements, such as kava, melatonin, and St. John’s wort. Taking CBD with stimulants (such as Adderall) may lead to decreased appetite, while taking it with the diabetes drug metformin or certain heartburn drugs (such as Prilosec) may increase the risk of diarrhea.

Researchers from Penn State College of Medicine evaluated existing information on five prescription CBD and delta-9-tetrahydrocannabinol (THC) cannabinoid medications: antinausea medications used during cancer treatment (Marinol, Syndros, Cesamet); a medication used primarily for muscle spasms in multiple sclerosis (Sativex, which is not currently available in the US, but available in other countries); and an antiseizure medication (Epidiolex). Overall, the researchers identified 139 medications that may be affected by cannabinoids. This list was further narrowed to 57 medications, for which altered concentration can be dangerous. The list contains a variety of drugs from heart medications to antibiotics, although not all the drugs on the list may be affected by CBD-only products (some are only affected by THC). Potentially serious drug interactions with CBD included

Cbd and lipitor

Often times, when there is a significant interaction that involves increased Lipitor concentrations, a dose adjustment may be needed to reduce the risk of side effects. For examples, practitioners will sometimes recommend to “hold” or decrease the dose of Lipitor when taking a known strong inhibitor of CYP3A4, like clarithromycin. While this most likely is not necessary with CBD, it is a possibility for a small number of individuals.

The pharmacist discusses whether or not CBD interacts with Lipitor or aspirin.

I take Aspirin 100mg, Reaptan 5/10 BP Med (morning) and Atorvastatin 40mg (night). I’d like to know if CBD has any interaction with these meds. If so, what can I do? Especially with the Atorvastatin. I take CBD twice a day (0.2ml per day).

Metabolizing enzyme inhibition can lead to increased concentrations of drugs that are typical substrates for a particular enzyme. As an example:

CBD And Lipitor (Atorvastatin)

Nevertheless, it is important to be aware of the potential interaction and the potential for increased side effects of Lipitor, most notably of which includes muscle pain or weakness.

Several studies have listed CBD as an inhibitor of CYP3A4. How strong of an inhibitor it is, and whether or not this inhibition is dose dependent (i.e. higher doses bring more effect) isn’t well known. Some studies even note that while CBD does inhibit CYP3A4, the extent of the inhibition is not significant and the blood concentrations of CBD needed to affect it far exceeds what is possible with usual dosing.

There is no data available regarding an interaction between CBD and Lipitor (atorvastatin). However, Lipitor is metabolized CYP3A4, which CBD may potentially inhibit. Per the prescribing information for Lipitor:

Anita asked

For what it’s worth, the prescribing information for Epidiolex, the recently approved CBD product, does not list aspirin as an interacting drug and does not state that CBD can cause bleeding episodes.

Below, we will list the highlights of that article and specifically look at aspirin and Lipitor (atorvastatin):

Cbd and lipitor

More often than not, it is difficult to find thorough drug interaction information on over the counter supplements and herbal products.

Additionally, the prescribing information for Epidiolex, the prescription CBD product, does not state that it can potentially affect CYP3A4 substrate drugs, like Lipitor.

At a glance

The result of CYP3A4 inhibition by CBD could potentially increase concentrations of Lipitor in the body, increasing the risk of side effects such as stomach cramping, diarrhea or even the more serious ones, like rhabdomyolysis (the breakdown of muscle).

CBD Interaction With CYP3A4

Even though there doesn’t appear to be a high risk of a Lipitor interaction, it is important to consider how CBD could interact with other drugs.