Prevalence of Cannabidiol (CBD) Use Among Patients Taking Medications with Known Drug–Drug Interactions: A Cross-Sectional Analysis

Abstract

Introduction: Cannabidiol (CBD) is widely available over the counter for presumed medical and recreational purposes. Despite its non-psychoactive nature, CBD exhibits intrinsic pharmacological activity that may lead to potential adverse drug events (ADEs) and drug–drug interactions (DDI) with common prescription medications through cytochrome P450 inhibition. Due to their largely unregulated nature and widespread advertising, consumers who use CBD products may not be aware of these potential negative drug interactions. The purpose of this study was to determine how frequently patients who use CBD products concurrently take prescription medication with known drug–drug interaction (DDI) potential, and to identify specific therapeutic classes most commonly involved. Methods: In this cross-sectional study, a survey was distributed to patients and family members in the adult and pediatric Emergency Departments of a Level 1 Trauma Center in eastern North Carolina. Respondents reported household CBD use and selected from a list of conditions for which they take prescription medications. Results: Of 681 eligible respondents, 254 (37.3%) reported CBD use in their household (CBDUIH). Among those with CBDUIH, 69.7% reported concurrent use of 1 or more medications with a potential DDI risk. The most common categories of prescriptions were antidepressants (64.4%) and antihypertensives (41.8%), followed by agents for diabetes, hyperlipidemia, and immune disorders. Conclusions: The majority of CBD users in this population are concurrently taking medications with DDI potential, highlighting the need for patient and provider education, and improved labeling of CBD-based products to accurately reflect risks. Further study of clinically significant interactions is needed to determine which medications within these common categories have the most substantial risk of DDI.