Daily Dose Q&A

2024-09-06

What is the most common mode of administration of CBD?

According to an online survey, the most common method of CBD administration was sublingual, followed by vaping, oral ingestion of capsules and liquids, smoking, edibles, and topical administration.

Corroon J, Phillips JA. A cross-sectional study of cannabidiol users. Cannabis Cannabinoid Res 2018; 3(1):152–61.

2024-09-05

Other than pill form, in what forms is CBD sold?

There are multiple CBD product types, including CBD oils (for oral/sublingual administration or vaporization), gummy candies, joint balms, creams, lotions, and capsules. CBD is also being sold in food products, beverages and healthcare goods, including hair products and skincare products. CBD has even been marketed as an ingredient in sleeping masks and dog treats.

“Ads Pitching CBD as a Cure-all Are Everywhere. Oversight Hasn’t Kept Up.” The New York Times, Aug 13, 2019 – https://www.nytimes.com/2019/08/13/business/media/cbd-marijuana-fda.html – accessed March 29, 2023.

2024-09-04

CBD interacts with warfarin. Does this drug:drug interaction lead to an increased risk of bleeding or a decrease in warfarin’s anticoagulation effect?

The inhibition of CYP2C19 by CBD can increase levels of warfarin, and multiple reports have indicated that the interaction between warfarin and CBD results in a greatly increased risk of bleeding.

Treese NM, Flowers M. Pharmacist’s guide to CBD oil. US Pharm. 2020; 45(3):20-23. Welty TE, Chapman KE, Faught RE, Kotloski RJ. American Epilepsy Society (AES): Written Comments to Norman E. “Ned” Sharpless, MD, Acting Commissioner of Food and Drugs, U.S. Food and Drug Administration (FDA), Department of Health and Human Services (HHS): on Docket ID# FDA-2019-N-1482, Scientific Data and Information about Products Containing Cannabis or Cannabis-Derived Compounds; Public Hearing; Request for Comments: Submitted on: July 16, 2019. Epilepsy Currents 2019; 19(6):361-368. doi:10.1177/1535759719878716

2024-09-03

Is cannabidiol (CBD) metabolized or excreted without being metabolized?

CBD is extensively metabolized in the liver by the cytochrome P450 enzymes CYP3A4 and CYP2C19. Of importance, approximately 60% of all prescribed medications are metabolized through CYP3A4, so there is a high potential for drug:drug interactions; drugs that induce or suppress CYP3A4 may affect the serum concentrations of CBD and CBD metabolites.

Balachandran P, Elsohly M, Hill KP. Cannabidiol Interactions with Medications, Illicit Substances, and Alcohol: a Comprehensive Review. J Gen Intern Med . 2021 Jan 29; doi: 10.1007/s11606-020-06504-8. Epub ahead of print. PMID: 33515191.

2024-08-30

It is often stated that CBD is not psychoactive and THC is psychoactive. Is that an accurate statement? Is CBD psychoactive?

Actually, both THC and CBD are psychoactive. By definition, a psychoactive drug is a substance that acts on the central nervous system where it alters brain function and neurotransmitter function, resulting in temporary changes in perception, mood, consciousness and behavior. Unlike THC, however, CBD does not induce euphoric feelings (a “high”) or induce hallucinations.

National Cancer Institute Dictionary. https://www.cancer.gov/publications/dictionaries/cancer-terms/def/psychoactive-substance.