The World Health Organization released a report in 2017 in regards to Cannabidiol and one conclusion reads: “In humans, CBD exhibits no effects indicative of any abuse or dependence potential…. To date, there is no evidence of public health related problems associated with the use of pure CBD.” That powerful statement penned by the World In our latest question and answer, the pharmacist discusses whether or not CBD (cannabidiol) oil interacts with NyQuil. Marijuana should not be used with NyQuil because its two active ingredients, doxylamine, and dextromethorphan, have drug interactions with cannabis.
When Not to Take CBD
The World Health Organization released a report in 2017 in regards to Cannabidiol and one conclusion reads: “In humans, CBD exhibits no effects indicative of any abuse or dependence potential…. To date, there is no evidence of public health related problems associated with the use of pure CBD.”
That powerful statement penned by the World Health Organization is one of many that praises the potential of CBD to assist with a myriad of health issues in both humans and pets. However, there is an important question we all need to consider, “When should I not take CBD?”
Firstly, always consult with a doctor if you are on medications and interested in taking CBD.
Cytochrome P-450 Enzyme System
The Cytochrome P-450 Enzyme System is found in the liver and the system responsible for metabolizing the majority of any drugs taken. The drugs are broken down by the system and turned into simple substances that our body can use or lose. The system is comprised of over 50 different enzymes to handle the metabolization process. CBD, when taken at higher doses, can affect the metabolization rate of this system in turn shifting how and the rate in which drugs are metabolized. In addition to CBD, grapefruit, St. John’s Wort, Goldenseal and Watercress can also slow the system’s metabolization rate. A slower metabolization rate can result in toxic drugs lingering in our body. An example of lingering toxins: CBD when taken with Nyquil (which contains Doxylamine) results in a slower metabolization of Doxylamine and higher levels of drowsiness and impaired motor function.
More studies are required to determine dosages labeled as “high” and also more information is needed regarding how CBD interacts with the Cytochrome P-450 Enzyme System and metabolization rates. It is best, at this point, to consult a doctor on a case-by-case basis.
Common questions include: When and if it is safe to mix CBD with Tylenol? Can I take CBD and Xanex? Can I take CBD and Gabapentin? Can I take CBD and Benadryl? These are all great questions to be asking if you are taking pharmaceuticals. Consult your doctor or the pharmacist in your local pharmacy if you have concerns.
The Department of Medicine and Clinical Pharmacology has compiled a wonderful list of drugs that are linked (Clickable) to all the known inhibitors and Inducers. It is called the Drug Interactions Flockhart Table. An inducer can increase the metabolism of a drug while an inhibitor can block the metabolism of a drug.
Where to Buy CBD
Once a doctor gives the green light, ingesting CBD offers little to be concerned about just as the World Health Organization has pointed out. Can we reccomend our well loved Balance CBD Oil? The biggest concern you have as a consumer is about the CBD oil you choose to buy. Not all CBD oil is equal in quality. Be certain to read labels, familiarize yourself with CBD related terms and ask for lab tests and more information if you have questions. The CBD company you choose to purchase from should be clear, transparent and responsive. Someone… like us, we love to connect. Ask us questions and let’s discuss the healing benefits of CBD.
Does CBD Interact With NyQuil?
In our latest question and answer, the pharmacist discusses whether or not CBD (cannabidiol) oil interacts with NyQuil.
Can you take CBD oil and NyQuil together?
There is no known interaction between cannabidiol (CBD) and NyQuil. They are generally considered to be safe to take together.
However, there are very few studies evaluating potential drug interactions between CBD and other medication. Nevertheless, in studies that have been done, there has been no indication that CBD interacts with any of the ingredients contained in NyQuil.
Cannabidiol (CBD) – NyQuil Interaction Information
NyQuil is a combination ingredient medication containing:
- Acetaminophen (analgesic)
- Dextromethorphan (cough suppressant)
- Doxylamine (sedating antihistamine)
NyQuil is most commonly used to treat the symptoms of cold and the flu while also providing a mild sedative effect due to the sedating antihistamine (doxylamine) contained in the product.
Cannabidiol, also known as CBD, is a major component of cannabis (i.e. marijuana). While THC (delta-9-tetrahydrocannabinol) is likely more well-known due to its psychoactive effects, CBD makes up almost 40% of cannabis extracts and has a wide range of effects and potential benefits when used medicinally.
Due to the relative recent nature of CBD use for medicinal purposes (at least legally), there is a distinct lack of studies when it comes to potential drug interactions between CBD and other medication.
Most recent studies do indicate that CBD potentially affects many different metabolizing enzymes in the body. In fact, studies have shown that CBD can inhibit the following liver metabolizing enzymes:
Metabolizing enzyme inhibition often leads to increased concentrations of drugs that are typical substrates for a particular enzyme.
Most studies that show CBD inhibition of metabolizing enzymes do so only in a lab setting (i.e. in vitro). Often times when humans are evaluated in regard to CBD inhibition of metabolizing enzymes, the effects aren’t significant.
In fact, many echo the following sentiment of the authors of a recent study:
“In extensive clinical application including complex drug regimens with opioids, tricyclic antidepressants, anticonvulsants, etc., no drug-drug interactions have been observed that would contraindicate or preclude use of [THC/CBD containing products] with any specific pharmaceutical, although additive sedative effects are always possible. “
As more studies are completed, we will get a better understanding of potential clinically significant interactions with CBD. One recent 2017 study reported several drug-drug interactions with CBD that involved certain anti-epileptic medications including Onfi & Topamax. It still isn’t known however, how significant these interactions are.
As mentioned above, there are no such studies that looked at CBD and potential interactions with any of the ingredients in NyQuil.
One possible area of concern in using CBD with NyQuil is an increased feeling of sedation when using both together. NyQuil is used partly for its sedative effects and many studies indicate that CBD can cause mild hypnotic or sedative effects. However, as NyQuil is generally only taken at night time, the additive sedation doesn’t appear to be much cause for concern.
Does Marijuana Interact with NyQuil?
Combining the cold medicine NyQuil with marijuana is not known to be dangerous, but the sedative effects of NyQuil may be enhanced if the two are combined. NyQuil contains two active ingredients, doxylamine, and dextromethorphan, shown to have a moderate drug-drug interaction with cannabis. Acetaminophen (Tylenol, paracetamol), also in NyQuil, is not known to have any adverse reaction when combined with cannabis.
What Is NyQuil?
NyQuil is a trademarked medication used for pain relief and treating cold symptoms like sore throat and is available as a liquid or liquicap. It is sometimes sold with DayQuil, so NyQuil is considered the nighttime medication.
Such cold medications (anti-tussives) usually contain one or a combination of analgesics, antihistamines, and decongestants.
Uses and How It Works
NyQuil is a cold medicine usually taken to relieve some of the symptoms of the common cold, influenza, or other similar upper respiratory tract conditions. It contains three active ingredients:
- Acetaminophen (Tylenol, paracetamol): An analgesic relieves pain and reduces fever. Acetaminophen relieves inflammatory pain via the CB1 receptor, inhibiting the uptake and degradation of anandamide. The liver metabolizes acetaminophen into the cannabinoid, N-arachidonoylphenolamine.
- Dextromethorphan(Robitussin, Delsym): A cough suppressant with stimulant properties in lower doses and sedative properties in moderate to high doses. Dextromethorphan is in the morphinan and anti-tussive class of medications and has multiple mechanisms of action. Dextromethorphan acts as a nonselective serotonin reuptake inhibitor and a sigma-1 receptor agonist. Dextromethorphan is not only used for cough suppression but also for withdrawal associated with opioid use disorder and some instances of treatment-resistant major depressive disorder when combined with bupropion.
- Doxylamine (Unisom, Vicks Formula 44 in combination with Dextromethorphan) – an antihistamine used to treat sneezing, runny nose, itching, and inability to get to sleep. Doxylamine is an anti-cholinergic, meaning it blocks the action of the neurotransmitter called acetylcholine (ACh) at synapses in the central and peripheral nervous system (CNS and PNS). Anticholinergic drugs are often used to treat dizziness, GI disorders, insomnia, and various respiratory disorders (e.g., asthma, chronic obstructive pulmonary disorder or COPD, chronic bronchitis).
Potential Benefits and Risks of Mixing Cannabis and NyQuil
Although there seems to be no dangerous interaction between cannabis and NyQuil, both medications have sedative effects that can interact with each other.
- Cannabis-based medications such as cannabis oils and tinctures may reduce the need for NyQuil.
- Cannabis contains terpenes like pinene and eucalyptol, which have decongestant and soothing properties that could be useful for managing uncomplicated coronavirus infections.
- Cannabis has anti-inflammatory properties.
- Cannabinoids in cannabis, like cannabidiol (CBD) and tetrahydrocannabinol (THC), can desensitize liver enzymes metabolized through the cytochrome P450 pathway. This could potentially increase levels of doxylamine and dextromethorphan and increase the chances of adverse side effects such as dizziness, extreme drowsiness and sedation, nausea and vomiting, hypotension, hypertension (decrease or increase in blood pressure), sweating, fever, and many more.
- Smoking weed may cancel out NyQuil’s cough suppressant properties.
- Cannabinoids are immunomodulators that can dampen inflammation, and this can be useful in chronic conditions where inflammation is out of control (dysinflammation). Still, when battling infections in the short term, this may inhibit the immune system from doing its job.
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What to Do If You Need to Use Both NyQuil and Marijuana
Suppose you are suffering from a cold or flu and are using NyQuil. In that case, it is wise to reduce or even stop your cannabis use unless instructed otherwise (e.g., you are utilizing medical cannabis and CBD to reduce seizures or other health problems).
The Bottom Line
Although there are no known significant dangers when combining cannabis and NyQuil, it’s not a good idea for most people unless recommended by a doctor.
Two of the three active ingredients in NyQuil — doxylamine, and dextromethorphan — are listed as having a moderate drug-drug interaction with cannabis. This is because both have sedative effects that may increase when used together to treat temporary medical conditions in the body. Cannabis may also interfere with how the active ingredients in NyQuil are metabolized, increasing the chances of an adverse effect. Going beyond the recommended dose of NyQuil also causes several adverse effects, so it is best not to mix cannabis and NyQuil.
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Article written by
Dipak Hemraj Head of Research and Education
Dipak Hemraj is a published author, grower, product maker, and Leafwell’s resident cannabis expert. From botany & horticulture to culture and economics, he wishes to help educate the public on why cannabis is medicine (or a “pharmacy in a plant”) and how it can be used to treat a plethora of health problems. Dipak wants to unlock the power of the plant, and see if there are specific cannabinoid-terpene-flavonoid profiles suitable for different conditions.
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