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Since the imperial doctor knew that he really didn t care about her secretly greed for the forty taels of silver, she gradually became more courageous, and Gu Tang s nano emulsified cbd words made her confused, so she quietly came to him: Sister Ran, what are you talking about, what does it hemp gummies mean cbd gummies on airplane cbd for sleep that this day has come, and what does it mean health gummies that there should be an end.

Go out, come back when the sun is three poles, and then go to work in the fields.

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General Xu Da was unfortunately implicated and killed, but at that time the northwest border was unstable, and General Xu Xiao He rushed to the border gate with his wife and children to fight the rebellion.

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She is so skilled thc free hemp with little brother, She must have done this more than once.

What can Aijia do? The Queen Mother sighed helplessly, By the way, Aijia remembers that Shun er s child also listened to you before, did you? Don t you try to persuade him.

I have a very small mind, so this king came here to tell you, the young man said solemnly. Mother, Mrs Qu s expression changed, what you mean now is xarelto and cbd oil that you want our entire Qu family to be their servants.

He really wants to medical cannabidiol do it, Sister Zao has been frightened and cried several times, but her aunt was there a few days ago.

However, after running with Sister Xiao for a few days, high potency flavorful gummies Sister Zao s legs and feet have become more agile, and the little child s pale face has gradually become a little bloody.

Sister, Now Su Xuan has changed her arrogance in front dolphin gummies of him, She has gummies a docile face, a smile on cbd oil near me her lips, and calls him softly, as if the person who didn t look at him as a human was not, He paused, he looked back at him best cbd oils suddenly, After the young man xarelto and cbd oil said it, he was also surprised, and he quickly stopped, Forget it, can you take 10mg cbd gummy with trazodone what s the use of me telling you this, that s your health gummies man, you don t think of him as the most important, who else can you think of as important, I m leaving, since you know it, then I know, I m leaving.

But after the second day of the first day, the third day and the fourth day sunset pain relief cbd gummies for anxiety 500 cbd oil of the new year, their family became lively again.

He pressed his temple lightly, Maybe so, Hey, being a princess is like that, There are too many trivial matters around me.

Judging from the color of the things and thc gummies the degree of wear and tear on the corners, plus gummies delicious it should be some years old. Before he knew it, he rambled a lot by himself, Seeing her bleak smile, she xarelto and cbd oil threw all the worries out of her mind, her eyes gradually became dark and unclear.

When Princess Jingyi saw it, she was so distressed, platinum phat hempies cbd gummies x cbd oil Poor child, what s the matter with you.

In this exam, we are the third and fourth, Let s discuss it in detail.

His family now has a large family business and many people, so there are more relatives walking around, The corner of Yue Concubine s mouth xarelto and titan infusions cbd gummies review cbd oil twitched, This kid, this is driving him to a dead end again.

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The intersection from the heart made his cbd oil and liver disease heart warm, Didn t I tell you earlier, we re going for a walk drugs gummies in the mountains today, he said softly.

And then, he asked, Then, of course, our reinforcements came, and then it became that we should cooperate with the inside and outside, like making dumplings, and then encircle them, she folded her hands, making a dumpling-making gesture.

These servants were specially selected by Mrs Zhou who could speak their local dialect. Then use this powder to gummy edibles mix salt xarelto and cbd oil and chives, spread it into pancakes in the pot, and the unique fragrance of the pancake will spread out again.

No, he s dead, a yamen shouted immediately after trying his breath, Chen cbd gummies no sugar Gongzi, who royal cbd gummies was crying, laughing and scolding, suddenly stopped his voice when he heard this, he turned his head back and stared at Sister Hua: You lie, the child is fine, how cbd for sleep can it die, it must be you killed him.

Although he has no evidence, you still don t know about those pariahs.

Since they came to the provincial capital, they have always heard of your name, the Eighth Master Qin. Little Young Master, don t go, don t go, xarelto and cbd oil this old how long for cbd gummies to work reddit slave has a lot to tell you, when Old Man Li saw him, he also called to catch up, but was stopped by Eunuch Lu.

She health gummies had just stood outside watching the fun from king cobra cbd gummies a distance, and didn t try to get closer to him and the is it better to take cbd oil at night others.

The next day, another guest came to their house, Hahaha, sister-in-law Li, it s been a long time, I m coming to see you again.

Well, anyway, the more she thought about it, the more dissatisfied she felt. It s tolerable, and htc gummies it s unbearable, Just for this, I will never forgive them in my what is just cbd gummies life, and cbd cream my children xarelto and cbd oil and grandchildren will xarelto does cbd help with back pain and cbd oil never interact with anyone who is related to Su Chengcai.

She kept retreating, they kept pressing, and cbd hemp oil uk it seemed that they had already forced him to his mother and son.

She learns kung fu, but she will study hard at other times, preparing to take the jinshi exam in two years, plus Gummy can testify on the side, to ensure that brother Quan is indeed more suitable for reading, and he will always urge brother Quan to study hard,? Shi only reluctantly agreed.

Now it is difficult to wait until the official trial is officially opened. The imperial xarelto and cbd oil doctor pouted, and was not stimulated by her words at all.

Sister Yue immediately lowered her head, cbd oil full spectrum vs isolate I was wrong, I will never do it again.

If there was no accident, they should have hid in the mountains, Sister Qian was busy again.

He couldn t help but get cold all michelle cbd oil over, Yes, the villain cbd gummies 4000mg knows it, The villain will keep the words of the prince in his heart, The villain will never do anything that is sorry to the prince or the palace, Li Yuanpu, Li Jun, how are you father and son, fresh thyme cbd oil price how dare you treat me like this, xarelto and cbd oil I will definitely kill you, let you die without a corpse, your soul will be cast into the eighteen layers of hell, and you will never be able cbd gummies marijuana to turn over, he clenched tightly.

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The solution took several months, so he knew full spectrum cbd oil effects the details inside, As a result, things have just come to cbd delights gummies 3000mg fruition, and the emperor and empress have already jumped out uncontrollably.

I have taken them to eat everywhere they got their name, but the restaurants in the capital, you know, are all fancy stuff, xarelto and cbd oil mi cbd gummies xarelto and cbd oil mi cbd gummies so cbd oil for lung fibrosis I can only fool those outsiders.

There were still people behind this incident, The county magistrate immediately arrested the people behind them and continued to torture them. However, just a few of us know about this matter today, and I hope cbd gummies for anxiety xarelto and cbd gummies candies oil you don t tell others, she said softly.

Knowing that cbd gummies epileapsy Mrs Luo and Mr Luo both thought about it, When she betrothed her daughter to Su Quan, she actually picked out many of Su Quan s faults in an instant.

You re such a good and understanding boy, he nodded with a reviews best cbd for anxiety smile, and Luo Huan s face flushed with praise.

Although she felt uncomfortable, she had to admit that her mother was right. From this time until arriving xarelto and cbd oil in the village, the sound of firecrackers has not stopped.

It cbd cbd gummy oil utah s all thc gummies your fault, Then she knew cbd oils that she was just uncomfortable and needed a chance to vent.

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As he said that, he had already picked up his daughter, and when he turned around, he took off a lot of the heavy things on his head, She already understood everything in her heart, In xarelto and cbd oil this case, I have nothing to be ashamed to say.

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The prefect hurriedly smiled and waved his hand: That s all, He has always been a sincere person, and only a sincere person can do a good job in a down-to-earth manner, now, After the news spread, the girls and servants of the Luo family also knew that the family surnamed Su, who Xarelto And Cbd Oil lived in their xarelto and cbd oil house these days, was actually so powerful.

You have nothing to do every cbd thc gummies anxiety day, so come and serve me, You are more reliable than those arranged by others.

It s really the two of Xarelto And Cbd Oil them, these two people came so quietly, and there was such a big thing happening to them.

After another month, he would send someone to help them harvest them, After the harvest is completed, the weight is weighed on the spot, and then it will be shipped directly to the capital to announce the good news to the emperor. At least, xarelto and cbd oil if something happened to her husband, she couldn t be so calm.

When Miss Luo Qi heard this, she smiled lightly, When a man marries a daughter-in-law, hemp bomb cbd gummies review he expects her to marry her husband and teach her children, manage the max sttength cbd gummies family business, and help her husband s family.

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In the palace, cbd oil for sleep the little guys who changed brother were cheering, Mother, mother, you are awesome, he hates gummies him to death, you should have kicked him out cbd gummies dosage chart a long time xarelto and cbd oil reviews ago, said Brother Chang loudly, She wasn t interested in them xarelto and cbd benefits of cbd gummies oil at all, okay? What are these people trying to do, he gritted his teeth, she was really annoyed by the entanglement of this group of people.

go to the room cbd oil uk organic to rest, Mother, I m not tired, Miss Qi quickly returned to her senses.

Concubine Yue nodded: Thanks for your trip today, but it s fine here.

She and Qian Da also followed them closely, All the way out of the house to the outside, the people outside were shocked when they saw them coming out. But now, he can t, thinking so in his heart, xarelto and cbd oil his faint eyes fell on Brother benefits of cbd gummies Zhuang again.

But that s not enough, Brother keoni cbd gummies for sale Quan and the others were already standing aside.

However, the village chief put his head up and sighed a few times before slowly standing up again, buy cbd gummies review If that s the case, then let health gummies s go and measure the land.

Mrs Zhou Shao and Mrs Qu and her party also came to the banquet today, over the counter health gummies but because of the lessons they had learned a few times before, Mrs Qu how do i know how many mg of cbd gummies i need and the others just went over to say hello to does cbd help anxiety him, and sat down to eat at a distance, not with him, They not only dressed her in heavy silk clothes, but also xarelto and cbd oil put a very delicate bun on her head.

After he was settled in the town, he invited the following squires to meet him, and then invited the scholars cannabisol cbd kaufen in the town to meet him, but Fudge.

He said softly, She quickly let out a long sigh of relief, It s just, But immediately, his voice sank again, You and I have xarelto and cbd oil mi cbd gummies different identities, this is a big problem.

It turned out that this eighth son of Qin had always been like a mirror in his heart, knowing that if he did not get into the top three, he and the entire Qin family would end up What, that s why he rushed over to find the gummy as soon cbd gummies for pain as he heard the news. The queen mother also quickly wiped the corners of her eyes, xarelto and cbd oil It s true that Aijia was negligent.

Such a girl, holding so many strawberry cbd oil fields and shops in her hands, is also a piece of fat.

He decided to accept me directly, He doesn t care what you say about him outside.

She and the others went to the mountain to practice the exercises every morning, and she persisted with gritted teeth, Mrs xarelto and cbd oil Zhou Shao benefits of cbd oil naturally also realized her indifference, and her enthusiasm was immediately withdrawn.

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In these years, she has experienced nothing less than the adults in many villages.

Finally, she came out of this weed gummies hellish canibus gummies place, Just thinking about it, she heard a riot of soldiers and horses in front of her again, only to hear the people outside shouting: Quickly let go, let go, the Royal Highness of Rong is coming down. Now xarelto and cbd oil the cabbage and radish seedlings thc gummies in the vegetable field have spread out one or two young leaves, and the green one looks particularly pleasing.

If my mother taught me a lesson because of this cbd oil el paso trivial matter, then my sister would have been trained many times.

She paused again, He lowered his eyes, his eyes became extraordinarily deep, but he couldn t see what he was thinking.

Who is sitting in this carriage, it must be a very high-status noble person, right, We xarelto and cbd oil just don t want your tricks to succeed, so we best sellers your cbd store will do our best to resist.

Is this asteroids cbd gummies review a spoiler, this is not a spoiler at all, he is spoiling the game.

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Princess, go out and have a look! His Royal Highness, His Royal Highness.

After thinking about it for a while, she still reluctantly admits, She is indeed doing better than Sister Qiu er. I feel so frustrated, I can t eat anything, xarelto and cbd oil I haven t eaten well for several days, a young voice suddenly sounded in my ear.

What are you doing, he asked, Don t gummies products make a sound, Sister Yue hurriedly green apple gummy cbd shook her head at her, her voice extremely low.

She didn t even look at him, you can go, she took Sister Xiao and left.

It s just that the sound that was pleasant to listen to before, now sounds like a flies buzzing in the ears of the concubine Yue, so annoying that he yelled: Go away, what cbd oil near me are you still doing here, wait to see if this concubine is a joke, If you don t get blue gummies strain out, this concubine will send you out now to be the servants in the utility room. daily gummies She originally wanted to teach her xarelto and cbd oil a lesson in dr oz cbd gummies cbd oil near me a fit of rage, but who knew that this woman.

That s right, mother, gummies 2022 she and Rong Wang secretly cooked cvs gummy cbd oil capsules a lot of delicious food today.

He nodded, is her, That s no wonder, Miss Qi nodded, Such a beautiful cbd gummies with thv little girl, as beautiful as peaches and plums, but as cold as frost, men will have a desire to conquer.

Don t you want to know if he is your real brother, he asked her softly, But when xarelto and cbd oil she has made friends, she will inevitably go out to entertain, treat guests at other places, and invite him solemnly.

Blood Thinners and CBD Oil Interaction

CBD oil has been making headlines for potentially being able to treat hypertension and heart disease, so naturally, if you suffer from a hemostasis disorder, you may be wondering if CBD could be of any help in treating your condition.

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Although CBD oil has been shown to be relatively safe, it should be used cautiously with some blood thinning medications, including some commonly prescribed anticoagulants.

If you are considering combining CBD oil and blood thinners, or simply want to explore if it’s a safe option, here is everything you need to know.

Effects of CBD on Blood Clotting

The effects of CBD oil on blood clotting are not well understood, but it is thought that a few factors may be involved. First is CBD oil’s impact on blood flow.

CBD oil can aid the circulatory system by dilating blood vessels. This allows the blood to flow quicker, and in turn, can make the occurrence of blood clots less likely. A 2017 study found that just a single dose of CBD significantly reduced the blood pressure of subjects both at rest and in stressful situations.

Broad spectrum CBD, or full spectrum CBD oil in particular, may be a useful tool in preventing thrombosis, or the formation of blood clots. A study on the anticoagulant effects of cannabis found the cannabinoids tetrahydrocannabinol (THC) and cannabinol (CBN) to be effective anti-thrombotics, doubling the amount of time it took for blood clots to form in obese and lean rat test subjects compared to the control group.

Both CBN and THC are present in full spectrum CBD oil, along with all the other cannabinoids and terpenes present in cannabis. CBD oil derived from the industrial or agricultural hemp variety of the cannabis plant contains less than 0.3% THC, which is in line with federal regulations.

If you’d rather not have any THC in your CBD product, but still want the anticoagulant effects of CBN and CBD, a broad spectrum CBD oil would be ideal. Broad-spectrum CBD products contain all the cannabinoids and terpenes of the hemp plant except THC. If you aren’t sure whether you’d like a full- or broad-spectrum product, a good place to start is researching your state’s laws on cannabis, THC, and CBD, as well as seeking advice from a medical professional.

Interactions Between CBD and Blood Thinners

Although CBD oil has been found to be generally well-tolerated and without any significant side effects in studies , it can interact negatively with some medications. Often referred to as the ‘grapefruit effect,’ CBD oil is one of a number of natural substances that can slow down systems the body uses to metabolize and break down toxins.

One of the main metabolic systems in the body is the cytochrome P-450 enzyme system , which is made up of liver enzymes that break down certain drugs in the body, with removal of potentially harmful byproducts. If the P-450 enzyme system is inhibited by a compound like CBD, medications typically broken down by the liver enzymes remain in the system for longer than desirable, making it more likely you will experience side effects from the medication.

As you’ll see in the table below, not all pharmaceuticals are processed by the cytochrome P-450 enzyme system. So while you may need to take care when taking CBD oil with a blood thinner like warfarin, for example, people taking heparin face fewer risks.

Ultimately, it’s important to consult with a doctor before using CBD oil if you take any blood thinning medication. Your doctor will make adjustments to your medication, taking into account any effects that CBD oil may have in any potential interactions with it.

As a starting point, here is a list of some of the most commonly prescribed blood thinners and what we currently know about their interaction with CBD oil.

Anticoagulant Type Brand Name Common Drug Side Effects Possible Side Effects of Combining Medication + CBD Oil
Rivaroxaban Xarelto Prolonged bleeding; bruising easily; nosebleeds; bleeding gums Rivaroxaban may remain in the system longer and increase the likelihood you’ll experience its side effects
Dabigatran Pradaxa Prolonged bleeding; bruising easily; nosebleeds; bleeding gums No known interaction
Apixaban Eliquis Prolonged bleeding; bruising easily; nosebleeds; bleeding gums Combine with caution; apixaban may remain in the system longer and make side effects more likely
Edoxaban Lixiana Prolonged bleeding; bruising easily; skin rash; reduced liver function; anemia No known interaction
Warfarin Coumadin; Jantoven Unusual bruising; bleeding gums; nosebleeds; prolonged bleeding Combine with caution; Warfarin may remain in the system longer and side effects could become more likely
Heparin Various Prolonged bleeding; bruising easily; nosebleeds; bleeding gums; skin irritation; allergic reaction No known interaction

How to Safely Take CBD and Blood Thinners Together

When combining CBD oil and blood thinners, there are a variety of factors that come into play. Your health, weight, and general tolerance can all influence how likely you are to experience possible drug-drug interactions. Because there are so many variables to consider, you should first speak to your doctor about the possibility of adding CBD oil to your medication regimen. Together, you can create a plan to ensure there is minimal disruption to your system.

In order to further minimize the risks of an adverse reaction between CBD oil and your anticoagulant, it’s suggested that you start with a lower dose than what is recommended for your chosen CBD product, and slowly increase the dosage over time if needed. This not only allows you to build a tolerance to CBD oil, but also provides your doctor with the time and flexibility to monitor changes and decrease the dosage of your blood thinners if necessary.

Safest CBD Oils to Take with Blood Thinners

With so many varieties of CBD oil available to you, how do you know where to start? If you’re looking for a safe CBD oil to combine with blood thinners, or are turning to CBD oil as a preventative measure against blood clots, there are a few things to consider to ensure you’re making the smartest and safest choice possible.

First, choose your CBD delivery method. You can buy CBD oil in a wide variety of forms including capsules, vapes , edibles , and drops . While vaping CBD will deliver the fastest results, drops are more discreet with longer-lasting effects, and capsules offer a user-friendly, familiar option for people who are new to CBD. When deciding on a method, it is worth noting that any format that’s processed through the digestive system will take longer to show effects and as such, may lose some of its potency.

After you have chosen your preferred method for CBD administration, look for a high quality CBD product that has been organically grown, sustainably sourced, and third-party lab tested. Reading the lab reports (called Certificates of Analysis) will ensure the product you purchase is in fact the safest CBD oil to take with blood thinners. A Certificate of Analysis should tell you if the CBD product you have contains herbicides, pesticides, heavy metals, or chemical additives.

When you have your CBD oil product, figuring out your ideal dosage is the final step to making sure you’re using CBD safely. The safest way to take CBD oil with blood thinners is to start with a small dose and gradually increase it over a period of time if needed. For additional guidance on CBD dosage, consider speaking with a naturopathic doctor who specializes in using CBD oil to treat medical conditions.

If you’ve spoken to your physician and are ready to choose a CBD oil, check out the Best CBD Oil Products to Buy .

What drugs should not be taken with CBD?

Cannabis is a complex plant, with hundreds of chemicals and over 100 distinct cannabinoids. The little research that examines cannabidiol or CBD, the second most common cannabinoid found in cannabis, shows evidence of potential health benefits for a wide range of conditions. As CBD becomes more mainstream, however, a key question comes to mind, “How will CBD interact with my current medication?”

Currently, sparse research suggests that CBD can illicit problematic interactions with certain other prescription drugs. The findings are far from conclusive — further research is still needed on CBD’s interaction with different medications. Many doctors and researchers urge individuals using CBD medically or recreationally to be cautious about mixing it with other prescriptions and to consult healthcare providers about possible interactions.

Many doctors urge individuals using CBD to be cautious about mixing it with other prescriptions and to consult healthcare providers about possible interactions.

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CBD interaction with drugs & medication

Have you heard of the grapefruit test? Many prescription drugs will include grapefruit warnings on the label, advising against consuming the citrus fruit while taking medication. Many medications are broken down in the liver and small intestine by a group of proteins called cytochrome P450 enzymes (CYPs). This process is what delivers a medication’s benefits to the intended target.

Grapefruit disrupts the activity of CYPs and slows the way these proteins usually break down medication. The fruit also increases the side effects and duration the drug stays in the system. One 2013 study titled “Grapefruit Medication Interactions: Forbidden Fruit or Avoidable Consequences?” published in the Canadian Medical Association Journal showed that grapefruit can increase blood content levels when interacting with at least 85 different drugs. The reported consequences were severe, including irregular heartbeat, organ failure, internal bleeding, and death.

Further, a 1993 study conducted by pharmacology researchers at the University of California, San Francisco, and published in the journal Biochemical Pharmacology, discovered that CBD, much like grapefruit, disrupts the normal function of cytochrome P450 enzymes in mice. The study postulated that while the blockage could allow patients to take lower doses of their prescriptions, it could also cause a toxic buildup of chemicals in the body. Since this study’s publication, several scientific and medical journals have published evidence of the grapefruit-like effects of CBD in humans.

The type, quality, and purity of CBD administered all affect how it interacts with your body and medication. The timing of when you take CBD and any other prescription drug also factors into how the two may interact in your body. And of course, every individual responds to medications differently, depending on genetics, age, weight, and other factors.

The type, quality, and purity of CBD administered all affect how it interacts with your body and medication. Photo by: Gina Coleman/Weedmaps

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Let’s examine the current research on CBD’s interaction with several common prescription and over-the-counter medications.

Should I take CBD with ibuprofen?

Ibuprofen is a nonsteroidal anti-inflammatory (NSAID) medicine that reduces pain and inflammation in the body. Ibuprofen has a risk of blood-thinning and can cause dizziness, shortness of breath, and nausea.

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Potentially, CBD can increase the duration and strength of ibuprofen, thereby increasing the risk of adverse side effects. No human studies to date examine CBD’s interaction with NSAIDs specifically. Still, two studies conducted on animal models in 2006 and 2008 and published respectively in the journals, Pain and Pharmacology, suggest that other cannabinoids may work synergistically with NSAIDs like ibuprofen to reduce pain.

Patients should consult with their healthcare provider before taking ibuprofen with CBD.

Should I take CBD with warfarin?

Warfarin, also known under the brand name Coumadin, is an anticoagulant (blood thinner) medication used to prevent the formation of harmful blood clots that could potentially cause heart attacks or strokes. Warfarin’s risks include severe bleeding, headaches, swelling, or sudden pain in extremities.

In 2017, researchers at the University of Alabama, Birmingham, conducted a study published in Epilepsy & Behavior Case Reports which showed that CBD increases the effects of drugs used for blood-thinning by slowing down how the body metabolizes warfarin and prolonging its presence in the system. By increasing the duration of warfarin’s presence in the body, CBD could potentially exacerbate some of the associated risks.

Patients taking generic warfarin or Coumadin should consult their healthcare provider for individualized information and get blood tests before beginning a CBD regimen.

Should I take CBD with thyroid medication?

Thyroid medication is used to treat thyroid disorders, most commonly hypothyroidism (an underactive thyroid) via thyroid hormone replacement, and hyperthyroidism (an overactive thyroid) via anti-thyroid medication. Different medications achieve these objectives through different pathways in the body. Side effects of thyroid hormone replacement therapies include chest pain, anxiety, headaches, and vomiting. While rare, anti-thyroid medication side effects can include rash, itching, fever, aches, and headaches.

Little research studying interactions between CBD and common thyroid hormone replacement and anti-thyroid medications currently exists. Patients taking thyroid medication who want to try CBD should consult with their physician.

Should I take CBD with Eliquis?

Eliquis (generically called apixaban) is a blood thinner used to lower the risk of stroke or a blood clot in veins, the heart, the lungs, and the legs following knee or hip replacement surgery. Eliquis increases the risk of severe bleeding, and patients taking Eliquis are typically prescribed precise dosages by their doctor.

CYP proteins process Eliquis in the liver, the same proteins on which CBD acts to delay metabolization. This process could cause an overdose of Eliquis’ chemicals in the body and a high risk of severe bleeding.

Patients taking Eliquis should speak to their doctor before using CBD products.

Should I take CBD with Plavix?

Plavix is the brand name of the drug clopidogrel, frequently prescribed for patients who have had or are likely to have a heart attack. The drug works by blocking blood platelets from forming clots in arteries near the heart.

According to a 2011 study published in the journal Life Sciences, it is possible that CBD has an inhibitory effect on CYP2C19, the enzyme that metabolizes Plavix. This could cause Plavix to remain longer in the body and weaken its overall effects. Further research is required to determine whether this could lower Plavix’s effectiveness in preventing heart attacks.

Patients using Plavix or clopidogrel should consult their physicians as to whether they should use CBD.

Should I take CBD with Tylenol?

Acetaminophen, the generic name for Tylenol, is a common drug used for pain and fever relief. Acetaminophen carries a risk of liver damage and disease, with side effects including nausea, headaches, and insomnia.

Acetaminophen and CBD both are metabolized by CYP450, which lowers the effectiveness of both chemicals as they’re processed in the body. One controversial 2019 study, conducted by the University of Arkansas on mice and published in the journal Molecules, claimed that high doses of CBD contributed to liver toxicity, which could compound acetaminophen’s liver damage potential. However, the study’s authors have been accused of cherry-picking research and designing experiments to showcase potential CBD toxicity. The one study they cited with human test subjects did not show liver toxicity from CBD.

More research is required to confirm potential interactions between CBD and acetaminophen. Patients looking to take both simultaneously should consult their physician.

Should I take CBD with metoprolol?

Metoprolol is a beta-blocker designed to treat high blood pressure by reducing the heart rate and changing the release of epinephrine, a hormone involved in stress and other processes. Beta-blockers lower blood pressure and sometimes produce side effects such as dizziness, nausea, stomach pain, heartburn, and cold hands and feet.

No studies have examined potential interactions between CBD and metoprolol. However, some placebo-controlled research conducted on healthy people at the University of Nottingham in England and published in 2017 in the journal JCI Insight has linked CBD with decreased blood pressure when taken on its own. For patients taking metoprolol, however, the combination with CBD could potentially have negative impacts on blood pressure.

A 2011 study performed on mice and published in the British Journal of Pharmacology also shows that CBD has potential nausea-reducing properties, which may help soothe side effects associated with metoprolol.

Patients taking metoprolol or other beta-blockers should consult their doctor as to whether to consume CBD.

Should I take CBD with metformin?

Metformin is a medication prescribed to adults with type 2 diabetes to help control blood sugar levels. Side effects of metformin include low blood sugar, nausea, diarrhea, vomiting, and muscle pain.

One 2006 study published in the journal Autoimmunity showed that CBD reduced the incidence of diabetes in animal models. To date, however, very little research has specifically covered CBD’s potential in human diabetes treatment or interactions with metformin. Only one study, conducted by the American Diabetes Association and published in 2016 in the journal Diabetes Care, has examined the efficacy of CBD in patients with type 2 diabetes and found it had no significant impact on glucose levels.

More research is needed on CBD’s interaction with diabetes. Patients taking metformin should talk to their doctor about whether CBD is right for them.

Should I take CBD with Xanax?

Xanax (generic name alprazolam) is a benzodiazepine medication used to treat panic disorders, anxiety, and depression. Common side effects of Xanax include drowsiness, lack of coordination, memory loss, and early-morning anxiety.

Xanax breaks down in the liver via an enzyme called CYP3A4, which is inhibited by CBD. Taking CBD could potentially increase the amount of time Xanax is in the system and prolong or increase the likelihood of unwanted side effects. CBD may one day be considered an alternative to Xanax as various research, including a 2011 study published in the journal Neuropsychopharmacology, has documented the cannabinoid’s potential anti-anxiety properties.

No research has explicitly documented interactions between Xanax and CBD. Patients taking Xanax who are interested in CBD should speak to their healthcare providers for more information.

Should I take CBD with statins?

Statins are a classification of drugs designed to lower cholesterol and protect against heart attack and stroke. Common side effects of statins are muscle soreness, blood sugar increase, headaches, and nausea.

Statins are processed by CYP function in the liver, which CBD inhibits. While no research has specifically studied interactions between statins and CBD, the cannabinoid could potentially increase the strength and duration of statins in the system and the risk of unwanted side effects.

Patients taking statins should speak to their healthcare provider before using CBD.

Drugs that should not be taken with CBD

CBD’s documented effects on liver function and enzymes that metabolize several medications are relevant when considering whether or not to consume CBD with certain drugs. CBD acts on the same metabolites as grapefruit — therefore, many of the prescription drugs that carry grapefruit warning labels may have similar risks when taken with CBD.

CBD acts on the same metabolites as grapefruit — therefore, many of the prescription drugs that carry grapefruit warning labels may have similar risks when taken with CBD. Photo by: Gina Coleman/Weedmaps

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These drug classifications include a large percentage of existing prescriptions, such as benzodiazepines, antihistamines, haloperidol, antiretrovirals, statins, cyclosporine, sildenafil, warfarin, and other drugs metabolized by CYP3A4 and CYP2D6.

Clobazam, used to treat epileptic seizures, is another type of drug that may not be advisable to take in conjunction with CBD. However, Epidiolex is an FDA-approved, CBD-based drug that physicians may prescribe to treat epilepsy. A significant amount of data, derived from clinical trials, exists on Epidiolex, although the drug can also cause adverse effects, according to a 2019 study conducted by researchers at Columbia University and published in the journal F1000Research.

No research conclusively warns patients against taking these drugs with CBD, though the previously cited 2013 study published in the Canadian Medical Association Journal has shown that grapefruit and drug interactions can lead to severe effects, including irregular heartbeat and sudden death, kidney failure, and muscle damage. Every patient’s case is unique, and individuals should speak to their healthcare providers if they are considering taking CBD in combination with particular prescription medications.

Does CBD oil affect blood pressure?

A previously cited 2017 study titled, “A single dose of cannabidiol reduces blood pressure in healthy volunteers in a randomized crossover study” published in the journal JCI Insight, supports CBD’s ability to lower blood pressure. Researchers also suggest that the anxiety- and stress-reducing properties of CBD may contribute to the overall ability to lower blood pressure. However, CBD taken with blood pressure medication or beta-blockers could potentially cause both drugs to double up on each other and lower blood pressure to unhealthy levels.

Does CBD oil thin the blood?

No research shows that CBD oil taken on its own can thin the blood. CBD oil does increase the effects of blood-thinning medications, such as warfarin, and could potentially push the presence of warfarin beyond therapeutic levels, as the previously cited 2017 study published in Epilepsy & Behavior Case Reports showed.

Does caffeine counteract CBD?

Caffeine and CBD are two substances gaining in popularity, particularly when they’re mixed. Caffeine can keep sleep-deprived individuals alert and clear-headed. Further, a 2007 study on rats published in the journal Pharmacology Reports showed that caffeine is metabolized by CYP enzymes, which CBD inhibits. This could extend the time caffeine stays in the body and has the potential to extend the stimulating effects of caffeine.

The information in this article is based on current research and should not be construed as medical advice. Please speak to your doctor or healthcare provider if you have questions regarding your medication and CBD use.