CBD (Cannabidiol) With Bupropion Interaction

There is a potential interaction but the overall effect is complicated and not well understood.

CBD (Cannabidiol) With Bupropion Interaction
Jan 08, 2019

Marie asked

Is it safe to take CBD oil while on bupropion? I currently take bupropion once a day at night. 100 mg. Thanks!

At a glance

  • CBD (cannabidiol) can potentially inhibit or induce (i.e. increase the effects of) the metabolizing enzyme CYP2B6, which is responsible bupropion metabolism. This can have unpredictable effects, either increasing or decreasing the effects of the drug.

Answer

CBD With Bupropion

There is a potential drug interaction between CBD (cannabidiol) and bupropion, although just how severe or concerning it is isn't well known.

The concern is that taking CBD (cannabidiol) and bupropion together could significantly alter concentrations of bupropion in the body, resulting in either an increased risk of adverse reactions or decreased effectiveness of the drug.

The description of this concern is vague and unfortunately, there haven't been any studies that have specifically evaluated the use of bupropion and CBD together.

The interaction is more theoretical based on what we know about the metabolism and pharmacokinetic profile of each.

Interaction Mechanism

The potential mechanism behind the interaction is as follows:

  • Bupropion is a substrate of the enzyme CYP2B6; meaning that the drug is metabolized by it.
  • CBD (cannabidiol) may inhibit and/or induce CYP2B6.
  • If CBD inhibits CYP2B6, bupropion metabolism will be reduced.
  • If CBD induces CYP2B6, bupropion metabolism will be increased.

**Enzyme 'inhibition' refers to a decrease in enzyme effect. 'Induction' refers to an increase in enzyme effect.**

The prescribing information for Wellbutrin, a brand name product containing bupropion, warns about interactions with drugs that affect CYP2B6:

Bupropion is primarily metabolized to hydroxybupropion by CYP2B6. Therefore, the potential exists for drug interactions between WELLBUTRIN and drugs that are inhibitors or inducers of CYP2B6.

Preliminary studies show that CBD (cannabidiol) can both induce and inhibit CYP2B6.

Although there aren't many drug interaction studies to draw conclusions from, a prescription CBD product approved in 2018, known as Epidiolex, discusses potential interactions in the prescribing information for the drug and lists bupropion specifically:

Video Summary

References
  • Elsevier ClinicalKey: Cannabidiol Monograph (Accessed 1/10/19)
  • Elsevier ClinicalKey: Bupropion Monograph (Accessed 1/10/19)
  • A preliminary evaluation of the relationship of cannabinoid blood concentrations with the analgesic response to vaporized cannabis. PubMed (Accessed 1/10/19)
  • Differential inhibition of human cytochrome P450 2A6 and 2B6 by major phytocannabinoids. Link (Accessed 1/10/19)
  • Epidiolex Prescribing Information (Accessed 1/10/19)

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