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More on Drug Interactions

In my practice, as a functional medicine clinician, I prescribe quite a bit of CBD for a myriad of pathologies. I do not, however, allow any of my clients to begin using CBD until I have reviewed their medication profiles for drug interactions. The importance of doing this can’t be over stated as the potential for severe side effects is quite high. The liver has 2 detox phases. Phase I (cytochrome p450 enzymes system) is where basically the majority of all drugs (60% or more) are metabolized via the cyp450 system, including CBD (specifically, cyp3a4, 3a5, ea7, cyp 2c9, 2c19 and cyp2d6. And phase II where the metabolites from Phase I are further metabolized and eliminated. The balance is critical between the 2 but a discussion for another time. So how does CBD via the cyp450 system interact with drugs to create a drug interaction? Quite simply, CBD competitively inhibits the cyp450 enzymes thus decreasing the metabolism of the drug resulting in increased blood levels with the potential to enhance associated side effects. A perfect example would be Prozac (see website for a blog addressing this interaction with a client) and other psychotropics all of which have the potential for serious side effects.

I have a number of clients come to me to either to help them get off the drugs they are on, or to minimize the number. I have a lot of ways addressing this, but CBD is on the top of my list. An obvious example would be pain management. CBD, in conjunction with palmotylethanolamine (PEA) works on a totally different pain receptor (different blog). The list is extensive in terms of what I have had success with, in replacing or minimizing the use of allopathic medicine. It includes, cancer, inflammation, depression/anxiety, BP medications, diabetes, dermatology, etc. I need to point out however, removing or minimizing the use of drugs can be a lengthy process (weeks to months in some cases) that involves balancing the dosing of CBD with the lowering of a particular drug especially the psychotropics, drugs used for autoimmunity, blood pressure meds etc. to avoid an exacerbation of symptoms. In terms of blood pressure meds, I use the drug interaction. The initial increase in the effectiveness of the BP med when combined with CBD frequently begins to lower the blood pressure allowing us to decrease the dose, or in the case of multiple BP meds, begin to eliminate one.

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