CBD and Potential Drug Interactions Certain substances such as (CBD, THC, grapefruit, St. John’s Wort, watercress, etc.) can affect drug metabolism, making certain drugs metabolize faster or slower than they would on their own. Cannabidiol (CBD) can temporarily inhibit the one of the most common metabolism pathways (CYP450) ability to metabolize certain drugs leading to an increase (or decrease) in blood levels, unwanted side effects, and sometimes, an overdose. Some pharmaceuticals, called “prodrugs” (tamoxifen,5-FU, Simvastatin, Levodopa, Enalapril) don’t become functional until they are metabolized into an active component. If CBD or THC slow the metabolism of a pro-drug, it can adversely affect final levels of the desired active drug. If you have been hospitalized resulting from CBD use or taking any of the below drugs consult with your doctor prior to registering. Drug by Class Pain Management Blood Glucose Antibiotics/Antivirals Opioid Pain Relievers Insulin - Zithromax - Codeine Oral hypoglycemic agents - Erythromycin - Oxycodone Sulfonylureas - HIV Antivirals - NSAIDS CNS Other Cardiovascular Antiepileptics/anticonvulsants PPIs Statins (some) Benzodiazepines Antihistamines Antiarrhythmics - Alprazolam - Zyrtec Beta Blockers - Clonazepam - Diphenhydramine Calcium Channel Blockers - Diazepam - Allegra - Cardizem Antidepressants including SSRIs Anti-Nausea agents - Norvasc - Amitriptyline Steroids Anticoagulants - Amoxapine Chemotherapeutics - Desipramine - Tofranil - Pamelor - Vivactil Antipsychotics ADD/ADHD stimulants Drug by Name Adderall Eliquis (apixaban) pimozide (Orap) Aliskiren (Tekturna) Erythromycin ranolazine (Ranexa) Allegra (fexofenadine) Etoposide saquinavir (Invirase, Fortovase) Alprazolam (Xanax) Fentanyl Seldane (terbinafine) Ambien (zolpidem) flibanserin (Addyi) Seroquel (Quetiapine fumarate) amiodarone (Pacerone) indinavir (Crixivan) sildenafil (Revatio, Viagra) Anafranil (clomipramine) Lexapro (escitalopram oxalate) Sporonox (itraconazole) atorvastatin (Lipitor) loratadine (Claritin) tadalafil (Adcirca, Cialis) Azithromycin losartan (Cozaar) Taxol Biaxin (clarithromycin) Lovastatin vardenafil (Levitra, Staxyn) carbamazepine (Tegretol) Methotrexate verapamil (Calan, Calan SR) cilostazol (Pletal) naloxegol (Movantik) Viagra (sildenafil) Citalopram nilotinib (Tasigna) Vyvanse (lisdexamfetamine Codeine Nizoral (ketoconazole) dimesylate) colchicine NSAIDs (aspirin, naproxen, diclofenac, Warfarin Concerta ketoprofen, ibuprofen, etc) Wellbutrin (Bupropion) cyclosporine (Gengraf, Neoral) Oxycodone Xarelto (Rivaroxaban) Cymbalta (duloxetine) palbociclib (Ibrance) Zocor (simvastatin) dronedarone (Multaq) pazopanib (Votrient) Zofran (ondansetron) Effexor (venlafaxine) Zyprexa (olanzapine) .