RX Interactions (“Contraindications”)

Hemp oil (industrial hemp in general) is not for everyone — despite few potential adverse side effects used on its own — and for some on pharmaceuticals or with certain conditions, it needs to be used with caution. A “contraindication” here simply means, not recommended. While we at EQ have seen success with hemp oil used with a whole host of pathologies and symptoms, with or without adjunct medication, the “contraindication” status of hemp oil and your medications is between yourself and your doctor!

Between the two EQ co-founders, Marcy and Coco have successfully used hemp oil with Paxil, Wellbutrin, Klonopin, Xanax, Propranolol, and Enbrel, and while they chose to stop or decrease use of those medications, it was not because of hemp oil in a negative sense. They worked quite well together, but ultimately they were happier and healthier with an altered/lowered pharmaceutical routine and more hemp oil. So everyone’s mileage may vary, and doctors are experts for a reason.

EQ hemp oil products are not intended to diagnose, treat, cure or prevent any disease or ailment.

Cytochrome P450 (CYP450)

One simple fact to keep in mind is that therapeutic plant compounds (such as hemp oil) can regulate our Endocannabinoid System (“ECS”) so well with their “homeostatic” tendencies that our medications work differently (if they use the CYP450 liver enzymes — keep reading!) What does this mean? Examples include folks on epilepsy, blood pressure, or narcotic medications experiencing these prescriptions working too well, meaning an uptick in side effects, upon which their doctors recommend lowering the dose of said medication. We advise always looping your doctor in when it comes to your hemp oil journey! Especially since the opposite can happen, though fewer medications are on such a list.

More about hemp oil + your liver

Outside of clinical environments, complaints of hemp oil interacting with medications is not often intrusive in a treatment plan, especially since the aforementioned risks are associated with fairly high doses of daily hemp oil. While everyone’s “high dose” is very personal, many reported interactions are at well over 100mg per day doses, and most EQ customers are at 50mg or below. We however recommend you ALWAYS consult with your doctor about your medications before starting hemp oil, and journal every day about any uptick in medication side effects or decrease in medication efficacy!

Medications themselves can also inhibit hemp oil’s ability to be metabolized properly. Phenobarbital, for instance, makes hemp oil less effective.

You may have been told to avoid grapefruits before taking a medication despite no allergy, and this also has to do with Cytochrome P450 (“CYP450”) family of liver enzymes. Hemp oil can change how this enzyme processes medication (as mentioned, usually faster but sometimes slower). A quick tip to get knowledge on your medications and CYP450 is to ask your doctor or pharmacist if you should avoid grapefruit with your medication; if YES, you know that you should use hemp oil carefully.

“According to the Indiana University Department of Medicine, drugs known to use the CYP450 system include:

  • Steroids
  • HMG CoA reductase inhibitors
  • Calcium channel blockers
  • Antihistamines
  • Prokinetics
  • HIV antivirals
  • Immune modulators
  • Benzodiazepines
  • Antiarrythmics
  • Antibiotics
  • Anesthetics
  • Antipsychotics
  • Antidepressants
  • Anti-epileptics
  • Beta blockers
  • PPIs
  • NSAIDs
  • Angiotension II blockers
  • Oral hypoglycemic agents
  • Sulfonylureas

This list does not include all of the potential medications impacted by hemp oil. Nor will every medication in the categories contained on this list cause an interaction. For these reasons, you should always consult with a medical professional before supplementing with hemp oil.

There are certain medications, known as “prodrugs,” that need to be metabolized to produce the therapeutic compound. In other words, you ingest an inactive compound and once in the body, it is processed into the active drug. If this processing is dependent on CYP3A4 (part of the larger CYP450 system), then inhibitors can result in too little active drug in the body for the desired therapeutic effect.

Codeine, for example, is a prodrug that is metabolized into morphine which provides the effect.

Vyvanse and Concerta are two other popular pharmaceutical medications for ADHD that fall into this category.

If you are worried that your CYP450 pathway may not be functioning properly, physicians can test the system to ensure that the medications you take are metabolizing as expected.” (source)

Hemp Oil + Glaucoma

There’s been research that shows that for those with glaucoma, or predisposition to it, hemp oil can increase intraocular eye pressure. Your eye doctor can very quickly check eye pressure for you at a routine visit, and drops can easily remedy as the effect is temporary.