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 … Cannabidiol (CBD) may interact with the analgesic naproxen, enhancing its anti-inflammatory and painkilling effects but also increasing the risk of side effects. The facts are that CBD oils are safer, healthier, and a better alternative for pain management than drugs that carry 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.
Does CBD Interact With Naproxen (Aleve)?
This combination is considered low-risk — but proceed with caution.
Naproxen, an analgesic drug belonging to the class of nonsteroidal anti-inflammatory drugs (NSAIDs), is used to treat different conditions such as osteoarthritis, rheumatoid arthritis, dysmenorrhea, and others. It also has antipyretic abilities.
CBD (cannabidiol) is a naturally-occurring cannabinoid with similar effects. Some people report taking both compounds together for added benefit.
Will CBD and naproxen (Aleve) interact? Is this combination safe?
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Does CBD Interact With Naproxen (Aleve)?
CBD can interact with naproxen, but the interaction is mostly mild. Some even consider this combination synergistic — offering a greater level of benefit in combination than either compound can offer on its own.
Both CBD and naproxen offer potent anti-inflammatory and analgesic benefits. They even work through similar mechanisms of action (inhibition of COX-2 and other pro-inflammatory mediators).
There’s also a possibility CBD and naproxen will interact through a concept called metabolic competition as well. Both CBD and naproxen require at least some activity from the CYP2C9 enzyme in the liver. Since both compounds require the same pathway, they can become overburdened and slower than expected — increasing the half-life of both substances. This is unlikely to result in side effects unless both substances are taken on a daily basis for several days, weeks, or months.
Similar Medications: CBD & NSAIDs
Naproxen is classified as an NSAID painkiller. CBD and NSAIDS all share similar risks for interaction and side effects.
Here’s a list of similar medications that share a similar level of risk when combined with CBD:
- Aspirin (Ascriptin, Aspergum, Aspirtab, Bayer, Easprin, Ecotrin, Ecpirin, Entercote)
- Ibuprofen (Motrin, Advil, Nuprin, Caldolor & Neoprofen)
- Celecoxib (Celebrex & Onsenal)
- Ketorolac (Toradol)
- Etodolac (Ultradol)
- Meloxicam (Mobic)
Is It Safe to Take CBD & Naproxen (Aleve) Together?
CBD and naproxen have a low risk of interaction and are generally considered safe to take in combination (if following the safe recommended dosages for both compounds).
Long-term use or large doses of CBD or naproxen may lead to some side effects. Too much naproxen in the body could cause side effects like liver failure, gastrointestinal upset, and ulcer formation.
Talk to your doctor first if you wish to start using CBD while taking a daily dose of naproxen.
Is CBD A Viable Alternative to Naproxen (Aleve)?
CBD may be a viable alternative to naproxen for certain symptoms.
CBD is an effective painkiller, especially in mild to moderate conditions like mild arthritis, pain, and inflammation. It works by binding to the transient receptor potential (TRP) channels, antioxidant effects, and various endocannabinoid-regulated pro-inflammatory pathways [1,2].
For mild conditions, CBD may be even more effective and carry fewer side effects than naproxen.
However, in some severe pain and inflammatory conditions, CBD may not provide enough relief as naproxen. Additionally, CBD lacks the antipyretic (fever-reducing) activity of naproxen.
What is Naproxen (Aleve)?
Naproxen is a nonsteroidal anti-inflammatory drug (NSAIDs). It’s used to treat mild to moderate pain, like rheumatoid arthritis, osteoarthritis, tendinitis, bursitis, muscle pains, acute gout, dysmenorrhea, and others.
It was approved as a prescription drug in 1976 and then for over-the-counter (OTC) use in 1994.
Naproxen (Aleve) Specs:
|Trade Name||Aleve, Aleve PM, Aleve-D, Anaprox, EC-Naprosyn, Naprelan, Naprosyn, Sallus, Sudafed Sinus & Pain, Treximet, Vimovo|
|Interaction With CBD||Agonistic, Metabolic competition,|
|Risk of Interaction||Mild|
What Does Naproxen (Aleve) Do?
Naproxen works by inhibiting cyclo-oxygenase (COX) isoenzymes. These enzymes are key mediators in the inflammatory process. By blocking these enzymes, inflammation is halted, reducing pain and swelling along with it.
The COX-1 enzymes are also found in normal tissues like the stomach lining, while the COX-2 enzyme is induced and makes prostaglandins that mediate pain, fever, and inflammation.
Stopping the production of these substances stops the inflammatory actions on the body and provides relief. Naproxen’s actions on the COX-2 enzyme give the desired antipyretic, analgesic, and anti-inflammatory properties, while its actions on COX-1 enzymes can give undesired adverse effects such as gastrointestinal upset and renal damage. Naproxen can thus stop the effects of inflammation but may cause some unwanted side effects.
The half-life of naproxen is 12-17 hours.
Side Effects of Naproxen
Naproxen has few deleterious effects on the health of its users. Long-term use of naproxen can increase blood pressure and cause upper gastrointestinal bleeding.
Naproxen should be avoided in patients with hypersensitivity, perioperative pain in the setting of coronary artery bypass graft (CABG) surgery, bleeding disorders, liver diseases, kidney failure.
Because naproxen is so easily available as an OTC drug, it is also more liable to be misused and overdosed. It can produce effects such as drowsiness, lethargy, epigastric pain, nausea, and vomiting.
Side effects of naproxen include:
- Abdominal pain
- Fluid retention
- Gastrointestinal bleeding
- Gastrointestinal perforation and ulcer
- Hearing disturbances
- Muscle cramps
Key Takeaways: Is it Safe to Take Naproxen (Aleve) With CBD?
CBD and naproxen are generally regarded as safe when taken in combination — however, be cautious with this combination and always follow the recommended dosages for both substances. Never consume alcohol when taking naproxen and CBD.
CBD and naproxen both decrease pain and inflammation, but both of them have different mechanisms of action. Naproxen works by acting on the COX enzymes. CBD decreases pain by acting on the endocannabinoids and TRP channels.
Some reports suggest an even greater level of pain reduction when combining CBD and naproxen together, but there are no studies to confirm whether this is safe or effective yet.
Why CBD Oil Is Better Than NSAIDs
America is a nation in pain according to NIH statistics, and a National Health Interview Survey found that 25.3 million adults complain of constant pain daily, that roughly 11% of the population, and close to 40 million people complain of the pain the cope with as being severe although it may not be everyday.
Americans are estimated to spend on average $50 billion a year trying to deal with pain, and many turn to chemical medications for relief, of which there is a clear link between the search for pain relief and the opioid crisis.
Not every person suffering with pain will rely on opioids, around 30 million people turn to nonsteroidal anti-inflammatory drugs such as ibuprofen or aspirin for relief. However even these drugs are not free from side effects such as risk of gastrointestinal ulcers or bleeds, kidney damage, and heart attack.
In attempts to avoid unpleasant side effects more Americans are looking for alternatives and switching to CBD oil for pain relief and management. According to a report in Waking Times there are at least 6 reasons why making the switch is better for health and the environment.
15% of NSAID users are exceeding the maximum daily dose with and without being aware which increases the potential for dangerous side effects such as risk of cardiovascular, gastrointestinal, and kidney problems, allergies, skin reactions, swelling, wheezing, hives, blisters, and skin rash. On the other hand, CBD oil does not carry these side effects, and human clinical trials with epilepsy patients and those with psychotic disorders have found CBD oils to have favorable safety profiles.
NSAIDs primary function is to reduce pain by decreasing inflammation. CBD oils have been found to have similar anti-inflammatory properties, again without the side effects.
In addition to the anti-inflammatory and pain reducing effects CBD oils help to decrease feelings of stress and anxiety by having a calming effect on the central nervous system. A meta-analysis showed that 79.2% of humans taking CBD daily experienced symptomatic improvement in one month with similar efficacy 1 month later.
CBD oils also contain other powerful health boosting nutrients and phytonutrients including cannabinoids, terpenes, and flavonoids. A full spectrum hemp oil product contains a wide array of compounds that will benefit the body thanks to its phytonutrients.
NSAIDs are released into the environment via excretion and unused drug waste which causes environmental damage and contaminates marine, ground, and surface water. In contrast CBD oil is a natural compound that is properly utilized by the body, even if some should end up in the environment it is fully biodegradable making it harmless.
Choosing CBD oil over NSAIDs also means that are you supporting gentler methods which use more natural products and hemp farmers which are most likely local entrepreneurs and small business owners rather than putting more money into the pockets of Big Pharma.
The facts are that CBD oils are safer, healthier, and a better alternative for pain management than dangerous drugs that carry side effects like opioids and NSAIDs; switching to CBDs will boost your health, help protect the environment, ease your pain, and soothe your social conscience.
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