'If the Patient Information Leaflet that comes with your medication says to avoid grapefruit juice, for instance, then do not take CBD, as the same type of interaction can affect circulating blood levels of your medicine. Even if the leaflet does not mention grapefruit juice, you should still check with your doctor before taking CBD. You should also not take CBD if you are pregnant or breastfeeding.’
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To make matters more confusing, nine states (including California, Washington, and Colorado) let residents buy cannabis-based products with or without THC. Nearly two dozen other “medical marijuana states” allow the sale of cannabis, including capsules, tinctures, and other items containing CBD or THC, at licensed dispensaries to people whose doctors have certified that they have an approved condition (the list varies by state but includes chronic pain, PTSD, cancer, autism, Crohn’s disease, and multiple sclerosis). Sixteen more states legalized CBD for certain diseases.
CBD oil is most readily available as a tincture. This can be taken by applying a few drops under your tongue, holding in your mouth for a few moments so it can be absorbed, before swallowing. It can also be added to water or smoothies. A spray form is available (simply spritz under your tongue), as are capsules, gummies, creams that can be applied topically, and e-liquid for vape pens.
Putting this in perspective, eating a portion of grapefruit would have a similar effect on the aforementioned liver enzymes. So neutralizing P450 enzymes should be viewed as a minor side effect of cannabidiol. However, if you are taking pharmaceutical drugs and wish to take CBD, you should discuss any potential complications regarding reduced P450 enzyme activity with your doctor and/or pharmacist.