Products containing cannabidiol (CBD) are very popular, promising relief from a wide range of maladies. But if you are considering taking a product containing CBD, be aware that if you are taking any other prescription or over-the-counter medications, supplements, or herbal products, CBD can interact with them and cause unexpected … There is little research into the interaction between Cymbalta and cannabis, but there may be one if the two are used together. Can CBD oil be taken with Cymbalta? Here's the general view and exceptions in which a doctor can prescribe both. Plus what each does and the side effects.
CBD and other medications: Proceed with caution
Products containing cannabidiol (CBD) seem to be all the rage these days, promising relief from a wide range of maladies, from insomnia and hot flashes to chronic pain and seizures. Some of these claims have merit to them, while some of them are just hype. But it won’t hurt to try, right? Well, not so fast. CBD is a biologically active compound, and as such, it may also have unintended consequences. These include known side effects of CBD, but also unintended interactions with supplements, herbal products, and over-the-counter (OTC) and prescription medications.
Doubling up on side effects
While generally considered safe, CBD may cause drowsiness, lightheadedness, nausea, diarrhea, dry mouth, and, in rare instances, damage to the liver. Taking CBD with other medications that have similar side effects may increase the risk of unwanted symptoms or toxicity. In other words, taking CBD at the same time with OTC or prescription medications and substances that cause sleepiness, such as opioids, benzodiazepines (such as Xanax or Ativan), antipsychotics, antidepressants, antihistamines (such as Benadryl), or alcohol may lead to increased sleepiness, fatigue, and possibly accidental falls and accidents when driving. Increased sedation and tiredness may also happen when using certain herbal supplements, such as kava, melatonin, and St. John’s wort. Taking CBD with stimulants (such as Adderall) may lead to decreased appetite, while taking it with the diabetes drug metformin or certain heartburn drugs (such as Prilosec) may increase the risk of diarrhea.
CBD can alter the effects of other drugs
Many drugs are broken down by enzymes in the liver, and CBD may compete for or interfere with these enzymes, leading to too much or not enough of the drug in the body, called altered concentration. The altered concentration, in turn, may lead to the medication not working, or an increased risk of side effects. Such drug interactions are usually hard to predict but can cause unpleasant and sometimes serious problems.
Researchers from Penn State College of Medicine evaluated existing information on five prescription CBD and delta-9-tetrahydrocannabinol (THC) cannabinoid medications: antinausea medications used during cancer treatment (Marinol, Syndros, Cesamet); a medication used primarily for muscle spasms in multiple sclerosis (Sativex, which is not currently available in the US, but available in other countries); and an antiseizure medication (Epidiolex). Overall, the researchers identified 139 medications that may be affected by cannabinoids. This list was further narrowed to 57 medications, for which altered concentration can be dangerous. The list contains a variety of drugs from heart medications to antibiotics, although not all the drugs on the list may be affected by CBD-only products (some are only affected by THC). Potentially serious drug interactions with CBD included
- a common blood thinner, warfarin
- a heart rhythm medication, amiodarone
- a thyroid medication, levothyroxine
- several medications for seizure, including clobazam, lamotrigine, and valproate.
The researchers further warned that while the list may be used as a starting point to identify potential drug interactions with marijuana or CBD oil, plant-derived cannabinoid products may deliver highly variable cannabinoid concentrations (unlike the FDA-regulated prescription cannabinoid medications previously mentioned), and may contain many other compounds that can increase the risk of unintended drug interactions.
Does the form of CBD matter?
Absolutely. Inhaled CBD gets into the blood the fastest, reaching high concentration within 30 minutes and increasing the risk of acute side effects. Edibles require longer time to absorb and are less likely to produce a high concentration peak, although they may eventually reach high enough levels to cause an issue or interact with other medications. Topical formulations, such as creams and lotions, may not absorb and get into the blood in sufficient amount to interact with other medications, although there is very little information on how much of CBD gets into the blood eventually. All of this is further complicated by the fact that none of these products are regulated or checked for purity, concentration, or safety.
The bottom line: Talk to your doctor or pharmacist if using or considering CBD
CBD has the potential to interact with many other products, including over-the-counter medications, herbal products, and prescription medications. Some medications should never be taken with CBD; the use of other medications may need to be modified or reduced to prevent serious issues. The consequences of drug interactions also depend on many other factors, including the dose of CBD, the dose of another medication, and a person’s underlying health condition. Older adults are more susceptible to drug interactions because they often take multiple medications, and because of age-related physiological changes that affect how our bodies process medications.
People considering or taking CBD products should always mention their use to their doctor, particularly if they are taking other medications or have underlying medical conditions, such as liver disease, kidney disease, epilepsy, heart issues, a weakened immune system, or are on medications that can weaken the immune system (such as cancer medications). A pharmacist is a great resource to help you learn about a potential interaction with a supplement, an herbal product (many of which have their own drug interactions), or an over-the-counter or prescription medication. Don’t assume that just because something is natural, it is safe and trying it won’t hurt. It very well might.
Should You Use Marijuana If You Take Cymbalta?
Cymbalta is a prescription medication used to soothe several medical conditions, such as anxiety, depression and chronic pain. Many of these symptoms are among the approved uses for medical marijuana in legalized states.
While a sizable amount of research explores cannabis’ connection with psychiatric disorders, there’s little that examines antidepressants like Cymbalta’s interaction with marijuana. Some sources suggest that Cymbalta (duloxetine) has a moderate drug-drug interaction with cannabis, potentially interfering with its metabolization by the liver.
Download Guide To Anxiety and Medical Cannabis
Download Free Guide to Marijuana and Chronic Pain
What Is Cymbalta?
Cymbalta — generically called duloxetine —‚ is one of the selective serotonin-norepinephrine reuptake inhibitors (SSNRIs) that increases the levels of serotonin and norepinephrine in the brain. These chemicals influence mood and pain sensations, and taking Cymbalta helps regulate them when their levels are imbalanced.
Side effects of Cymbalta range in severity and include:
Uses and How It Works
SNRIs are a newer class of antidepressants that have shown a more promising ability to regulate mood without the traditional adverse effects of SSRIs like Prozac. Medications like Cymbalta work by modulating the neurotransmitters in the brain that communicate information between brain cells. By preventing the reuptake of serotonin and norepinephrine in the brain, Cymbalta can lift patients out of depression and soothe experiences of pain.
Potential Benefits and Risks of Mixing Cannabis and Cymbalta
We do not yet know if cannabis interacts with Cymbalta. Current research implicates marijuana as a promising aid to treat various conditions, including several disorders doctors prescribe Cymbalta to treat. As such, medical marijuana may offer an alternative for individuals who cannot or choose not to take SNRIs.
Evidence suggests that individuals who regularly use medical marijuana experience less depression. CBD, too, counteracts many of the adverse effects of THC’s psychoactivity, which could worsen anxiety with too high a dose. However, CBD is known to interact with many medications due to its impact on metabolic activity in the liver. Be sure to discuss using cannabis and Cymbalta with your doctor before making any changes to your medication routine.
CBG is another promising cannabinoid that could boost the antidepressant ability of Cymbalta. It works by preventing the reuptake of GABA, which contributes to a sense of peace and calm using a different neural pathway than SNRIs.
Download A Free Guide to Medical Marijuana
While marijuana use and Cymbalta produce many of the same results, users should exercise caution before taking them simultaneously. Cannabis use with Cymbalta could impair cognitive and motor function, making it more difficult to focus or complete tasks.
Additionally, some of marijuana and Cymbalta’s side effects are similar, which could magnify these experiences if the drugs are taken in tandem. Both cannabis and Cymbalta display central nervous system (CNS) depressant properties, which can dangerously reduce heart rate and breathing when too much is taken.
The Bottom Line
There’s still much to learn about mixing cannabis with Cymbalta or other SRNIs; each person’s body handles drugs differently. Always discuss potential changes to your prescription routine with a medical professional before taking action, as a doctor should be able to answer most questions.
Leafwell’s dedicated team of medical professionals is here to guide you through applying for your MMJ card online.
Can CBD Oil Be Taken With Cymbalta? Here’s What Happens
If you’re asking can CBD oil be taken with Cymbalta, then you’re not alone. The use of CBD in oil, and other forms, has become more prevalent in recent years.
So, it’s not surprising that those taking Cymbalta are looking to understand its interactions with CBD products.
In this article, we’ve outlined what each does, how they work, and whether CBD oil can be taken with Cymbalta – and if so, when and how. Here’s a summary to give you a brief overview.
Can CBD oil be taken with Cymbalta? In general, CBD oil should not be taken with Cymbalta as it can intensify side effects in relation to cognitive process and motor skills. In severe cases, this can lead to serotonin syndrome and liver failure. Some see most side effects as moderate, and doctors can prescribe both.
With that brief takeaway to give you a clear overview of the answer, it’s important to help you become familiar with both these medications and their side effects.
Only through this will it be easier to grasp why CBD oil can or cannot be taken with Cymbalta.
Cymbalta, CBD, and their side effects
In the lead-up to a more comprehensive answer, we’re going to recap on the significance of both Cymbalta and CBD and discover the similarities in which each operates and how both affect the body.
Cymbalta is an SNRI antidepressant. SNRI stands for serotonin-norepinephrine reuptake inhibitor.
What this medication essentially does is block serotonin and norepinephrine from being reabsorbed into your neurons.
Duloxetine is the main active ingredient of Cymbalta.
Cymbalta is used to treat:
- Major depressive disorder
- Generalized anxiety disorder
- Pain caused by diabetic neuropathy
- Osteoarthritis pain
- Chronic musculoskeletal pain
The common side effects of Cymbalta include:
- Dry mouth
- Loss of appetite
- Dizziness and lightheadedness
- Tiredness and drowsiness
- Increased sweating
- Increased blood pressure
CBD stands for cannabidiol. CBD oil is made by extracting CBD from the cannabis plant, then diluting it with a carrier oil like coconut or hemp seed oil.
While CBD is an essential component of the “marijuana plant,” it is derived from the hemp plant. Both plants belong to the same species, but the hemp plant contains 0.3 percent or less THC. Therefore, CBD does not contain THC, which is the psychoactive ingredient in marijuana.
CBD oil is used to treat:
- Anxiety and depression
- Chronic pain
- Arthritis or joint pain
- Epilepsy and other seizure disorders
- Multiple sclerosis (MS)
- Lung conditions
- Sleep disorders
- Allergies or asthma
- Cluster and other headaches
- Post-traumatic stress disorder (PTSD)
- Parkinson’s disease
- Alzheimer’s disease
Common side effects of CBD oil include:
- Dry mouth
- Weak appetite
- Liver inflammation
- Mood changes
- Decrease in alertness.
Can CBD oil be taken with Cymbalta – the general view
As you can see, both CBD oil and Cymbalta are used for treating similar medical conditions, and equally, they exhibit many similar side effects.
So, essentially, if CBD oil is taken with Cymbalta, the side effects of each other could be magnified, resulting in more severe adverse reactions.
In scientific terms, when both these drugs interact, they can cause problems related to cognitive and motor function.
Cognitive problems include confusion, impaired judgment, concentration problems, and difficulty in thinking. Motor function problems include dizziness and impaired coordination.
Some consider the side effects of taking CBD oil with Cymbalta – and their interactions – to be moderate.
It is also believed that doctors can recommend CBD oil to be taken with Cymbalta under special circumstances.
This is in situations in which your healthcare provider decides the benefits would likely outweigh the risk.
However, if such a combination is provided, your healthcare provider will need to closely monitor your side effects to ensure you are not at risk of severe adverse reactions.
So, from the perspective of absolute safety, CBD oil should not be taken with Cymbalta, as magnified side effects from taking both together can cause other potentially severe issues too, which we’ll cover below…
What happens if you take CBD oil with Cymbalta?
There are three main negative outcomes of taking CBD oil with Cymbalta. Below are those three outcomes in the order of least to most severe.
1. Intensified side effects
As we mentioned earlier, the primary negative result of taking CBD oil with Cymbalta is intensified side effects.
In this scenario, 80% of all pharmaceutical products are broken down in the liver. This action is performed by a group of enzymes called Cytochrome P450 (CYP450).
It’s the liver that breaks down both Cymbalta and the cannabinoids like CBD oil and THC.
This naturally means that when CBD oil is taken with Cymbalta, both of these compounds will compete for the enzyme cytochrome P450 (CYP450) in your liver for breaking them down and metabolizing them.
This means that there is a slower rate of metabolizing them. Thus, the effect of each compound is longer and more potent.
The result of this could be exacerbated side effects.
2. Serotonin syndrome
Cymbalta specifically is a serotonin inhibitor that blocks serotonin from being absorbed into your system.
In safe doses, the blockage helps Cymbalta treat the conditions for which it’s been prescribed.
It’s believed that when you add a new drug to your regimen with Cymbalta or when you increase the dose of Cymbalta, it can easily cause “serotonin syndrome.”
Serotonin syndrome is when you have too much serotonin in your system, which could cause a range of side effects.
Some of these side effects include:
- Agitation or restlessness
- Rapid heart rate and high blood pressure
- Dilated pupils
- Loss of muscle coordination or twitching muscles
- Muscle rigidity
- Heavy sweating
3. Liver failure
This is the final and the most severe risk of taking CBD oil with Cymbalta. Liver failure results in loss of liver functions.
One main reason for liver failure includes overwhelming your liver function by combining medications or supplements like CBD oil and Cymbalta.
Liver failure occurs when your liver cells are damaged and they can no longer perform due to exhaustion.
Symptoms of liver failure include:
- Malaise (general sense of feeling unwell)
- Abdominal swelling
- Jaundice (yellowing of your skin and eyeballs)
Exceptions for taking CBD oil with Cymbalta
Some believe that you can replace Cymbalta with CBD oil – and vice versa.
However, this is not scientifically proven and should only be undertaken through consultation with your healthcare provider.
To mitigate against potential problems, some also opt for methods such as:
- Space out the time between taking CBD oil and Cymbalta (1 – 3 hours generally). This will prevent the drugs from overlapping with the effects of one another.
- Microdose your cannabis therapy treatment. This is to practice taking the minimal amount of a given substance to achieve your desired results.
- Slowly increase your cannabis therapy dosage over time. This is where you take your regular dose of Cymbalta and then slowly increase only the intake of CBD oil until the point you feel it’s tolerable or doesn’t reflect intense side effects.
- Find and consult with a pro-cannabis medical professional. This is the best exception we can recommend. A CBD professional knows exactly how it can work for your body and condition. They may be able to offer dose advice or other strategies to take CBD oil with Cymbalta in such a way as not to intensify the side effects and exacerbate other related problems taking them together.
Again, these are only general guidelines and are NOT meant for official medical advice when taking CBD oil with Cymbalta. Always consult your healthcare provider before making any changes to your treatment.
We hope this has armed you with what you need to know regarding the question can CBD oil be taken with Cymbalta. There are other ways in which Prescription Hope can assist you too…
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