Is CBD Safe to Take While Using Medications or Contraceptives?
One of the most common questions the Onyx & Rose team gets has to do with mixing our organic, all-natural product with medications and contraceptives. The risks associated with mixing pharmaceuticals and alcohol are well documented, so it’s natural that people would also have concerns regarding mixing CBD and prescription medications.
The short answer to this frequently asked question is that you should always check with your primary care physician before adding CBD to your daily routine.
If you’d like to take a deeper dive with us, read on!
The first important thing to note is that it’s possible for CBD to interact with other medications. While our product is organic and all natural, it can have an impact on metabolic rates, which in turn have an impact on the efficacy of certain medications. The good news is that this interaction often makes prescription medications more effective, leading to a lower dose of chemical medication when taken alongside CBD.
CBD and the P450 System
However, any drug that is metabolized by the liver will be affected by CBD, due to the cytochrome P450 enzyme system. This system is responsible for metabolizing potentially toxic compounds, and doctors use the amount of time it takes for various medications to be processed through the P450 system to determine safe and healthy dosages for patients. CBD can impact the P450 system, making it possible for certain drugs to spend more time in your system. Medications that may interact with CBD include antihistamines, NSAID pain relievers, beta blockers, antidepressants, antibiotics, and steroids. That’s why it’s especially important to consult with your physician before beginning a CBD regimen.
CBD and Birth Control
One of the most common medications that can interact with CBD is the birth control pill. Enzyme inhibitors such as CBD can potentially increase breakthrough bleeding and decrease estrogen-based contraceptive effectiveness, leading to an increased risk of unwanted pregnancy.
The active hormones in your method of birth control may also make a difference. Estrogen-containing contraceptives such as pills, patches, injections, and rings carry a higher risk of failure in the presence of CBD than non-estrogen forms. Progesterone-only alternatives may be a more reliable alternative for CBD users, and you’re a woman who’s concerned about becoming pregnant, you should consult with your doctor about your options. In the meantime, we advise using additional birth control methods such as condoms. Research in this area is still in progress, so we recommend that every woman use caution.
Talking With Your Doctor About CBD
If you don’t feel comfortable discussing your CBD regimen with your doctor, and you’re not prepared to begin the search for a new primary care physician at this time, then you can use what is commonly referred to as The Grapefruit Test to determine whether or not your medication will interact with CBD. CBD interacts with medications the same way grapefruit does, so if you’re unsure about mixing your medications with CBD, just ask your pharmacist or physician if you should avoid eating or drinking grapefruit while taking your medication. If the answer is yes, then your medication will interact with CBD and it will be important for you to have a more candid conversation with your doctor.
Endocannabinoid professionals recommend taking this precaution with every medication you may be prescribed, as many pharmacists and physicians are not highly educated on the endocannabinoid receptor system, and may not realize that patients may experience interactions. However, even though a lot of doctors aren’t up-to-date when it comes to CBD, they will still be the most important link to your health. They have the ability to monitor blood work and deserve your complete honesty when it comes to your CBD use. Only through transparency can you help destigmatize CBD and encourage the medical field to continue to research and study the endocannabinoid receptor system.
Is CBD Safe to Take While Using Medications or Contraceptives? One of the most common questions the Onyx & Rose team gets has to do with mixing our organic, all-natural product with medications
CBD Oil and Birth Control – November 2020
Can CBD help with birth control, and if so, how?
There are several ways by which CBD may interfere with the effectiveness of birth control methods, primarily hormonal ones.
CBD has been shown to compete with estradiol, influence hormones, and interfere with how contraceptives are broken down in the body.
CBD Competes with Estradiol
Estradiol is one of three estrogen hormones naturally produced in the body. Increased estradiol levels precede the maturation and release of the egg from the ovary and the thickening of the uterus lining to implant a fertilized egg (1 ) .
A study published in The Journal of Pharmacology and Experimental Therapeutics examined CBD’s interference with estrogen receptors in rats (2 ) . At large doses, cannabis exhibited neither estrogenic or non-estrogenic effects .
Of several other common cannabinoids tested, only cannabidiol competed with estradiol for estrogen receptor binding. This binding action was evident only at very high concentrations of cannabidiol.
The study found that CBD might compete with estradiol for estrogen receptors found in the female reproductive system.
Scientists believe this action is how CBD prevents estrogen-based contraceptives from working properly, possibly leading to an increased risk of unwanted pregnancy.
CBD Influences Sex Hormones
Hormonal contraceptives work by influencing hormone behavior. In a study published in 2019 in the International Journal of Reproductive Medicine , it was noted that the essential component for any hormonal contraceptive method is progestogen (3 ) .
Progestogens are synthetic forms of progesterone, a naturally occurring sex hormone. Progestogen’s primary role is to prevent ovulation through a negative feedback mechanism, resulting in a decrease in luteinizing hormone.
Luteinizing hormone is associated with reproduction and ovulation. Its stimulation of either ovary or testicles results in the release of an egg from the ovary (ovulation) in women or testosterone production in men (4 ) .
A study found that carefully-controlled regulation of the endocannabinoid system (ECS) is required for successful reproduction, and marijuana from the Cannabis sativa plants may disrupt the delicate balance of the ECS in the female reproductive system (5 ) .
A study published in the Journal of Ovarian Research in 2019 examined the role of the endocannabinoid system in female reproductive tissue s (6 ) .
The authors found that chronic exposure to cannabinoids resulted in reduced sperm count, serum testosterone levels, and reduced ovulation in women (5 ) .
In females, chronic exposure to cannabinoids delayed sexual maturation, caused menstrual cycle disruption, and reduced serum concentrations of sex hormones.
CBD Interferes with Metabolism of Contraceptives
Preclinical research shows that CBD is broken down by cytochrome P450 enzymes while functioning as a competitive inhibitor of the same liver enzymes (7 ) .
The cytochrome P450 enzyme system is responsible for breaking down over 60% percent of any drugs, including contraceptives (8 ) .
CBD can inhibit the cytochrome P450 system’s ability to metabolize certain drugs, leading to an overall increase in processing times (9 ) .
When hormone-based contraceptives are taken with CBD, CBD can decrease how quickly the liver breaks down these oral contraceptives, which theoretically would increase the contraceptive hormone levels and increase the contraceptive’s effectiveness. However, unwanted side effects may occur as a result.
This enzyme-inhibiting action of CBD is suspected to increase breakthrough bleeding due to excess estrogen levels as a result of a slower breakdown. The role of marijuana or CBD on the effectiveness of oral contraceptives is unknown. Furthermore, marijuana is known to have adverse effects on fertility for both men and women. In women, it lowers the rate of ovulation which would lower pregnancy rates.
Further research is needed to determine what level of CBD impacts estrogen. Currently, there is no guideline as to the safe levels of CBD for women on birth control.
Before deciding to use CBD as a supplemental birth control method, consult with a doctor, preferably an obstetrician-gynecologist, who is experienced in cannabis use.
Given that CBD competes with contraceptives for estradiol as studies showed, estrogen-containing pills, injections, patches, and rings may be rendered weak or even ineffective when used with CBD.