CBD Gummies And Warfarin

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CBD & warfarin (Coumadin) carry a moderate to high risk of interaction. Speak to your doctor about CBD if you’ve been prescribed blood thinners. Taking warfarin with CBD can make warfarin stay in the body for too long without being broken down. This may have detrimental effects like overdose. Learn more. Warfarin is an anticoagulant that helps to prevent blood clot formation and is used to treat deep vein thrombosis

Does CBD Interact With Warfarin (Coumadin)?

CBD & warfarin (Coumadin) carry a moderate to high risk of interaction. Speak to your doctor about CBD if you’ve been prescribed blood thinners.

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Warfarin (Coumadin) is an anticoagulant. It’s used to prevent clot formation in conditions such as deep vein thrombosis, pulmonary embolism, to prevent stroke, and as an adjunct treatment for angina and myocardial infarction.

Cannabidiol (CBD), a cannabinoid from hemp and marijuana plants, is a popular alternative treatment for pain, inflammation, anxiety, insomnia, and as a general health supplement.

Is it safe to mix blood thinners like warfarin with CBD or other cannabinoids?

Table of Contents

Does CBD Interact With Warfarin (Coumadin)?

Yes. CBD may interact with warfarin (Coumadin). This combination is considered moderate to high risk of interaction and should be avoided unless otherwise specified by your doctor.

This combination may slow the breakdown and elimination of warfarin, leading to increased serum levels of both substances over time. If serum concentrations become too high, side effects will result — some of which are severe and require medical attention (such as internal bleeding).

There are two main ways by which CBD can interact with warfarin:

A) Slowed Elimination (Metabolic Inhibitor)

Metabolic inhibition occurs when two drugs need the same enzymes to get metabolized. Hence, they end up competing against each other for the said enzymes. This action could result in slowing down the metabolism of one or both drugs.

Warfarin is metabolized by the CYP450 enzymes, mainly by CYP3A4 and CYP2C19, and less commonly by CYP1A22, CYP2D6, and CYP3A5.

These same enzymes metabolize CBD as well. Besides this, CBD is also capable of inhibiting these enzymes. So taking warfarin and CBD together could slow down the former’s metabolism.

This action could also lead to an excess accumulation of warfarin in the body, causing severe side effects such as bleeding, bruising, severe headaches, etc.

B) Increased Effect (Agonistic Interaction)

Agonistic interaction occurs when two drugs have similar effects on the body. When used together, both these drugs push on the same receptors or cause some effects in the same direction.

CBD can cause excess accumulation of warfarin in the body. It can also make it sustain for a longer time. It means warfarin would stay in the body for longer and become more potent. Hence, CBD could work as an agonist for warfarin as well. But this could also lead to heightened abilities of warfarin and cause more side effects as well.

Is It Safe to Take CBD & Warfarin (Coumadin) Together?

CBD and warfarin (Coumadin) are unlikely to result in serious side effects — however, this combination isn’t considered safe because of the severity of potential side effects should there be an interaction.

This combination could lead to an increase in the side effects of warfarin. Some recent studies have explored the potential interaction of these compounds [1]. Studies have shown high chances of a rise in the international normalized ratio (INR) of the users who are on long-term warfarin.

This means the blood may clot more slowly in users taking both these drugs, causing a tendency to bleed more easily. This could result in serious internal bleeding, bruising, or hemorrhage from relatively small injuries.

It is not recommended to take these two medicines together. Always consult your physician first before you decide to start CBD while on warfarin or any other blood thinner medications.

Your doctor may want to modify your dose of warfarin or CBD and may suggest taking both substances at least 2 hours apart.

If necessary, take only a minimal dose of CBD and always be wary of any abnormal side effects. In patients who are taking warfarin and have started CBD, it’s suggested to do regular laboratory tests, especially the INR test. If you experience any side effects, contact your medical practitioner at once.

Similar Medications: CBD & Blood Thinners

Warfarin is classified as an anticoagulant. CBD and most blood thinners share a similar risk of interaction and side effects.

Here’s a list of similar medications that share a similar level of risk when combined with CBD:

Is CBD A Viable Alternative to Warfarin (Coumadin)?

CBD is not a viable alternative to warfarin. These medications work through entirely different mechanisms and are used to treat different conditions altogether.

Some studies show that cannabis, the base ingredient of CBD, may have some anticoagulant properties [2]. A study performed on obese rats demonstrated that cannabis displays some anticoagulant activity.

It also showed that the cannabinoids cannabinol (CBN) and delta 9 tetrahydrocannabinol (THC) might also have anticoagulant abilities.

However, these effects are substantially weaker than the anticoagulant effects of warfarin and are therefore not suitable as a substitute for this prescription medication.

What is Warfarin (Coumadin)?

Warfarin, the generic name of the drug Coumadin, is a type of anticoagulant or blood thinners.

It’s a vitamin K antagonist that can decrease the rate of clotting of blood in the body.

Warfarin is used to treat and prevent blood clots in several conditions such as deep vein thrombosis, pulmonary embolism, etc. It’s used as a preventative for patients at risk of a stroke (such as those diagnosed with atrial fibrillation, valvular heart disease, or artificial heart valves).

Warfarin is also used to reduce the risk of death in patients with recurrent myocardial infarction (heart attack), stroke, and systemic embolism.

Coumadin is a prescription drug approved for use by the FDA in 2007.

Warfarin Specs:

Drug Name Warfarin
Trade Names Coumadin, Jantoven, Warf, Warfin, Farin, Fargem, Warco
Classification Anticoagulant
CYP Metabolism Major: CYP3A4 & CYP2C19. Minor: CYP1A22, CYP2D6, & CYP3A5
Interaction With CBD Metabolic inhibitor, agonistic
Risk of Interaction High

What Does Warfarin Do?

Warfarin is an anticoagulant. It was originally produced as rat poison, but its anticoagulant ability proved to be a valuable asset in treating hypercoagulable conditions. It was formally approved for human use in 1954 to treat blood clots.

Warfarin can disrupt the coagulation cascade and stop clot formations. It is a vitamin K antagonist that inhibits the production of vitamin K by using an enzyme called vitamin K epoxide reductase.

Warfarin blocks the liver from using vitamin k to make clotting factors. It can thin out the blood so that clotting time increases. It takes about three days for its abilities to take full effect. After this, however, it can take a few weeks to get a stable level of warfarin in the blood and get the body to settle on the correct dosage.

Warfarin stops the synthesis of biologically active forms of clotting factors II, VII, IX, and X. It also inhibits the synthesis of regulatory factors protein C, protein S, and protein Z. It does this by competitively inhibiting the vitamin K epoxide reductase complex 1 (VKORC1), an enzyme essential for activating the vitamin K in the body.

The precursors of these factors need their glutamic acid residues to undergo gamma-carboxylation. Gamma carboxylation is required so that the coagulation factors can bind to phospholipid surfaces inside blood vessels. The enzyme that allows the carboxylation of glutamic acid is gamma-glutamyl carboxylase.

Carboxylation reaction is possible only if the carboxylase enzyme converts vitamin k hydroquinone (a reduced form of vitamin k) to vitamin k epoxide. The vitamin k epoxide gets recycled back to vitamin K and vitamin k hydroquinone by another enzyme called vitamin k epoxide reductase.

Warfarin inhibits vitamin k epoxide reductase. This action leads to the diminishing of the available vitamin K and vitamin K hydroquinone in the tissues, which decreases the carboxylation activity of the glutamyl carboxylase. The drug works by inhibiting the formation of Vitamin K and making coagulation factors unable to work.

When this occurs, the coagulation factors are no longer carboxylated at some glutamic acid residues and are incapable of binding to the endothelial surface of blood vessels. This makes them biologically inactive. Hence, the coagulation factors are still being produced but have decreased ability to work.

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Warfarin needs to be adjusted according to individual needs, and the dosage may be increased or decreased depending on the response of the treatment. Dosing and adjusting warfarin can be complicated as it is known to interact with many medications. Regular laboratory tests, including international normalized ratio (INR), are mandatory after starting warfarin to monitor the coagulation levels in the body.

The risk factors of excess bleeding on using warfarin can be found in patients with high intensity of anticoagulation or high INR, age of over 65 years, highly variable INR, patients with a history of gastrointestinal bleeding, high blood pressure, serious heart disease, anemia, and renal insufficiency.

Warfarin is contraindicated in some conditions such as pregnancy, recent major surgery, thrombocytopenia, coagulation defects, decompensated liver disease, known hypersensitivity, and hemorrhagic tendencies.

Side Effects of Warfarin

  • Severe bleeding such as heavy menstrual bleeding and internal hemorrhage
  • Bleeding from gums, nosebleeds
  • Easy bruising
  • Red or brown urine
  • Black or bloody stool
  • Severe headache
  • Stomach pain
  • Joint pain
  • Joint swelling or discomfort
  • Vomiting blood or coffee-ground like materials
  • Coughing up blood
  • Abnormal bruising
  • Dizziness
  • Blood dyscrasias
  • Hepatitis
  • Weakness
  • Vision changes
  • Intracranial hemorrhage
  • Lethargy
  • Hypersensitivity
  • Purple toe syndrome
  • Renal injury
  • Taste disturbance
  • Flatulence
  • Hair loss
  • Intraocular hemorrhage
  • Warfarin necrosis
  • Osteoporosis
  • Valvular and vascular calcification

Other Names For Warfarin (Coumadin)

Warfarin is sold under many different names. All share the same risk and potential interactions.

Other names for warfarin include:

Key Takeaways: Is it Safe to Take Warfarin With CBD?

CBD carries a moderate to high risk of interaction with warfarin. The severity of this interaction can be life-threatening.

It can decrease its rate of metabolism, make it more potent, have a longer duration of action, and increase the chances of experiencing side effects. Therefore, it’s not recommended to take them together unless advised by your prescribing medical practitioner.

If needed, use only a minimal amount of CBD and always be on the lookout for any side effects.

CBD and Warfarin – August 2022

Warfarin (brand names: Coumadin, Jantoven) is an oral anticoagulant or blood thinner that is primarily used to help prevent and treat blood clots. It can also be administered to treat blood clots arising from certain heart conditions, heart attack, or open-heart surgery (4 ) .

Warfarin is metabolized by Cytochrome P450, also known as CYP450. It is a class of liver enzymes that play an essential role in the metabolism of warfarin and other medications before the drugs are cleared through the renal system (5 ) .

CYP450 includes CYP3A4, CYP1A1, CYP2C8, CYP1A2, CYP2C18, CYP219, and CYP2C69, which predominantly metabolize warfarin (6 ) .

Consequently, medications, treatments, and other factors that affect the CYP269 enzyme can also alter the effects of warfarin in the body (7 ) .

Like warfarin, CBD is metabolized through the hepatic P450 enzyme system. Both CBD and warfarin share similar proteins during their respective metabolism processes.

CBD is metabolized by the body through CYP1A1, CYP1A2, CYP2C19, CYP3A4, CYP2D6, CYP269, and CYP3A5, five of which are active enzymes that act on warfarin.

A 2017 study facilitated by the U.S. National Library of Medicine National Institutes of Health explained that CBD competes in a similar metabolic pathway with that of warfarin (8 ) .

CBD also acted as a powerful inhibitor of CYP3A4 enzymes, which can diminish the degradation of warfarin (9 ) . This is also known as the “grapefruit effect” as the grapefruit juice can also slow down the body’s absorption of warfarin (10 ) .

As such, taking warfarin together with CBD can make warfarin stay in the body for too long without being broken down. This may have detrimental effects such as bleeding, or worse, overdose (11 ) .

This is why regular measurement of a user’s international normalized ratio (INR) is necessary, more so when warfarin is taken with CBD. It ensures that the blood levels remain within a narrow range to avoid the side effects brought by warfarin.

Mayo Clinic presented a number of warfarin side effects that require immediate medical attention (12 ) :

  • Excessive bleeding, including heavy menstrual bleeding, nosebleed, and internal hemorrhage
  • Bloody or black stool
  • Brown or red urine
  • Reduced urine output
  • Bruises that appear even without suffering from any injury
  • Chronic pain in the stomach
  • Vomiting of blood
  • Changes in the vision
  • Unusual weakness, tiredness, or dizziness
  • Joint pain, swelling or discomfort, especially after experiencing an injury
  • Stupor

Other less serious side effects of warfarin are:

  • Bleeding between menstruation period
  • Gum bleeding after brushing the teeth
  • Vomiting, diarrhea, or being unable to eat for 24 hours or more
  • Fever

In rare cases, warfarin can also cause necrosis or death of skin tissue. Any changes in skin temperature or color, as well as severe pain on the skin, warrant prompt medical care. Be on the lookout for blotchy, net-like spots on the skin, too.

Pain in the toes, especially when they turn dark or purple in color, signifies a severe health problem.

Patients who intend to use CBD with warfarin must seek the advice of a licensed medical professional first to ensure that the drug interactions will be beneficial to their health.

Can Another Oral Anticoagulant Be a Substitute for Warfarin so CBD Oil Can Be Taken?

Among the remaining three oral anticoagulants approved by the FDA to treat irregular rapid heart rate, two are also metabolized by the CYP450 system. Thus, they can also be subjected to the grapefruit effect of CBD (13 ) .

These oral anticoagulants are rivaroxaban and apixaban (14 ) .

Meanwhile, a 2011 review explained that another approved oral anticoagulant, dabigatran (Pradaxa), does not undergo metabolism through CYP450. According to the review, dabigatran has shown a few drug-food and drug-drug interactions. Medical professionals are also considering dabigatran as a substitute for warfarin therapy (15 ) .

However, it is still best to schedule a consultation with a health professional before taking any anticoagulant along with CBD to ascertain safety and body tolerance.

The U.S. Food and Drug Administration or FDA has authorized the use of warfarin for the following purposes:

  • Treat clots that form in the vein (venous thrombosis) and associated pulmonary embolisms or blood clot in the lungs (16 )
  • Treat thromboembolic complications caused by cardiac valve replacement or irregular or rapid heart rate (atrial fibrillation) (17 )
  • Reduce the risk of death, recurrent heart attack or myocardial infarction (MI) and other thromboembolic events such as stroke and systemic embolism that may occur after a cardiac arrest (18 )

Can CBD Replace Warfarin?

There is no specific study or case report that directly expounds on CBD as a safe substitute for warfarin or any anticoagulants.

One study used an obese rat model to describe how cannabis extract could possibly contain anticoagulant effects is that of a 2007 study written in the journal Phytomedicine (19 ) .

The study showed that cannabinoids such as cannabinol (CBN) and tetrahydrocannabinol (THC) demonstrated anticoagulant activity (20 ) .

Thus, the authors suggested that Cannabis sativa and the cannabinoids THC and CBN can be potentially used to treat thrombosis and type 2 diabetes, a kind of ailment which could cause an irregular increase of blood clotting (21 ) .

Since there are limited studies on whether CBD can act as an anticoagulant, it is still best to ask a medical expert before considering CBD as a replacement for a prescription drug, and there is currently no evidence to suggest that CBD could be anticoagulant medications.

What to Look for in a CBD Product

There are several things to keep in mind before purchasing CBD products, the first of which is seeking a doctor’s approval. Once it is done, consider these action steps prior to buying any CBD product.

  1. Check the laws in the area where the product will be bought and consumed. In the United States, there are jurisdictions that have specific restrictions regarding the allowable THC content in CBD products.
  2. Take time to read reviews before buying from an online store. When buying from a clinic or a physical store, make sure that it is an authorized CBD seller by the government. Remember to purchase from reliable and legitimate brands only.
  3. Examine the additional ingredients. Some products include beneficial ingredients like MCT oils or melatonin. However, there are also CBD products that contain potentially dangerous ingredients such as vegetable glycerin and propylene.
  4. Determine the right dosage. CBD intake may be low dose or higher depending on the user’s condition.
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It is advisable to talk to a trusted and experienced medical professional who has deep knowledge about CBD to minimize probable risks and avoid side effects, especially because CBD has other verified drug interactions, too.

Studies show that aside from warfarin, CBD also inhibits the metabolism of other drugs, including clobazam, an anti-epileptic medicine (22 ) .

The grapefruit effect also applies to certain kinds of benzodiazepines, a class of prescribed medications for anxiety. Some of the benzodiazepines that are metabolized by the CYP450 system are alprazolam (Xanax), brotizolam, triazolam, and midazolam (23 ) .

An author and professor of medicine at Harvard Medical School, Peter Grinspoon, MD, warns the public through a Harvard Health article that CBD can cause nausea, irritability, and fatigue (24 ) .

In addition, Brent A. Bauer, M.D., medical editor of Mayo Clinic Book of Alternative Medicine , also explained that other side effects of CBD include diarrhea, reduced appetite, dry mouth, fatigue, and drowsiness (25 ) .

What food, supplements, and drugs interact with warfarin?

Warfarin, like other medications, can interact with vitamins, nutritional supplements, drugs, and food. The interaction might lessen the efficacy of warfarin or increase the risk of bleeding.

Aside from grapefruit, some of the typical food and drinks that can interact with warfarin are:

  • Garlic
  • Alcohol
  • Cranberry juice or cranberries
  • Pomegranate
  • Black licorice

Common herbal or nutritional supplements that might interact with warfarin include:

  • Dong Quai
  • Ginseng
  • Coenzyme Q10 (ubiquinone)
  • Green tea
  • St. John’s wort
  • Vitamin E

Some of the common drugs that have been identified to have warfarin interaction include:

  • Laxatives or antacids
  • Aspirin or any product that has aspirin
  • Antifungal medications like fluconazole (Diflucan)
  • Acetaminophen or any product that has acetaminophen
  • Several antibiotics
  • Allergy or cold medicines
  • Naproxen sodium (Naprelan, Aleve) or ibuprofen (Motrin IB, Advil)
  • Medications used to treat abnormal heart rhythms (Nexterone, Pacerone)

Some of the medical conditions that can also increase the risk of bleeding are:

  • Uncontrolled blood pressure
  • Stomach ulcer, peptic disease or gastritis
  • Cancer
  • Alcoholism
  • Kidney ailments
  • Liver disease
  • Increased risk of falling
  • Stroke history

The presence of the following ailments may affect the usage of warfarin:

  • Catheter insertion
  • Congestive heart failure
  • Anemia
  • Diabetes
  • Kidney disease
  • Blood disease called Polycythemia vera
  • Deficiency in Protein C
  • Thrombocytopenia (heparin-induced)
  • Bowel problems or stomach ache including bleeding
  • Inflammation of blood vessel (vasculitis)
  • Spinal anesthesia
  • Intestinal or stomach ulcer
  • Threatened miscarriage (patients who have this condition are strictly discouraged from taking warfarin)
  • Deficiency in Vitamin K
  • Malnutrition
  • Fats in the stool or steatorrhea
  • Diarrhea
  • Trauma

How to Minimize the Risk of Bleeding while Taking Warfarin

There are action steps that can be taken to lower the risk of bleeding while undergoing warfarin treatment:

  • Inform the attending physician of all the medications and supplements that a patient is taking. Doing so can help the doctor evaluate if further testing or dosage adjustment is needed, or if a new drug might alter the effect of the warfarin treatment.
  • Be cautious of injury, especially from falling. As much as possible, abstain from participating in contact sports that may cause bruising or physical damage. Report any chronic pain in case an injury occurred.
  • Keep away from sharp objects to avoid being cut.
  • Refrain from nose-picking and, if needed, gently blow the nose.
  • If a patient who is having warfarin treatment undergo surgeries or even minor procedures like dental cleanings or vaccinations, tell the assigned health care provider about it to ensure proper and safe medical attention.
  • Use a soft-bristled toothbrush, electric razor, and waxed dental floss for hygiene and grooming. Ask the physician for a safer way to clean the gums and teeth.
  • In case of emergency, it will be helpful if a patient has a card or note that says he is having warfarin treatment (and other medications, if any) so the medical providers can take the right course of action.

Understanding the Role of Vitamin K with Warfarin Treatment

Vitamin K is a nutrient that can lessen the effectiveness of warfarin. However, it is vital for the heart and bones. Consistency in Vitamin K intake is necessary when taking warfarin. A sudden increase in Vitamin K consumption can significantly increase clotting risk.

The recommended Vitamin K intake level for adult men and women is 120 micrograms (mcg) and 90 mcg, respectively.

Food and drinks that are rich in Vitamin K include:

  • Spinach
  • Kale
  • Collards
  • Chard
  • Mustard greens
  • Turnip greens
  • Broccoli
  • Asparagus
  • Plums
  • Asparagus
  • Rhubarb
  • Green tea
  • Brussels sprouts
  • Certain oils extracted from vegetables such as soybean oil and canola oil

Before making any changes in the diet, it is encouraged to consult a physician for proper guidance.

Conclusion

Cannabidiol or CBD is one of the chemical compounds found in the cannabis plant. It is a non-psychoactive substance, which means it will not make a person “high”. The body reacts to cannabinoids through the receptors in the endocannabinoid system.

Since CBD is absorbed by the body through the CPY450 system, which is also responsible for the metabolism of warfarin in the body, it is not recommended to take CBD and warfarin together. Doing so may cause the warfarin to stay longer in the body than necessary and may lead to harmful effects such as excessive bleeding and overdose.

Expert medical advice is highly encouraged before consuming CBD products either as a replacement for a prescribed drug or a nutritional supplement.

Yamaori S., Ebisawa J., Okushima Y., Yamamoto I., Watanabe K. Potent inhibition of human cytochrome P450 3A isoforms by cannabidiol: role of phenolic hydroxyl groups in the resorcinol moiety. Life Sci. 2011;88(15–16):730–736
Yamaori S., Koeda K., Kushihara M., Hada Y., Yamamoto I., Watanabe K. Comparison in the in vitro inhibitory effects of major phytocannabinoids and polycyclic aromatic hydrocarbons contained in marijuana smoke on cytochrome P450 2C9 activity. Drug Metab Pharmacokinet. 2012;27(3):294–300.
Deaton, J. G., & Nappe, T. M. (n.d.). Warfarin Toxicity. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK431112/
Mayo Clinic. (2020, February 1) Warfarin (Oral Route) Retrieved from: https://www.mayoclinic.org/drugs-supplements/warfarin-oral-route/description/drg-20070945
Lynch T, Price A. The Effect of Cytochrome P450 Metabolism on Drug Response, Interactions, and Adverse Effects. Am Fam Physician. 2007 Aug 1;76(3):391-396. Retrieved from https://www.aafp.org/afp/2007/0801/p391.html
Coumadin Product Data- FDA. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5789126/
Johnson J.A. Clinical pharmacogenetics implementation consortium (CPIC) guideline for pharmacogenetics-guided warfarin dosing: 2017 update. Clin Pharmacol Ther. 2017 (n/a-n/a); Whirl-Carrillo M., EMM, Hebert J.M., Gong L., Sangkuhl K., Thorn C.F. Pharmacogenomics knowledge for personalized medicine. Clin Pharmacol Ther. 2012;92(4):414–417; Wadelius M., Chen L.Y., Downes K., Ghori J., Hunt S., Eriksson N. Common VKORC1 and GGCX polymorphisms associated with warfarin dose. J Pharm. 2005;5(4):262–270. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5789126/
Yamaori and Koeda, op. cit.
Yamaori and Okushima, op. cit.
Grinspoon, P. (2019, Aug 27). Cannabidiol (CBD) — what we know and what we don’t. Retrieved from https://www.health.harvard.edu/blog/cannabidiol-cbd-what-we-know-and-what-we-dont-2018082414476 .
Deaton, J. G., & Nappe, T. M. (n.d.). Warfarin Toxicity. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK431112/
Mayo Clinic. Warfarin Side Effects: Watch for Interactions. Retrieved from https://www.mayoclinic.org/diseases-conditions/deep-vein-thrombosis/in-depth/warfarin-side-effects/art-20047592
Doliner B, Jaller JA, Lopez AJ, Lev-Tov H. Treatments to prevent primary venous ulceration after deep venous thrombosis. J Vasc Surg Venous Lymphat Disord. 2019 Mar;7(2):260-271.e1.
W., M., D., K., & M., B. (2013). Co-administration of rivaroxaban with drugs that share its elimination pathways: pharmacokinetic effects in healthy subjects. doi: 10.1111/bcp.12075.
Ganetsky, M., Babu, K. M., Salhanick, S. D., Brown, R. S., & Boyer, E. W. (2011). Dabigatran: Review of Pharmacology and Management of Bleeding Complications of This Novel Oral Anticoagulant, 7(4). doi: 10.1007/s13181-011-0178-y
Sharp CR, deLaforcade AM, Koenigshof AM, Lynch AM, Thomason JM. Consensus on the Rational Use of Antithrombotics in Veterinary Critical Care (CURATIVE): Domain 4-Refining and monitoring antithrombotic therapies. J Vet Emerg Crit Care (San Antonio). 2019 Jan;29(1):75-87.
Badjatiya A, Rao SV. Advances in Antiplatelet and Anticoagulant Therapies for NSTE-ACS. Curr Cardiol Rep. 2019 Jan 12;21(1):3.
Unger, E. F. (2015, October 16). Atrial fibrillation and new oral anticoagulant drugs. Retrieved from https://www.fda.gov/drugs/news-events-human-drugs/atrial-fibrillation-and-new-oral-anticoagulant-drugs
Coetzee, C., Levendal, R. A., van de Venter, M., & Frost, C. L. (2007). Anticoagulant effects of a Cannabis extract in an obese rat model. Phytomedicine , 14 (5). doi: 10.1016/j.phymed.2006.02.004
Anderson, L. L., Absalom, N. L., Abelev, S. V., Low, I. K., Doohan, P. T., Martin, L. J., … Arnold, J. C. (2019). Coadministered cannabidiol and clobazam: Preclinical evidence for both pharmacodynamic and pharmacokinetic interactions. Epilepsia, 60(11). doi: 10.1111/epi.16355.
Otani, K. Cytochrome P450 3A4 and Benzodiazepines. Seishin Shinkeigaku Zasshi. 2003;105(5):631-42. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/12875231
Grinspoon, P. (2019, Aug 27). Cannabidiol (CBD) — what we know and what we don’t. Retrieved from https://www.health.harvard.edu/blog/cannabidiol-cbd-what-we-know-and-what-we-dont-2018082414476 .
Bauer, B. A. (n.d.). What are the benefits of CBD — and is it safe to use? Retrieved from https://www.mayoclinic.org/healthy-lifestyle/consumer-health/expert-answers/is-cbd-safe-and-effective/faq-20446700

Table of Contents

  • Does CBD interact with warfarin?
  • Can CBD Be Taken with Warfarin?
  • Can Another Oral Anticoagulant Be a Substitute for Warfarin so CBD Oil Can Be Taken?
  • Can CBD Replace Warfarin?
  • What to Look for in a CBD Product
  • What food, supplements, and drugs interact with warfarin?
  • How to Minimize the Risk of Bleeding while Taking Warfarin
  • Understanding the Role of Vitamin K with Warfarin Treatment
  • Conclusion
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Dr. Aaron Wiegmann, BS, FL, MD, MS

Aaron Wiegmann, BS, FL, MD, MS is a general surgeon and scientist currently training to become a plastic and reconstructive surgeon. He practices in Chicago, where he was born and raised. He has several peer-reviewed publications (mostly on surgical outcomes).

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Can you consume CBD gummies along with Warfarin?

Warfarin is an anticoagulant that helps to prevent blood clot formation. It is mainly used to treat deep vein thrombosis, myocardial infarction, pulmonary embolism, etc.

On the other hand, CBD is present in marijuana and hemp plants to help treat insomnia, inflammation, anxiety, and more. Since Warfarin is a blood thinner, one of the most commonly asked questions is if it can be mixed with Sunday Scaries CBD gummies . We will discuss it thoroughly in the coming sections.

What is the impact of CBD on the body?

Many people use CBD oil because of the benefits that it has to offer. CBD is obtained from cannabis plants and can have numerous positive impacts on the body. Hemp-based oil has been legalized in many places. Nonetheless, the legality of marijuana-based CBD oil will vary significantly .

Contrary to popular belief, CBD isn’t addictive. Therefore, it can have different impacts on the body. CBD will not get you high and isn’t psychoactive. Nonetheless, CBD does the following benefits:

  • Treats acne
  • Weight management
  • Brain health
  • Relieves pain
  • Healthy for the cardiovascular system
Will CBD gummies interact with medicines?

There are numerous health supplements and herbal products that can interact with CBD. While you start using CBD gummies, you need to understand if they will interact with medicines. As a result, when you introduce CBD to your body, you will need to reduce the use of other drugs.

You should know that not every medicine can be taken together. Therefore, it is advisable to consult professionals before starting the use. The influence of drug interactions will have an essential role in determining if you should be using or not. Furthermore, it would help to consider the dose of medicine, your health condition, and CBD dosage . Talk to your doctor whenever you start using CBD gummies or any medicine.

Will CBD gummies interact with Warfarin?

Yes. Therefore, it is advisable not to consume CBD gummies with warfarin. The interaction will vary depending on the dosage of consumption. Since it can pose a high risk, you shouldn’t start usage unless you’re advised. The combination will have a slow impact on the body.

It will break down and eliminate warfarin from the body. As a result, your body will increase serum levels. If the serum concentration in your body increases, you will likely experience some side effects. These side effects require immediate medical conditions, or they can cause internal bleeding.

How do CBD gummies interact with Warfarin?

The CBD interaction with Warfarin usually happens in two ways. These include:

This condition happens when two medicines will require the same enzyme for metabolism. As a result, both will start competing against each other to get the enzyme. The metabolic inhibitor will lead to slower elimination. As a result, it will slow down the metabolism of both drugs.

The metabolism of Warfarin happens through CYP459 enzymes. However, the CYP2C19 and CYP3A4 enzymes play a significant part, whereas those with lesser impact include CYP2D6, CYP3A5, and CYP1A22.

These enzymes play an essential role in the metabolism of CBD as well. Therefore, when these two medicines are taken together, CBD gummies overpowers Warfarin. As a result, the body may notice the excessive accumulation of Warfarin, which may eventually lead to various side effects, mainly headache and bruising.

While the previous impact slows down, it can also lead to an increased effect that can be dangerous. This condition occurs because two drugs will have the same impact on the body. If these two medicines are used together, they will act upon the same receptor, causing directional impact.

Since CBD gummies are overpowering, it will take over Warfarin, thereby ensuring the latter’s accumulation in the body. When Warfarin stays in your body for a long time, it will become potent, increasing the risk of side effects.

Should you take CBD gummies with Warfarin?

No. As suggested above, CBD gummies and Warfarin can pave the way for a host of side effects. Over-accumulation of Warfarin in the body will cause most of the side effects. As a result, the process of blood clotting will become slow. Therefore, people will be prone to bleeding easily, increasing the risk of bruising and internal bleeding. Many people may also experience hemorrhage, even due to minor injuries.

Medical professionals recommend never to take these two medicines together. You should see a doctor before you start using CBD gummies with Warfarin. The same may be followed when using any other blood-thinning medicine. It is often advisable to start with a minimal dosage of CBD gummies.

Can CBD gummies replace Warfarin?

While CBD gummies are more potent than Warfarin, it shouldn’t be an efficient replacement. Every medicine works differently and can help treat different conditions. CBD as a base will often have an anticoagulant impact, and the anticoagulant impact due to CBD gummies is weaker than that of Warfarin. Furthermore, Warfarin is a prescription drug. Therefore, people can’t use CBD gummies as an alternative unless advised.

What increases the risk of internal bleeding?

However, the treatment of Warfarin can increase the risk of internal bleeding in the initial stages. However, the impact will be severely high for older adults, and it will have the same impact on various blood-thinning medicines.

Common conditions that may contribute to the increased risk of bleeding due to Warfarin usage include kidney problems, alcoholism, liver disease, stroke, blood pressure, gastritis, ulcer, and peptic disorders. Genetic factors are also an important point to consider. The doctor will be able to recommend genetic tests that can eventually help you understand what the best Warfarin dosage is.

Conclusion

If you plan to use CBD gummies and Warfarin together, you need to be familiar with the side effects. Our body will absorb CBD with the help of CPY450, which also impacts the absorption of Warfarin. Many times consistent usage can also increase the risk of fatality.

Before using any product, you must seek medical advice. The cbd cherry gummies can prove to be highly beneficial. However, it is always advisable to be familiar with the dosage quantity. Furthermore, it is advisable to go for only the tested products.

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