Can CBD Capsules Be Mixed with Other Medicinal Tablets?

CBD has gained widespread recognition for its potential therapeutic effects, ranging from stress relief to sleep-aid and pain management properties. Moreover, many use CBD as a general-purpose supplement to support overall wellbeing. 

Adding to the allure of CBD is its safety profile and low risk for side effects. However, there is one big caveat; CBD has the potential to interact with some prescription medications.

As such, users need to exercise caution when using CBD pills and capsules with other medicinal tablets. 

Why CBD Interacts with Other Medications

When you take a medication or substance, your body has to metabolize it. A family of enzymes called cytochrome P450 (CYP450) is responsible for breaking down many medications in the liver and small intestine. This process is what delivers a medication’s benefits to the intended target. 

CBD is also metabolized by this group of enzymes and can interact with other substances metabolized by similar enzymes. Specifically, CBD can either accelerate or inhibit the medication metabolism process.

This is problematic because it means CBD may reduce or enhance the effects of other medications. If your body is metabolizing a medication too slowly, it could increase the drug’s level in your system, exaggerating its effects. This includes harmful or unwanted side effects.

On the flip side, if your body is metabolizing a drug too quickly, you may not have enough of it in your system at once, rendering it less effective. 

The “grapefruit test” is an excellent way to determine whether CBD will interact with other medications. Many prescription drugs come with a grapefruit warning, advising against consuming the fruit while taking the drug.

CBD and grapefruit bind to the same enzymes. Although research suggests that CBD has more potent effects because it binds in multiple parts of the liver and gut, while grapefruit primarily affects enzymes in the liver. If a medication advises against using grapefruit, it should be surmised that CBD pills should be avoided, too. 

Most Common CBD Drug Interactions

There are many medications that CBD capsules could interact with. Certain seizure medications, muscle relaxers, antidepressants, and drugs that suppress the central nervous system, such as benzodiazepines and opioids, may have particularly strong interactions. 

Here are a few of the most common interactions between CBD and medications.


CBD can enhance the duration and strength of ibuprofen, increasing the risk of negative side effects. However, health experts suggest that potential interactions are dosage-dependent. If an excessive dosage is consumed, mixing CBD pills and NSAIDs like ibuprofen can lead to potentially serious nervous system issues. 

Warfarin and Other Blood Thinners

As reported in one 2017 study, CBD increases the effects of blood-thinning drugs. The cannabinoid slows down how the body metabolizes warfarin and prolongs its presence in the system. Therefore, CBD could increase the risk of some associated side effects, including swelling, severe bleeding, and headaches.

Seizure Disorder Medications

Drug interactions are common when CBD is used with seizure medications, especially if you consume a high dose of CBD. The blood levels of the following drugs may increase when CBD is used in conjunction; topiramate, rufinamide, zonisamide, and eslicarbazepine.

Moreover, seizure patients may experience abnormalities in liver function when CBD capsules are used with the seizure drug valproic acid.

Using CBD Capsules Safely with Other Medicinal Tablets

While CBD can interact with around 60% of prescription drugs, there are a few ways to safely use CBD capsules in conjunction with other medicinal tablets.

Firstly, you should not stop taking your prescribed medication before consulting your doctor. This goes for drugs that interact with CBD and those that don’t.

Then, there are some small things you can do to improve the safety of CBD. From introducing CBD into your regime at a lower than usual dose to timing out when CBD pills should be taken to allow the medication to break down first. Your doctor can help you figure these things out. 

More importantly, your doctor can advise against CBD capsules if there is potential for a negative interaction with the current medication you’re using. Or perhaps, they will be able to formulate a plan that allows you to use CBD pills and your medication. 

Final Thoughts on Mixing CBD Capsules with Other Medicinal Tablets

CBD can interact with many medicinal products, including over-the-counter drugs, herbal supplements, and prescription medications.

At a minimum, the grapefruit warning on medications should give a good indication as to whether CBD will interact with a drug. However, you should always consult your doctor if you’re considering using CBD capsules with other medicinal tablets.

To summarize, you can mix CBD pills with some medications but not others. Doctors will know best and can give you guidelines to use CBD safely. 

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