CBD, or cannabidiol, is a chemical compound in the cannabinoid family found in cannabis. It has recently gained popularity due to its numerous potential therapeutic properties, such as alleviating chronic pain, treating epilepsy, and reducing stress and anxiety. However, before adding this beneficial natural supplement to your daily routine, it is essential to be aware of the potential interactions between CBD and medications, particularly co-prescribed ones like Lisinopril. In this article, we will first discuss the general aspects of how Lisinopril works, and then examine how CBD might interact with it. What is Lisinopril and when is it prescribed?
Lisinopril is an antihypertensive medication belonging to the class of angiotensin-converting enzyme (ACE) inhibitors. It is frequently prescribed in Europe under various brand names such as
Zestril, Prinivil, or Lisodura.
Lisinopril is primarily used to treat high blood pressure and heart failure, two conditions that can be life-threatening if left uncontrolled. ACE inhibitors work by blocking the action of the enzyme responsible for converting angiotensin, a hormone that causes blood vessels to narrow and blood pressure to rise. By preventing the production of this hormone, lisinopril promotes dilation of blood vessels and thus reduces the risks associated with hypertension.
Potential drug interactions with CBD
CBD is generally considered safe and well-tolerated by most users without causing significant side effects. However, when CBD is taken with certain other medications, it can lead to adverse effects resulting from altered metabolic behavior. Specifically, scientific studies show that cannabidiol can inhibit the activity of certain enzymes in the cytochrome P450 (CYP450) enzyme system found in the human liver. These enzymes are essential for breaking down infectious agents, toxins, and various medications, allowing their elimination from the body. Thus, if their function is impaired by CBD, the plasma concentrations of certain medications may be altered, potentially triggering an excessive or insufficient response.
Role of Cytochrome P450
One of the main roles of cytochrome P450 is to metabolize ingested medications and break them down into simpler components that can be eliminated by the body. When the CB1 cannabinoid receptor of the endocannabinoid system is activated, it can exert an inhibitory effect on certain CYP450 enzymes (including the CYP3A4 and CYP2D6 isoenzymes), thus disrupting their normal function.
- Interactions between CBD and the angiotensin-converting enzyme lisinopril (ACEI)
- To date, there is no precise scientific data regarding a direct interaction between CBD and lisinopril. However, we know that the antihypertensive molecule is primarily metabolized via the CYP3A4 isoenzyme of cytochrome P450. This enzyme is also responsible for the metabolism of approximately 50% of all medications on the market. The simultaneous intake of CBD and lisinopril could therefore theoretically alter the plasma levels of the latter in the body, either increasing or decreasing its concentration, depending on the patient’s individual biological parameters. CBD-induced enzyme inhibition: If CBD inhibits the action of the CYP3A4 isoenzyme involved in the metabolism of lisinopril, this could lead to an increase in the blood concentration of lisinopril. This could result in a stronger antihypertensive effect and an increased risk of hypotension, as well as other side effects such as dizziness, difficulty breathing, extreme fatigue, or kidney problems. A 2019 study showed that CBD can potentially significantly inhibit CYP3A4 activity.
Conversely, there is also a risk of decreased effectiveness of lisinopril if CBD stimulates cytochrome P450 enzymes responsible for its degradation. In this case, the molecule would be eliminated more rapidly from the body, leading to poorly controlled blood pressure and, in the long term, associated complications (heart failure, stroke, etc.).
However, it’s important to keep in mind that these hypotheses are based primarily on assumptions about how CBD and lisinopril affect the liver, and not on definitive conclusions from clinical studies conducted in humans. Furthermore, it’s crucial to note that everyone reacts differently to various compounds; therefore, it’s always best to consult a healthcare professional before starting CBD treatment in combination with other medications.
- What advice is there for users of CBD and lisinopril?
- If you wish to incorporate CBD into your daily routine while taking lisinopril, it is strongly recommended that you consult your doctor beforehand. They can help you determine if combining these two substances is safe and appropriate for your medical situation, and adjust the dosages if necessary.
Furthermore, when combining CBD and Lisinopril, patients are advised to: Strictly adhere to the dosage of both treatments, as well as the recommendations provided by their doctor.
