QUESTIONS AND ANSWERS

Does CBD Interact with Lipitor?

In our latest question and answer our medical cannabis pharmacist discusses CBD's interaction with Lipitor (atorvastatin) and several other medications.
Does CBD Interact with Lipitor?

Cruisintt Asked

Can I take CBD if I am taking atorvastatin, diltiazem, prednisone, and protonix?

Summary

CBD and Lipitor (atorvastatin) are metabolized by the same enzyme (CYP3A4) in the liver.
Some studies suggest CBD can inhibit CYP3A4 which could increase atorvastatin levels in the body.
An interaction between CBD and lipitor isn't likely because of the high doses of CBD that are necessary to produce CYP3A4 inhibition.

Answer

Hi Cruisintt and thank you for your question. First, I'll focus on answering your question about whether CBD interacts with Lipitor. Then I'll get to whether CBD interacts with all the other meds listed in your question. Lipitor or atorvastatin is a "statin" medication that is very commonly prescribed and is used to treat high cholesterol. There is a lot of information about this drug interaction available online.  

Does CBD interact with Lipitor?

CBD and atorvastatin (Lipitor) are both metabolized by CYP3A4; an enzyme in the liver that is responsible for the metabolism of more than 50% of all drugs. CBD could potentially decrease the activity of CYP3A4 enzyme. Theoretically, this could increase Lipitor levels in the body increasing the risk of certain side effects such as stomach upset, diarrhea, or rhabdomyolysis (muscle breakdown). 

However, the overall risk of this interaction appears to be quite low in reality. When researchers examined the doses of CBD you'd need to consume in order to inhibit the CYP3A4 enzyme they found that they were extremely high, higher than anyone would reasonably consume. 

Does CBD interact with Diltiazem?

Cardizem or "diltiazem" is a calcium-channel blocker that is used to treat high blood pressure and chest pain called angina. Diltiazem works by relaxing blood vessels which reduces the resistance the heart must pump against. It also increases the delivery of blood and oxygen to the heart. 

There are no known drug interactions with diltiazem and CBD. 

Does CBD interact with Protonix?

Pantoprazole is a proton pump inhibitor that is used to reduce symptoms of gastroesophageal reflux disease. CBD could inhibit the metabolism of pantoprazole via the CYP2C19 enzyme. This could increase the risk of side effects from pantoprazole such as:

  • headache
  • nausea
  • vomiting
  • gas
  • joint pain
  • diarrhea
  • Dizziness

CBD is a known substrate and moderate inhibitor of CYP2C19.

Does CBD interact with Prednisone?

Prednisone is a corticosteroid drug that is commonly used to treat diseases or conditions associated with inflammation. There have been no studies looking specifically at an interaction between CBD and Prednisone.

CBD is known to have anti-inflammatory effects, but not enough research has been done to determine if these effects product any interference with the effects of prednisone. 

 

In summary

CBD could potentially inhibit the metabolism of atorvastatin and pantoprazole via CYP3A4 and CYP2C19 inhibition respectively. However, because of the high doses of CBD required to produce these interactions, it is likely nothing to worry about. 

  1. Epidiolex. Carlsbad, CA: Greenwich Biosciences; 2018. [package insert] [package insert].
  2. Lipitor. Dublin, IR: Pfizer Pharmaceuticals; 2009. [package insert].
  3. Cardizem. Bridgewater, NJ: Valeant Pharmaceuticals; 2014. [package insert].
  4. Protonix. Konstanz, DE: Pfizer Pharmaceuticals; 2012. [package insert].
  5. Prednisone Tablets. Columbus, OH: Roxane Labs; 2012. [package insert].

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