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Can CBD Enhance Antibiotics’ Effects?

Medical science and the pharmaceutical industry have both advanced with giant steps over the generations. But what has remained the same so far is what nature had provided for us.

While newly discovered and lab-designed medications may have become more improved, alongside surgical procedures, they are not without their side effects.

Unfortunately, nature always seems to find a way around these drugs and overpowers what man designs.

That is exactly what seems to happen – time and again – with new strains of microorganisms lifting their ugly heads every now and then.

However, the herbal medicines still seem to work just the same way it did all those centuries back.

Cannabis is one of such nature’s gifts that today’s researchers have finally been forced to acknowledge. Modern-day scientists have realized what the “healers” of the olden days were going on about.

If this sounds strangely preachy to you, we’ve got news for you!

Until recently, doctors and researchers would advise you against using CBD while being on antibiotics – this even after CBD was legalized in the US. Well, they had their reasons. Scientifically too!

However, all that changed with this new study that reveals that CBD can actually act like a “helper” or a booster to enhance the effects on antibiotic-resistant bacteria.

While all these may sound strange and contradictory to you, read on to understand what CBD does in our body and how it interacts with bacteria – at least some of them.

Can CBD and Antibiotics Be Taken Together?

Previously, there were concerns about using CBD alongside certain kinds of prescription medications. It was believed that CBD would interfere or interact with the pharmaceutical medications and cause worse side effects than the side effects of cannabinoids and prescription drugs combined.

Patients were, in fact, discouraged by their doctors, as well as the medical fraternity, including scientists and researchers, from using CBD along with antibiotics, among a long list of several specific types of medications (according to Indiana University Department of Medicine) that include:

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  • Steroids
  • NSAIDs
  • Antibiotics
  • Antihistamines
  • Prokinetics
  • HIV antivirals
  • Immune modulators
  • Benzodiazepines
  • Antiarrhythmics
  • HMG CoA reductase inhibitors
  • Calcium channel blockers
  • Anesthetics
  • Antipsychotics
  • Antidepressants
  • Anti-epileptics
  • Beta-blockers
  • PPIs
  • Angiotensin II blockers
  • Oral hypoglycemic agents
  • Sulfonylureas

It used to be common knowledge that one should never mix painkillers or antibiotics with alcohol or any other substance that may have a strong impact on our nervous system. And with good reason too.

Commonly known as the “grapefruit effect”, this indicates that if you’re unable to take grapefruits (and other related citrus fruits) alongside antibiotics, then you’d probably do well to stay away from CBD when you’re on these prescription drugs.

Cannabinoids, like most pharmaceutical drugs, utilize certain liver enzymes, found in the body’s cytochrome P450 system (CYP450 system), to break down to their basic compounds and get absorbed into the bloodstream.

This means that they may interact with each other and even interfere with each other’s actions. Even though cannabinoids may not have the same pathways from there on, there is still a chance that these two types of compounds can prove detrimental to the body by remaining stored over a longer period than they’re intended to do so.

Drug Interaction & Cytochrome P450 System

Ever since penicillin was discovered by Sir Alexander Fleming in 1928, antibiotics have proven to be effective life-saving drugs, protecting us from a wide range of bacterial infections.

Even today, millions of Americans are given these drugs by their doctors every year to fight a wide variety of bacterial infections. These antimicrobial drugs are can either prevent or protect from or treat a bacterial invasion.

Over time, however, many strains of bacteria have mutated to become immune to the effects of antibiotics, making them antibiotic-resistant. That is why the need for alternatives is always growing.

CBD has widely been accepted as a means to up your immunity. However, it has long been known that substances, like cannabinoids, should ideally be avoided while you’re on certain types of prescription drugs, which until recently included most antibiotics.

The reason for this understanding was based on the fact that our body’s CYP450 system, which metabolizes all potentially dangerous toxins, is responsible for breaking down over 60% prescription drugs (enlisted above).

The CYP system, located in the liver, is a purifying system that hosts a group of around 50 enzymes, which are responsible for removing toxins and metabolizing a wide range of medications, including antibiotics. According to the type of drugs and their dosage, this system takes varying periods to metabolize them.

Now the problem arises when a cannabinoid, like CBD, is introduced into the body. CBD has often acted as an inhibitor of the Cytochrome P450 system, changing the system’s normal metabolization of antibiotics. This is because CBD, too, requires the CYP450 enzymes to break down and reach the bloodstream (that is if CBD goes down the digestive system route).

Owing to this, there is the risk of overdosing on prescription drugs, as these drugs will remain stored in the body in the presence of this inhibitor until it is again able to get metabolized and enters the bloodstream.

This process has been emphasized and elaborated in quite a few studies, most of which are available in the public domain.

  • For instance, a July 2019 review, published in the Journal of Clinical Medicine, indicated that CBD use – medical or consumer-grade – can have adverse effects when taken alongside most conventional prescription drugs. Among the various reasons cited by the researchers, they also mentioned that some of the side effects of CBD in high doses (while maybe negligible on normal bodies) can be more enhanced in a person if those adverse effects are typical symptoms of that kind of disease (or bacterial attack).
  • A March 2019 research, published in the Medicines (Basel), pointed to the same issues. Researchers maintained that although “cannabinoids are usually well-tolerated”, they have “bidirectional effects”, especially when administered alongside metabolizing enzymes like Cytochrome P450 and UDP-glucuronosyltransferases. They particularly warned against giving CBD alongside such prescription drugs to the elderly, people with chronic diseases, or kidney and liver conditions.
  • Researchers of another 2019 review, published in the Journal of Clinical Psychopharmacology, also came to the same conclusion.

In spite of CBD’s well-established antibacterial properties, it has so far been considered unsafe to use CBD while being on antibiotics. This is even though CBD is a well-known and an effective immunity modulator.

Common antibiotics, like penicillin, have been found to be inhibitors of this system.

Will Every Antibiotic Interact with CBD?

Now, just because most prescription drugs, including antibiotics, interact with CBD, not all antibiotics would necessarily interact negatively with CBD.

Perhaps it is this understanding based on which a new narrative has emerged concerning antibiotic-resistant bacteria.

The Recent Studies Tell a Different – More Positive – Story!

A recent study has brought good news for doctors and patients who are suffering from diseases caused by antibiotic-resistant bacteria. While it was widely known that using CBD while being on antibiotics wasn’t a good idea, new research indicates that it is not only safe to use CBD alongside antibiotics, it even enhances the latter’s effects, improving their efficacy in treating the patient.

The research, ‘Cannabidiol is an effective helper compound in combination with bacitracin to kill Gram-positive bacteria’, published in the Scientific Reports by the scientists at University of Southern Denmark, and made available online in March 2020, shows how CBD acts as a ‘helper compound’, improving and enhancing the usual abilities of the antibiotics “bacitracin”.

For this study, the scientists reviewed the effects of CBD, alongside bacitracin on patients infected with Staphylococcus aureus bacteria.

CBD Acts as a “Helper” For the Antibiotics

Antibiotics, on which humanity depended for decades, have become much less effective, owing to the increasing resistance from the increasing number of mutated strains of bacteria.

This is why alternative strategies, like utilizing non-antibiotic ‘helper compounds’, are becoming critical to man’s survival.

The cannabinoid, CBD, has, so far, been effective in enabling humans to overcome many ailments by boosting the efficacy of the body’s endocannabinoids. That’s why this research looked into CBD’s potential for enhancing antibiotics’ effects.

During the course of the study, the scientists realized that their suspicions were right.

“If we combine an antibiotic with a helper compound, that enhances the effect of the antibiotic, we need less antibiotic to achieve the same effect. This may contribute to the development of fewer resistant bacteria,” Janne Kudsk Klitgaard, the Principal Investigator in the research said.

She added: “When we combined CBD and antibiotics, we saw a more powerful effect than when treating with antibiotics alone. So, in order to kill a certain number of bacteria, we needed less antibiotics.”

According to the researchers, the combination of CBD and antibiotics may be a novel treatment of infections with antibiotic-resistant bacteria.

“Cannabidiol is an effective helper compound in combination with bacitracin to kill Gram-positive bacteria,” Claes Søndergaard Wassmann, the first author of the research paper said.

How CBD “Helped” Bacitracin Fight Staphylococcus Aureus

A number of drug-resistant variants of the Staphylococcus aureus bacteria have surfaced, making them more infectious and harder to fight. Researchers, working on this study, got three kinds of results when patients, infected by this category of bacteria, were treated by the combination of CBD and antibiotic bacitracin.

  1. The bacteria could no longer divide normally.
  2. The expression of certain key genes in the bacteria was lowered. These genes were those that induce cell division and multiplication, as well as autolysis genes, i.e. those that generate enzymes to destroy the body’s cells.
  3. The bacterial membrane became unstable, leading to its destruction.

The researchers said that the main reason behind antibiotic resistance is the overuse of antibiotics by patients.

There have been a few studies in the recent past that have indicated that CBD can, in fact, boost the effects of antibiotics that have otherwise become ineffective on several strains of bacteria. Additionally, other cannabinoids, such as CBG, have also been found to be effective in improving antibiotics’ bacteria-fighting abilities.

Other Studies Reflecting CBD’s Anti-Bacterial Properties: With or Without Antibiotics

  • A joint study by research centers and universities from across the world that was submitted to the Molecular Bacterial Pathogenesis, a section of the journal Frontiers in Cellular and Infection Microbiology, where it was published in September 2019, comes to an interesting conclusion regarding the effectiveness of CBD, both without as well as in combination with specific antibiotics.

While their dosage and type of antibiotic may vary in cases of gram-negative and gram-positive bacteria, but CBD can still inhibit the bacterial activity and heighten the antibiotics’ effects on resistant bacteria to a great extent.

It was mostly found more effective against gram-negative bacteria when combined with antibiotics.

  • An Australian study last year found evidence of CBD alone being an effective antibiotic, killing all strains of antibiotic-resistant bacteria in a lab.

The study, led by Mark Blaskovich, PhD, senior research officer at the Centre for Superbug Solutions at the Institute for Molecular Bioscience at the University of Queensland in Australia, was submitted to the ASM Microbe, the annual meeting of the American Society for Microbiology.

The scientists found that the bacteria didn’t become resistant to CBD even after 20 days (the period bacteria takes to develop resistance to antibiotics).

While the study showed that CBD alone can’t do much to tackle gram-negative bacteria, it can, however, destroy gram-positive ones all on its own.

The researchers tested the CBD against some strains of staphylococcus, which can cause skin infections, and streptococcus bacteria, which cause strep throat.

They compared the effects of CBD with common antibiotics, like vancomycin and daptomycin. “We looked at how quickly the CBD killed the bacteria. It’s quite fast, within 3 hours, which is pretty good. Vancomycin (Vancocin) kills over 6 to 8 hours.”

[Gram-positive bacteria, like staphylococcus, cause serious skin infections, pneumonia, among other severe conditions, while gram-negative bacteria, includes bacteria like salmonella (found in undercooked foods) and E Coli (that causes urinary tract infections, diarrhea, and other ailments).]

Parting Thoughts

Even though it was widely accepted that antibiotics can’t be taken alongside CBD and vice versa, these recent studies hold the evidence that scientists and doctors have been looking for all this time.

While these studies do not prove that CBD can be used along with any and all antibiotics to treat all kinds of bacterial infection, this definitely presents a potential for future research as well as some solid evidence for the utilization of CBD along with certain antibiotics while trying to treat some specific bacterial infections.

Nevertheless, we must warn our readers that it’s always best to consult your doctor before you try out CBD or attempt to mix it with doses of antibiotics.

He would not only understand your predisposed conditions better than you, he would also the right person to judge if a particular formulation of pharmaceutical medication can have a beneficial or an adverse effect if taken alongside CBD.

Ivan writes about Cannabis at The Cannabis Radar. He has a degree in Nutrition Sciences from University of Oklahoma Health Sciences Centre. He likes to spend his spare time reading to his daughter or spending time with his wife.

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