What is Warfarin?
Warfarin is the most commonly used anticoagulation medication and is often referred to as a “blood thinner”, even though it is specifically aimed at preventing blood clots. Common medication brand names include Coumadin and Jantoven, and both medications are designed to encourage the healthy flow of blood and the decrease of certain protein levels within the body that could potentially cause blood clots.
Blood clotting can be especially dangerous to health, and is typically caused by:
- Heart diseases,
- Heart attacks, and
Warfarin is very different from other commonly prescribed medications (such as antidepressants) as it requires a greater level of attention in monitoring INR, or international normalized ratio. INR levels can only be monitored by medical professionals within a lab, putting greater strain on the patient to properly dose themselves and to use extreme caution in making changes to their regimen.
Oddly enough, warfarin is also an SSRI, a type of medication that is most common among antidepressants. Warfarin also carries a much higher side effect profile than other medications – causing bruising, increased bleeding, headaches, and even hair loss. As warfarin requires constant monitoring, the drug is very high-maintenance, and also poses risks when taken in conjunction with foods high in vitamin K (i.e. leafy vegetables like cabbages, kale, broccoli, and brussels sprouts).
CBD and Warfarin – A Lack of Research
In general, research is currently very limited on CBD and its reactions within the endocannabinoid system. However, research is even more limited on the role of CBD as an anticoagulant and any similar properties to THC that it may carry. Those seeking to experiment with CBD and warfarin should therefore proceed with great caution, and ensure that your medical professional is well-informed on any changes that could be made to your regimen.
A lack of research has posed a great sense of uncertainty among the CBD community, as well as uncertainty among some medical professionals who have joined in the online conversation. Based on the few studies that do exist, evidence seems to provide focus mainly on THC’s anticoagulant activities, rather than that of CBD’s. Even so, in one of these studies, it was observed that when a patient was administered CBD for epilepsy treatment there was also a 30% reduction in warfarin dose, thus maintaining “therapeutic INR values”.
The Greatest Source of Concern
As warfarin is considered an SSRI medication, it is important to note the effect CBD has on the P450 enzyme. This relationship is easily the single-largest concern of those considering CBD as an adjunct treatment to prescribed medications. In addition, the serious nature of blood clotting and blood clotting medications tends to pose concerns when experimenting with CBD dosage levels.
In relation to the P450 enzyme, taking CBD with warfarin may cause the warfarin to increase its potency, as CBD and warfarin use the same internal pathways to take effect within the liver. This could potentially cause unhealthy INR levels. However, this interaction isn’t always bad, and can also be obtained by consuming simple citrus fruits with SSRIs. CBD can also cause medications to become more effective, so much so that you can reduce the dosage of the other drugs, and thus experience less negative side effects.
Though scientific research is limited, some medical professionals have published their opinions online, stating through their own experiences that CBD rarely has such a serious effect on medications like warfarin. Others, however, voice cautious advice regarding CBD and the P450 enzyme and seem to be unsure about CBD’s relationship with the medication.
In forums where patients and their loved ones dominate the conversation, the general consensus seems to show a great apprehensiveness to the use of CBD with such drugs as warfarin. For example, one lengthy comment thread expresses mixed advice and experiences, yet a medical professional that joined in the conversation stated no serious after effects would be present as long as dosage was monitored carefully. On the other hand, another commenter on Reddit stated there was no change to her loved one’s INR levels, though she was only using a small dosage of CBD.
It is also important to note that newer anti-clotting medicines do not need INR monitoring and dose changes like warfarin does, however caution must still be taken. Because of this, it may be advisable to talk to your doctor about newer anticoagulant medications if you wish to introduce CBD into your daily routine.
Generally, concerns regarding simultaneous use of CBD and warfarin tend to hold more focus on the dangerous nature and risk of blood clotting itself, rather than CBD’s interactions with the P450 enzyme.
Along with very limited scientific research being available on the subject, it’s understandable that some may be apprehensive in using CBD in conjunction with such medications.