Overview

Cannabidiol (CBD) is a chemical in the Cannabis sativa plant, also known as cannabis or hemp. One specific form of CBD is approved as a drug in the U.S. for seizure.

Over 80 chemicals, known as cannabinoids, have been found in the Cannabis sativa plant. Delta-9-tetrahydrocannabinol (THC) is the most famous ingredient in cannabis. But CBD is obtained from hemp, a form of the Cannabis sativa plant that only contains small amounts of THC. CBD seems to have effects on some chemicals in the brain, but these are different than the effects of THC.

A prescription form of CBD is used for seizure disorder (epilepsy). CBD is also used for anxiety, pain, a muscle disorder called dystonia, Parkinson disease, Crohn disease, and many other conditions, but there is no good scientific evidence to support these uses.

Laws passed in 2018 made it legal to sell hemp and hemp products in the US. But that doesn't mean that all CBD products made from hemp are legal. Since CBD is an approved prescription drug, it can't be legally included in foods or dietary supplements. CBD can only be included in "cosmetic" products. But there are still CBD products on the market that are labeled as dietary supplements. The amount of CBD contained in these products is not always the same as what is stated on the label.

How does it work ?

Uses & Effectiveness ?

Likely Effective for

  • Seizure disorder (epilepsy). A specific prescription product (Epidiolex, GW Pharmaceuticals) is approved by the US FDA to treat seizures caused by Dravet syndrome, Lennox-Gastaut syndrome, or tuberous sclerosis complex. It is unclear if other forms of CBD are helpful for seizure. For now, stick with the prescription product.
There is interest in using CBD for a number of other purposes, but there isn't enough reliable information to say whether it might be helpful for these uses.

Possibly Effective for

  • Multiple sclerosis (MS). A prescription-only nasal spray product (Sativex, GW Pharmaceuticals) containing both 9-delta-tetrahydrocannabinol (THC) and cannabidiol has been shown to be effective for improving pain, muscle-tightness, and urination frequency in people with MS. This product is used in over 25 countries outside of the United States. But there is inconsistent evidence on the effectiveness of cannabidiol for symptoms of multiple sclerosis when it is used alone. Some early research suggests that using a cannabidiol spray under the tongue might improve pain and muscle tightness, but not muscle spasms, tiredness, bladder control, mobility, or well-being and quality of life in patients with MS.

Side Effects

When taken by mouth: CBD is possibly safe to take in appropriate doses. Doses of up to 200 mg daily have been used safely for up to 13 weeks. With the guidance of a healthcare provider, a specific prescription CBD product (Epidiolex) has been used at higher doses and for longer durations.

CBD can cause some side effects, such as dry mouth, low blood pressure, light headedness, and drowsiness. Signs of liver injury have also been reported with high doses of the prescription form of CBD, called Epidiolex.

When applied to the skin: There isn't enough reliable information to know if CBD is safe or what the side effects might be.

Special Precautions and Warnings

Pregnancy and breast-feeding: It may be unsafe to take CBD if you are pregnant or breast feeding. CBD products can be contaminated with other ingredients that may be harmful to the fetus or infant. Stay on the safe side and avoid use.

Children: It is possibly safe for children to take a specific prescription CBD product (Epidiolex) by mouth in doses up to 25 mg/kg daily. This product is approved for use in children with certain conditions who are at least 1 year old. It isn't clear if other CBD products are safe in children.

Liver disease: People with liver disease may need to use lower doses of CBD.

Parkinson disease: Some early research suggests that taking high doses of CBD might make muscle movement and tremors worse in some people with Parkinson disease.

Interactions ?

    Moderate Interaction

    Be cautious with this combination

  • Medications changed by the liver (Cytochrome P450 1A1 (CYP1A1) substrates) interacts with CANNABIDIOL (CBD)

    Some medications are changed and broken down by the liver. CBD might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.

  • Medications changed by the liver (Cytochrome P450 1A2 (CYP1A2) substrates) interacts with CANNABIDIOL (CBD)

    Some medications are changed and broken down by the liver. CBD might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.

  • Medications changed by the liver (Cytochrome P450 1B1 (CYP1B1) substrates) interacts with CANNABIDIOL (CBD)

    Some medications are changed and broken down by the liver. CBD might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.

  • Medications changed by the liver (Cytochrome P450 2A6 (CYP2A6) substrates) interacts with CANNABIDIOL (CBD)

    Some medications are changed and broken down by the liver. CBD might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.

  • Medications changed by the liver (Cytochrome P450 2B6 (CYP2B6) substrates) interacts with CANNABIDIOL (CBD)

    Some medications are changed and broken down by the liver. CBD might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.

  • Medications changed by the liver (Cytochrome P450 2C19 (CYP2C19) substrates) interacts with CANNABIDIOL (CBD)

    Some medications are changed and broken down by the liver. CBD might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.

  • Medications changed by the liver (Cytochrome P450 2C9 (CYP2C9) substrates) interacts with CANNABIDIOL (CBD)

    Some medications are changed and broken down by the liver. CBD might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.

  • Medications changed by the liver (Cytochrome P450 2D6 (CYP2D6) substrates) interacts with CANNABIDIOL (CBD)

    Some medications are changed and broken down by the liver. CBD might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.

  • Medications changed by the liver (Cytochrome P450 3A4 (CYP3A4) substrates) interacts with CANNABIDIOL (CBD)

    Some medications are changed and broken down by the liver. CBD might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.

  • Sedative medications (CNS depressants) interacts with CANNABIDIOL (CBD)

    CBD might cause sleepiness and slowed breathing. Some medications, called sedatives, can also cause sleepiness and slowed breathing. Taking CBD with sedative medications might cause breathing problems and/or too much sleepiness.

  • Clobazam (Onfi) interacts with CANNABIDIOL (CBD)

    Clobazam is changed and broken down by the liver. CBD might decrease how quickly the liver breaks down clobazam. This might increase the effects and side effects of clobazam.

  • Eslicarbazepine (Aptiom) interacts with CANNABIDIOL (CBD)

    Eslicarbazepine is changed and broken down by the body. CBD might decrease how quickly the body breaks down eslicarbazepine. This might increase levels of eslicarbazepine in the body by a small amount.

  • Rufinamide (Banzel) interacts with CANNABIDIOL (CBD)

    Rufinamide is changed and broken down by the body. CBD might decrease how quickly the body breaks down rufinamide. This might increase levels of rufinamide in the body by a small amount.

  • Topiramate (Topamax) interacts with CANNABIDIOL (CBD)

    Topiramate is changed and broken down by the body. CBD might decrease how quickly the body breaks down topiramate. This might increase levels of topiramate in the body by a small amount.

  • Valproate interacts with CANNABIDIOL (CBD)

    Valproic acid can cause liver injury. Taking cannabidiol with valproic acid might increase the chance of liver injury. CBD and/or valproic acid might need to be stopped, or the dose might need to be reduced.

  • Zonisamide interacts with CANNABIDIOL (CBD)

    Zonisamide is changed and broken down by the body. CBD might decrease how quickly the body breaks down zonisamide. This might increase levels of zonisamide in the body by a small amount.

  • Medications changed by the liver (Cytochrome P450 2C8 (CYP2C8) substrates) interacts with CANNABIDIOL (CBD)

    Some medications are changed and broken down by the liver. CBD might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.

  • Medications changed by the liver (Glucuronidated drugs) interacts with CANNABIDIOL (CBD)

    Some medications are changed and broken down by the liver. CBD might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.

  • Medications that increase the breakdown of other medications by the liver (Cytochrome P450 2C19 (CYP2C19) inducers) interacts with CANNABIDIOL (CBD)

    CBD is changed and broken down by the liver. Some drugs increase how quickly the liver changes and breaks down CBD. This could change the effects and side effects of CBD.

  • Medications that increase breakdown of other medications by the liver (Cytochrome P450 3A4 (CYP3A4) inducers) interacts with CANNABIDIOL (CBD)

    CBD is changed and broken down by the liver. Some drugs increase how quickly the liver changes and breaks down CBD. This could change the effects and side effects of CBD.

  • Medications that decrease the breakdown of other medications by the liver (Cytochrome P450 2C19 (CYP2C19) inhibitors) interacts with CANNABIDIOL (CBD)

    CBD is changed and broken down by the liver. Some drugs decrease how quickly the liver changes and breaks down CBD. This could change the effects and side effects of CBD.

  • Medications that decrease the breakdown of other medications in the liver (Cytochrome P450 3A4 (CYP3A4) inhibitors) interacts with CANNABIDIOL (CBD)

    CBD is changed and broken down by the liver. Some drugs decrease how quickly the liver changes and breaks down CBD. This could change the effects and side effects of CBD.

  • Brivaracetam (Briviact) interacts with CANNABIDIOL (CBD)

    Brivaracetam is changed and broken down by the body. CBD might decrease how quickly the body breaks down brivaracetam. This might increase levels of brivaracetam in the body.

  • Everolimus (Zostress) interacts with CANNABIDIOL (CBD)

    Everolimus is changed and broken down by the body. CBD might decrease how quickly the body breaks down everolimus. This might increase levels of everolimus in the body.

  • Tacrolimus (Prograf) interacts with CANNABIDIOL (CBD)

    Tacrolimus is changed and broken down by the body. CBD might decrease how quickly the body breaks down tacrolimus. This might increase levels of tacrolimus in the body.

  • Methadone (Dolophine) interacts with CANNABIDIOL (CBD)

    Methadone is broken down by the liver. CBD might decrease how quickly the liver breaks down methadone. Taking cannabidiol along with methadone might increase the effects and side effects of methadone.

  • Carbamazepine (Tegretol) interacts with CANNABIDIOL (CBD)

    Carbamazepine is changed and broken down by the body. CBD might decrease how quickly the body breaks down carbamazepine. This might increase levels of carbamazepine in the body and increase its side effects.

  • Sirolimus (Rapamune) interacts with CANNABIDIOL (CBD)

    Sirolimus is changed and broken down by the body. CBD might decrease how quickly the body breaks down sirolimus. This might increase levels of sirolimus in the body.

  • Stiripentol (Diacomit) interacts with CANNABIDIOL (CBD)

    Stiripentol is changed and broken down by the body. CBD might decrease how quickly the body breaks down stiripentol. This might increase levels of stiripentol in the body and increase its side effects.

  • Lithium interacts with CANNABIDIOL (CBD)

    Taking higher doses of CBD might increase levels of lithium. This can increase the risk of lithium toxicity.

  • Warfarin interacts with CANNABIDIOL (CBD)

    CBD might increase levels of warfarin, which can increase the risk for bleeding. CBD and/or warfarin might need to be stopped, or the dose might need to be reduced.

  • Tamoxifen (Soltamox) interacts with CANNABIDIOL (CBD)

    Tamoxifen is changed and broken down by the body. CBD might affect how quickly the body breaks down tamoxifen. This might affect levels of tamoxifen in the body.

  • Caffeine interacts with CANNABIDIOL (CBD)

    Caffeine is changed and broken down by the body. CBD might decrease how quickly the body breaks down caffeine. This might increase levels of caffeine in the body.

  • Citalopram (Celexa) interacts with CANNABIDIOL (CBD)

    Citalopram is changed and broken down by the body. CBD might decrease how quickly the body breaks down citalopram. This might increase levels of citalopram in the body and increase its side effects.

  • Medications changed by the liver (Cytochrome P450 2E1 (CYP2E1) substrates) interacts with CANNABIDIOL (CBD)

    Some medications are changed and broken down by the liver. CBD might change how quickly the liver breaks down these medications. This could change the effects and side effects of these medications.

Dosing

CBD has most often been used by adults in doses of 200 mg or less per day. Speak with a healthcare provider to find out what dose might be best for a specific condition.

For information on using prescription CBD, a product called Epidiolex, speak with a healthcare provider.
View References

CONDITIONS OF USE AND IMPORTANT INFORMATION: This information is meant to supplement, not replace advice from your doctor or healthcare provider and is not meant to cover all possible uses, precautions, interactions or adverse effects. This information may not fit your specific health circumstances. Never delay or disregard seeking professional medical advice from your doctor or other qualified health care provider because of something you have read on WebMD. You should always speak with your doctor or health care professional before you start, stop, or change any prescribed part of your health care plan or treatment and to determine what course of therapy is right for you.

This copyrighted material is provided by Natural Medicines Comprehensive Database Consumer Version. Information from this source is evidence-based and objective, and without commercial influence. For professional medical information on natural medicines, see Natural Medicines Comprehensive Database Professional Version. © Therapeutic Research Faculty 2018.