Everything You Should Know About CBD Oil

MyDosage provides you with trustworthy and unbiased information about the use of cannabinoids. All based on the most recent science discoveries.

CBD Side Effects: The 5 Most Common Side Effects of CBD and What To Do

CBD and CBD Side Effects: The 5 Most Common Side Effects of CBD and What To Do

Cannabidiol, better known as CBD is arguably the most studied and therapeutically active cannabinoid found in the Cannabis sativa plant. CBD is also gaining a tremendous amount of users and devotees, swearing by it to help relieve the symptoms of a variety of physical and mental health conditions.

Especially amongst individuals who are looking for a safer, more natural yet effective treatment option, CBD is often replacing their traditional pharmaceutical drugs as both they, and a growing number of physicians, researchers and scientists, considers CBD to be a non-toxic, well-tolerated treatment option.

However, despite a lot of people tending to think of natural medicines such as CBD as being a hundred percent safe and without side effects, as with any type of therapeutic compound, CBD works because it interact with the body in very specific and profound ways. And because of this, for some people the powerful effects of CBD can unfortunately also cause some unpleasant side-effects.

What Are The Side Effects Of CBD?

If you’re using CBD from organically grown hemp (i.e., without pesticides, insecticides and GMO-free), side effects tend to be few and far between. Notwithstanding, they do exist for some people, so let’s take a look at what these are and how you can remedy them.

1. Tiredness, Drowsiness or Feeling Sleepy

For those users taking CBD for reasons other than insomnia, it is important to note that, although not a typical effect, you can become drowsy, especially after taking a high dose of CBD.

The reason for this is because CBD works differently for different people. In most users, CBD has a revitalising effect, making the user feel more alert and energetic. In others however, it can produce just the opposite effect. Especially in very high doses of 300 mg or more, some people report feelings of drowsiness and sleepiness after consuming CBD.

If CBD makes you drowsy, just like with other types of medications that cause this side effect, it is best NOT operate any heavy machinery or drive a vehicle – for your safety as well as those around you. You might also want to cut back on the dosage of CBD you are consuming to help reduce drowsiness, or try another product with a different cannabinoid profile.

2. Dry Mouth

Common among people who use any type of cannabinoid, dry mouth is a phenomenon that is also sometimes reported in CBD users.

If you sometimes feel like your mouth is stuffed with cotton balls after taking a dose of CBD, you might be one of those individuals who are prone to the “dry mouth” side effect. The reason this happens is because of the way in which cannabinoids such as CBD interact with the endocannabinoids system (ECS) which also have receptors in the salivary glands, inhibiting secretion.

If CBD gives you dry mouth, it’s pretty simple to remedy – just drink a glass or two of water, herbal tea or some other type of hydrating beverage. It might also be a good idea to try a different product type (i.e. switch from a vape to a water soluble CBD product.

3. Dizziness or Lightheadedness

Similar to drowsiness and although pretty rare, some people can feel dizzy or lightheaded after taking a dose of CBD.

The reason for this is that there is evidence that CBD oil can lower their blood pressure, an effect that can be useful in people suffering from heart disease, high blood pressure and even diabetes. However, for people who have a normal blood pressure, these hemodynamic changes can prove to be less beneficial.

People who suffer from low blood pressure or are taking blood pressure medications should consult a doctor before considering CBD oil as an alternative or complimentary treatment. If you have normal blood pressure but occasionally get the odd dizzy spell after a dose of CBD, drinking coffee can help. Similarly, try and take a lower dosage more often or try a slow release CBD product like a gel cap or try another product with a different cannabinoid profile which might counteract the blood pressure effect of CBD.

4. Changes in Appetite and Weight

Some people taking CBD over a prolonged period of time report that they experience changes in their appetite and/or weight.

A growing body of research is showing that CBD has the potential to regulate glucose levels in the body. Although this is great news for people suffering from diabetes or insulin resistance disorder, for users that do not have these kinds of issues, this can lead them to sometimes feel either more or less hungry. Similarly, over time changes in eating habits can also have an effect on weight.

Try and take a lower dosage more often or try a slow release CBD product like a gel cap or try another product with a different cannabinoid profile which might counteract this side effect. Also take your dosage with, or directly after your meal to help buffer CBD’s effect on blood sugar, and make sure to eat a health, balanced diet which will also help stabilize blood sugar and weight.

5. Digestive Changes and Diarrhoea

One of a group of commonly experienced side effects reported by CBD users is a change in their digestive function, most often diarrhoea.

As part of studying the general safety profile of CBD, researchers found that subjects reported experiencing some common side effects including diarrhoea. However, the researchers were quick to point out that these symptoms were mostly reported in patients using Epidiolex, and that often times it is was not possible to draw a reliable conclusion on the causation of the observed side effects because most of the patients were severely sick.

If you experience digestive changes and/or diarrhoea when taking CBD, the first thing to do is reduce your dosage. You can also try using a product with a different cannabinoid profile as the other cannabinoids might counteract this side effect. If this does not help, you might also want to have a check up with your doctor to, at the very least make sure there aren’t any complications such as dehydration resulting from the diarrhoea, but also eliminate other causes while helping you find the right dosage.

Key Takeaways

Considering the relatively few side effects and next-to-nothing chance of overdosing, CBD is undeniably an extremely attractive treatment option for many people – either complimenting and sometimes replacing their pharmaceutical drugs in favor of this natural alternative.

And despite some individuals experiencing some of the side effects discussed above, when using an organic, high quality and natural CBD product, CBD has repeatedly shown to be safe. Similarly, by making a few changes like decreasing dosage, changing the type of CBD product or trying a different profile of cannabinoids, most of the discomfort will decrease significantly, if not disappear completely.

Find your personalized CBD dosage

Answer several key questions and calculate the best CBD dosage for your needs with our AI algorithm based on proven science

The future of health

Share and help
your mother father brother sister relative friend

MyDosage isn’t just about you. It’s about all of us. Over time, the app will continue to learn which products and dosages deliver the best results for certain conditions. Meaning every time you give feedback, you’ll be helping someone else find their best dosage faster.

Learn from a trustworthy source

MyDosage provides you with trustworthy and unbiased information about the use of cannabinoids. All based on the most recent science discoveries.

Join our weekly newsletter in which we share the top stories form the world of CBD.

Everything You Should Know About CBD Oil

Cannabidiol (CBD) is a cannabinoid that is mixed with a carrier oil to make CBD oil.

Cannabinoids act on the body’s endocannabinoid system to regulate anxiety, mood, and appetite. CBD is extracted from cannabis plants (e.g., Cannabis indica, Cannabis sativa, and Cannabis ruderalis). However, the hemp plant (Cannabis ruderalis) typically contains higher quantities of CBD.

The other main component of Cannabis indica and Cannabis sativa species–but not typically Cannabis ruderalis—is delta-9-tetrahydrocannabinol (THC).

THC can cause a sense of euphoria but can also cause other sensations, like paranoia. CBD oil should not contain more than 0.3% THC, so it does not typically cause a feeling of euphoria—so many people assume it’s safe, although it may not be, especially for specific populations.

See also  What Cbd Oil Is Best For Dementia?

cbd oil

CBD products are of interest to researchers and consumers. One source projected that the products may make more than $20 billion in the United States alone by 2024. CBD has been studied for its use in seizures, chronic pain, anxiety, inflammation, and more. However, varying levels of scientific evidence exist for these claims, meaning it’s unclear if CBD works for these conditions.

Note that CBD oil is different from hemp oil. Hemp oil is processed differently (pressing hemp seeds) and typically contains no CBD.

Here’s the latest evidence on over-the-counter CBD—its uses, interactions, and what to remember if you decide to try it.

Product Facts

  • Active ingredient(s): Cannabidiol
  • Alternate name(s): Cannabis, Cannabis ruderalis extract, hemp plant extract
  • Legal status: Prescription drug (Epidiolex), legal in most states, not considered a dietary supplement by the FDA (FD&C Act).
  • Suggested dose: Varies based on condition. CBD is not meant to prevent, treat, or cure disease.
  • Safety considerations: Contraindicated in pregnancy and breastfeeding, not for use in children, interacts with alcohol and many prescription medications.

Uses of CBD Oil

Supplement use should be individualized and vetted by a healthcare professional, such as a registered dietitian, pharmacist, or healthcare provider. No supplement is intended to treat, cure, or prevent disease.

Proponents of CBD oil claim that it benefits people with various health problems. As CBD has gained popularity, researchers have been trying to study it more—but so far, human trials remain sparse. There is little evidence to support its myriad health claims.

Here’s a deeper dive into CBD oil’s more compelling health benefits.


In June 2018, the FDA approved a CBD oral solution called Epidiolex. Epidiolex is a prescription drug, not an over-the-counter (OTC) product.

Epidiolex is used to treat two rare forms of epilepsy in children under 2 years: Dravet syndrome and Lennox-Gastaut syndrome. These rare genetic disorders cause lifelong seizures in the first year of life.

In 2020, it was also approved for tuberous sclerosis complex, a rare genetic condition that causes benign tumors to grow throughout the body, often accompanied by seizures. Epidiolex is approved for use in people 1-year-old and older for all three of these disorders.

Besides these three disorders, CBD’s effectiveness for treating seizures is unknown. Even with Epidiolex, it’s unclear whether the anti-seizure effects are from CBD or another factor.

Keep in mind that Epidiolex is not a supplement. It requires a prescription from a healthcare provider. CBD products, on the other hand, are not regulated or standardized. And so far, they have not shown benefit in treating seizures.


CBD might help treat anxiety disorders, although there have not been many trials to look at CBD’s anxiety-relieving effects in humans.

In one study, 57 men took either CBD oil or a sugar pill with no CBD (placebo) before a public-speaking event. The researchers assessed the participants’ anxiety levels using blood pressure and heart rate measures. The researchers also used a reliable test for mood states called the Visual Analog Mood Scale.

The men who took 300 milligrams of CBD oil reported less anxiety than the men who were given a placebo; however, the men who took 100 or 600 milligrams of CBD oil did not experience the same effects. This trial was limited by a small sample size and only enrolled men, so more data is needed to see if CBD has a similar impact on women.

In another double-blind placebo-controlled study (meaning neither participants nor researchers knew who took the substance and who took a placebo), CBD was also shown to decrease symptoms of Social Anxiety Disorder in teenagers. This study was well-designed but very small-only 37 people were studied.


Preliminary studies about CBD’s effects on addiction have shown mixed results.

A small randomized controlled trial in fifty people with heroin use disorder showed benefits from CBD at 400 and 800 milligrams doses. People receiving CBD vs. placebo (a sugar pill) showed less anxiety and decreased cravings for heroin. More robust trials are needed to determine the safety and effectiveness of CBD oil for this use.


In a randomized controlled trial of 88 people already taking medication for schizophrenia, 1,000 milligrams per day of CBD oil decreased positive psychotic symptoms (hallucinations or delusions). However, there were no significant differences between CBD oil and placebo regarding negative psychotic symptoms (like blunt affect or disinterest in others).

Also note that CBD oil was studied as an add-on therapy here since the people in the trial were already taking prescription medicines to treat schizophrenia.

Products with significant amounts of THC may worsen symptoms of psychosis, schizophrenia, and paranoia.

Although the data is preliminary, CBD oil has also been studied for the following, some with little to no evidence of benefit:

  • Acne
  • Arthritis
  • Autism spectrum disorder
  • Chronic pain
  • Depression
  • Digestive disorders
  • High blood pressure
  • Insomnia
  • Parkinson’s disease
  • Skin conditions like eczema and psoriasis

Most of these studies were performed on animal models, so similar results may or may not be seen in humans. There is not enough data to recommend CBD oil for any of these uses just yet.

CBD Oil vs. Marijuana
CBD Oil Marijuana
A component of the hemp plant Separate plant in the hemp family that contains CBD and hundreds of other compounds.
No or trace amounts of THC (0.3% or less) Significant amounts of THC
Works receptors in the brain, but not those that induce psychoactive effects (e.g., opioid receptors that help control pain, glycine receptors that impact mood control) THC binds to cannabinoid receptors in the brain to create a “high” feeling

What Are the Side Effects of CBD Oil?

Clinical research has shown that CBD oil can cause side effects. In one study, 91% of people with seizure disorders who took the prescription product Epidiolex had side effects from the medicine. The specific side effects and their severity vary from one person to the next and from one type of CBD to another.

Common Side Effects

The most common side effects of CBD oil that were reported include the following:

  • Change in appetite
  • Drowsiness or fatigue
  • Diarrhea
  • Change in liver enzymes

Severe Side Effects

Severe side effects have been noted in people with treatment-resistant epilepsy (ongoing seizures despite multiple medications). These include:

  • Status epilepticus (a life-threatening medical emergency where a seizure lasts longer than five minutes)
  • Pneumonia (infection of the air sacs in the lungs)

Also, consider that CBD products are not regulated and may be adulterated or labeled misleadingly. One study found that 21% of CBD products sold online also had THC. Severe side effects of THC, particularly at doses above 2.4 milligrams, can be quite severe and include:

  • Anxiety
  • Impaired cognition (lowered IQ scores and memory loss)
  • Psychosis (including suspiciousness, emotional withdrawal, and hallucinations)

If you notice these effects while using CBD oil, discontinue and discuss side effects with a healthcare provider as soon as possible.

Adolescent users are at increased risk of psychological disorders from THC. These psychological disorders include an increased risk of psychosis and schizophrenia.

Do not drive or use heavy machinery when taking CBD oil—especially when you first start using it or switch to a new brand. Remember that some products do contain THC, even in small amounts.


Your healthcare practitioner may advise against using CBD oil if you:

  • Have liver disease: CBD oil may increase liver enzymes, a marker of liver inflammation. Talk with your healthcare provider before taking CBD oil. You may need to check your liver enzymes regularly if you use CBD.
  • Have eye issues: CBD oil may also cause eye-related side effects. A 2018 study found that it may increase pressure inside the eyes. For people with glaucoma, this can make the condition worse. Some people also report dry eyes as a side effect of CBD oil.
  • Are pregnant or nursing: You should not use CBD oil if you’re pregnant or breastfeeding. Even though the effects of CBD are not fully understood, it does pass through the placenta. The American Academy of Pediatrics (AAP) further states that pregnant people should not use marijuana products because of the potential risks to developing fetuses.
  • Drink alcohol or take other sedating medications: Using CBD with these drugs could cause excess drowsiness.
  • Children: Children should not use CBD oil.

Dosage: How Much CBD Oil Should I Take?

Always speak with a healthcare provider before taking a supplement to ensure that the supplement and dosage are appropriate for your individual needs.

There are no guidelines for CBD products or a “correct” dose of CBD oil. CBD has been used in doses ranging from 40 to 1,280 milligrams per day. For example, in one trial, patients admitted to the emergency room for acute back pain were given a one-time dose of 400 milligrams of CBD oil.

In another trial, schizophrenic patients were given 600 milligrams per day of CBD oil for six weeks. As a general rule, never take more than the recommended dose.

What Happens If I Take Too Much CBD?

Doses of up to 1,500 milligrams per day seem well-tolerated in adults. Keep an eye out for serious side effects like fatigue, changes in appetite, seizures, or pneumonia. And keep in mind that CBD may be adulterated and contain ingredients that are not listed, such as THC, and may not contain the amount of CBD listed on the bottle.

See also  Wild Lettuce: Does It Provide Natural Pain Relief?

Children can be especially vulnerable. Dangerously slowed breathing has been noted in children who unintentionally ingested too much CBD oil.

CBD is also found in many foods and drinks in the US, so if you plan to consume these, discuss your total daily dose with your healthcare provider.

If you have questions or concerns about the use or unintended (accidental) ingestion of CBD products, please contact your healthcare provider, health department, or local or regional Poison Control Center at 800-222-1222. Call 911 if there’s an emergency.


CBD oil can interact with medications, including many used to treat epilepsy. One of the reasons for this has to do with how your body breaks down (metabolizes) drugs.

Cytochrome P450 (CYP450) is a liver enzyme your body uses to break down some drugs. CBD oil is broken down by and can also affect CYP450. That means taking CBD oil with these drugs could have a more substantial effect than you need or make them not work as well.

Drugs that could potentially interact with CBD include:

  • Anticonvulsants like phenobarbital, Lamictal (lamotrigine), Onfi (clobazam), Dilantin (phenytoin), Tegretol (carbamazepine) and Trileptal (oxcarbazepine). In general, these will decrease the level of CBD. CBD increases lamotrigine levels.
  • Antidepressants like Paxil (paroxetine), Celexa (citalopram), Remeron (mirtazapine), and Tofranil (imipramine). CBD may increase the levels of these medicines and exacerbate their side effects.
  • Antifungals like ketoconazole
  • Antipsychotics like Haldol (haloperidol)
  • Benzodiazepine sedatives like Klonopin (clonazepam), Ativan (lorazepam), and Valium (diazepam). CBD decreases the effect of clonazepam and increases the impact of the others, which may increase side effects like drowsiness.
  • Echinacea species
  • Erectile dysfunction drugs like Viagra (sildenafil)
  • Immune-suppressants like Sandimmune (cyclosporine). CBD may increase the levels of these drugs.
  • Macrolide antibiotics like clarithromycin
  • Opioid painkillers like morphine. CBD increases the effect of morphine.
  • Rifampin-based drugs used to treat tuberculosis.
  • Statins to treat cholesterol like Lipitor (atorvastatin) and Zocor (simvastatin)

Always tell your healthcare provider and pharmacist about all your medicines, including prescription, OTC, herbal, or recreational drugs. Alcohol or other recreational drugs that cause drowsiness may have increased side effects if used with CBD oil.

The interactions between these medications and CBD may be mild, and you might not have to change your treatment. However, in some cases, you might have to change drugs or space out your doses to avoid a reaction. Never change or stop medication without talking to your provider.

It is essential to carefully read a product’s ingredient list and nutrition facts panel to know which ingredients and how much of each ingredient is included. Please review this supplement label with your healthcare provider to discuss potential interactions with foods, other supplements, and medications.

How to Store CBD Oil

Store CBD oil in a dark, dry place. Refrigeration may help it to stay stable for a more extended period. For prescription Epidiolex, discard 12 weeks after opening the bottle. Discard after one year or as indicated on the packaging.

Keep this drug and all medications out of the reach of children and pets.

Similar Products

Other cannabinoids that are isolated from the cannabis plant are popping up in dispensaries and pharmacies, including the following:

  • CBC (cannabichromene)
  • CBDV (cannabidivarin)
  • CBG (cannabigerol), touted for digestive diseases
  • CBN (cannabinol)

These products have very little evidence to support their use. More research is needed to clarify their safety and effectiveness.

Supplements that are not cannabinoids but that act in similar ways include:

  • Palmitoylethanolamide (PEA): Targets similar pathways as CBD and may help with inflammation and pain
  • Echinacea: May help with anxiety
  • Kava: May help with anxiety and sleep by acting on the endocannabinoid system
  • Valerian
  • Passionflower
  • German chamomile
  • L-theanine
  • Magnesium
  • Melatonin

Frequently Asked Questions

  • Isolates contain only CBD.
  • Broad-spectrum oils have nearly all of the components of the plant (e.g., proteins, flavonoids, terpenes, and chlorophyll) but do not have THC.
  • Full-spectrum oils have all the compounds, including THC (up to 0.3%)

While some healthcare practitioners believe that the compounds provide more health benefits, there’s a lack of evidence to support these claims.

Not necessarily. While the names are sometimes used interchangeably, hemp oil can also refer to hemp seed oil, which is used for cooking, food production, and skincare products. CBD oil is made from the leaves, stems, buds, and flowers of the Cannabis indica or Cannabis sativa plant. It should contain less than 0.3% THC. Hemp oil is made from the seeds of Cannabis sativa and does not have TCH in it.

Yes. It’s possible to overdose on CBD oil, especially in children. Dangerously slowed breathing has been noted in children who unintentionally ingested CBD oil. It’s important to remember though that many CBD products have been found to also contain THC, which poses risks like heightened anxiety when taken at high doses.

Can I buy CBD oil in all US states? Is traveling with it between states okay?

The legality of buying and selling CBD is quite murky. In 2018 it became legal to sell CBD oil that comes from the hemp plant and has less than 0.3% THC in it provided it is not marketed as a dietary supplement or claiming to treat medical conditions. Most states now allow the sale of CBD with low levels of THC, though it is still illegal in some states. For state-specific guidelines before traveling, check out a site like State Medical Cannabis Laws from the National Conference of State Legislatures. Some states do not allow CBD that has been purchased in other states.

How can I make sure the product I buy is of high quality?

Choose products with a certificate of analysis (COA) from an independent lab and/or from companies with current Good Manufacturing Practices (cGMP) certification. The COA means that the product has been tested for CBD and THC levels, along with possible contaminants. Because CBD comes from a plant, it is susceptible to chemicals like pesticides. Make sure the lab making the product also meets ISO 17025 standards, which shows high scientific standards are met. The FDA has issued several warning levels to companies whose products are mislabeled or adulterated (they contain potentially unsafe ingredients that can make you sick). Check them out here and avoid buying these products if possible.

Studies have shown that pure CBD will not cause a positive urine drug screen, as these are designed to measure THC. However, CBD products such as full-spectrum oils that contain THC may result in positive drug tests.

Not enough is known about CBD use in animals. Always discuss with a veterinarian before using a CBD product for your pet. The FDA suggests keeping an eye out for the following side effects: sleepiness, depression, heavy drooling, vomiting, agitation, tremors, and convulsions.

As mentioned, CBD oil is from a plant (hemp, typically Cannabis ruderalis). Hemp is in the same family as the marijuana plant. However, CBD oil does not typically produce the feelings of euphoria that can make someone feel “high.” The reason why is that it does not contain enough tetrahydrocannabinol (THC). THC is the compound responsible for causing euphoria and other potential emotions, like paranoia.

Sources of CBD Oil and What to Look For

CBD can be derived from two types of cannabis plants—marijuana, which has a higher amount of THC, or hemp, which has a low amount of THC. Since 2018, the FDA has allowed CBD products to be sold as long as they have less than 0.3% THC. [cite] The FDA has made it illegal for companies to market CBD as dietary supplements or to claim that they treat specific conditions.

Remember that CBD oils are unregulated. There’s no guarantee that a product is what it claims to be on its packaging. You also can’t know for sure that it’s safe and effective.

A 2017 study reported that only 31% of CBD products sold online were correctly labeled. Most had less CBD in them than was advertised, and 21% had significant amounts of THC.

Food Sources of CBD Oil

It is illegal to add CBD oil to food or drinks because an approved prescription product is available (Epidiolex for seizures). However, despite FDA warnings, CBD oil has increasingly been added to foods and beverages and can be found in different products such as coffee, chocolate, and sparkling water.

CBD is thought to be absorbed better if taken with a meal higher in fat. CBD is lipophilic, meaning it dissolves best with fat.

CBD Oil Products

Available forms of CBD run the gamut and include:

  • Tinctures (CBD oil mixed with a base oil)
  • Capsules
  • Tablets
  • Gummies
  • Sprays
  • Creams
  • Gels
  • Inhalation liquids (vape pens)
  • Suppositories

Which product you choose primarily depends on your preference and what you hope to get in terms of effects. How fast your body absorbs the oil varies based on how it’s administered. For example, CBD starts to act within five minutes when it’s vaped vs. up to an hour when taken by mouth.

Note that vaping is harmful to both your body and anyone that you vape around due to secondhand exposure to toxins.

See also  7 of the Best CBD Creams for Pain Relief in 2023

Each product works a bit differently, depending on the form, so following the directions and making healthier choices are essential.


The FDA does not regulate CBD oil, and contrary to popular opinion, it does come with some risks. Until more research is done on CBD oil, it’s important to remember that it may not live up to the hype and could even be dangerous. CBD products have not shown strong evidence of benefit for most of the advertised conditions.

There is significant variability among the products you’ll find at dispensaries, smoke shops, or online. Each product can contain very different amounts of CBD or THC than what’s listed on the package and can also contain harmful additives.

If you choose to use CBD oil, always discuss it with your healthcare provider to ensure it doesn’t interact with your prescription medications. CBD is not appropriate for pregnancy, breastfeeding, or in children.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

  1. Lowe H, Toyang N, Steele B, Bryant J, Ngwa W. The Endocannabinoid System: A Potential Target for the Treatment of Various Diseases. International Journal of Molecular Sciences. 2021;22(17):9472. doi:10.3390/ijms22179472
  2. O’Mathúna D, Larimore WL. Dietary Supplements – The Wild West of Good, Bad, and a Whole Lotta Ugly. The Medical Clinics of North America. 2022;106(5):881-898. doi:10.1016/j.mcna.2022.03.004
  3. Balachandran P, Elsohly M, Hill KP. Cannabidiol Interactions with Medications, Illicit Substances, and Alcohol: a Comprehensive Review. Journal of General Internal Medicine. Published online January 29, 2021. doi:10.1007/s11606-020-06504-8
  4. Food and Drug Administration. FDA Regulation of Cannabis and Cannabis-Derived Products, Including Cannabidiol (CBD).
  5. Food and Drug Administration–Office of the Commissioner. What You Should Know About Using CBD When Pregnant or Breastfeeding.
  6. Centers for Disease Control. CBD: What You Need to Know.
  7. Wiley JL, Gourdet CK, Thomas BF. Cannabidiol: Science, Marketing, and Legal Perspectives. Research Triangle Park (NC): RTI Press; April 2020
  8. U.S. Food and Drug Administration. FDA approves first drug comprised of an active ingredient derived from marijuana to treat rare, severe forms of epilepsy. June 25, 2018.
  9. Food and Drug Administration. FDA Approves New Indication for Drug Containing an Active Ingredient Derived from Cannabis to Treat Seizures in Rare Genetic Disease
  10. Peruca E. Cannabinoids in the treatment of epilepsy: hard evidence at last?J Epilepsy Res. 2017 Dec;7(2):61-76. doi:10.14581/jer.17012
  11. Blessing EM, Steenkamp MM, Manzanares J, Marmar CR. Cannabidiol as a potential treatment for anxiety disorders. Neurotherapeutics. 2015;12(4):825-36. doi:10.1007/s13311-015-0387-1
  12. Linares IM, Zuardi AW, Pereira LC, et al. Cannabidiol presents an inverted U-shaped dose-response curve in a simulated public speaking test. Braz J Psychiatry. 2019 Jan-Feb;41(1):9-14. doi:10.1590/1516-4446-2017-0015
  13. Masataka N. Anxiolytic Effects of Repeated Cannabidiol Treatment in Teenagers With Social Anxiety Disorders. Frontiers in Psychology. 2019;10. doi:10.3389/fpsyg.2019.02466
  14. Prud’homme M, Cata R, Jutras-Aswad D. Cannabidiol as an intervention for addictive behaviors: a systematic review of the evidence. Subst Abuse. 2015;9:33-8. doi:10.4137/SART.S25081
  15. Hurd YL, Spriggs S, Alishayev J, et al. Cannabidiol for the Reduction of Cue-Induced Craving and Anxiety in Drug-Abstinent Individuals With Heroin Use Disorder: A Double-Blind Randomized Placebo-Controlled Trial. American Journal of Psychiatry. 2019;176(11):911-922. doi:10.1176/appi.ajp.2019.18101191
  16. McGuire P, Robson P, Cubala WJ, et al. Cannabidiol (CBD) as an Adjunctive Therapy in Schizophrenia: A Multicenter Randomized Controlled Trial. Am J Psychiatry. 2018;175(3):225-231. doi:10.1176/appi.ajp.2017.17030325
  17. Arseneault L, Cannon M, Poulton R, Murray R, Caspi A, Moffitt TE. Cannabis use in adolescence and risk for adult psychosis: longitudinal prospective study. BMJ. 2002;325(7374):1212-1213. doi:10.1136/bmj.325.7374.1212
  18. Scheau C, Badarau IA, Mihai LG, et al. Cannabinoids in the Pathophysiology of Skin Inflammation. Molecules. 2020;25(3):652. doi:10.3390/molecules25030652
  19. Hammell DC, Zhang LP, Ma F, et al. Transdermal cannabidiol reduces inflammation and pain-related behaviours in a rat model of arthritis. European Journal of Pain. 2015;20(6):936-948. doi:10.1002/ejp.818
  20. Aishworiya R, Valica T, Hagerman R, Restrepo B. An Update on Psychopharmacological Treatment of Autism Spectrum Disorder. Neurotherapeutics. Published online January 14, 2022. doi:10.1007/s13311-022-01183-1
  21. Boyaji S, Merkow J, Elman RNM, Kaye AD, Yong RJ, Urman RD. The Role of Cannabidiol (CBD) in Chronic Pain Management: An Assessment of Current Evidence. Current Pain and Headache Reports. 2020;24(2). doi:10.1007/s11916-020-0835-4
  22. Bilbao A, Spanagel R. Medical cannabinoids: a pharmacology-based systematic review and meta-analysis for all relevant medical indications. BMC Med. 2022;20(1):259. Published 2022 Aug 19. doi:10.1186/s12916-022-02459-1
  23. Martínez V, Iriondo De-Hond A, Borrelli F, Capasso R, del Castillo MD, Abalo R. Cannabidiol and Other Non-Psychoactive Cannabinoids for Prevention and Treatment of Gastrointestinal Disorders: Useful Nutraceuticals?International Journal of Molecular Sciences. 2020;21(9). doi:10.3390/ijms21093067
  24. Jadoon KA, Tan GD, O’Sullivan SE. A single dose of cannabidiol reduces blood pressure in healthy volunteers in a randomized crossover study. JCI Insight. 2017;2(12). doi:10.1172/jci.insight.93760
  25. Babson KA, Sottile J, Morabito D. Cannabis, cannabinoids, and sleep: a review of the literature. Curr Psychiatry Rep. 2017;19(4):1-2. doi:10.1007/s11920-017-0775-9
  26. Babayeva M, Assefa H, Basu P, Chumki S, Loewy Z. Marijuana Compounds: A Nonconventional Approach to Parkinson’s Disease Therapy. Parkinsons Dis. 2016;2016:1279042. doi:10.1155/2016/1279042
  27. Scheau C, Badarau IA, Mihai LG, et al. Cannabinoids in the pathophysiology of skin inflammation. Molecules. 2020;25(3):652. doi:10.3390/molecules25030652
  28. Laux LC, Bebin EM, Checketts D, et al. Long-term safety and efficacy of cannabidiol in children and adults with treatment resistant Lennox-Gastaut syndrome or Dravet syndrome: Expanded access program results. Epilepsy research. 2019;154:13-20. doi:10.1016/j.eplepsyres.2019.03.015
  29. Iffland K, Grotenhermen F. An update on safety and side effects of cannabidiol: a review of clinical data and relevant animal studies. Cannabis Cannabinoid Res. 2017;2(1):139-154. doi:10.1089/can.2016.0034
  30. Bonn-Miller MO, Loflin MJE, Thomas BF, Marcu JP, Hyke T, Vandrey R. Labeling accuracy of cannabidiol extracts sold online. JAMA. 2017;318(17):1708–1709. doi:10.1001/jama.2017.11909
  31. Legare CA, Raup-Konsavage WM, Vrana KE. Therapeutic Potential of Cannabis, Cannabidiol, and Cannabinoid-Based Pharmaceuticals. Pharmacology. 2022;107(3-4):131-149. doi:10.1159/000521683
  32. Cloak CC, Alicata D, Ernst TM, Chang L. Psychiatric Symptoms, Salivary Cortisol and Cytokine Levels in Young Marijuana Users. J Neuroimmune Pharmacol. 2015;10(2):380-390. doi:10.1007/s11481-015-9606-0
  33. Miller S, Daily L, Leishman E, Bradshaw H, Straiker A. Δ9-tetrahydrocannabinol and cannabidiol differentially regulate intraocular pressure. Invest Ophthalmol Vis Sci. 2018;59:5904-5911. doi:10.1167/iovs.18-24838
  34. Ryan SA, Ammerman SD, O’Connor ME. Marijuana use during pregnancy and breastfeeding: implications for neonatal and childhood outcomes. Pediatrics. 2018;142(3) doi:10.1542/peds.2018-1889
  35. Food and Drug Administration–Office of the Commissioner. What to Know About Products Containing Cannabis and CBD
  36. Good P, Haywood A, Gogna G, et al. Oral medicinal cannabinoids to relieve symptom burden in the palliative care of patients with advanced cancer: a double-blind, placebo controlled, randomised clinical trial of efficacy and safety of cannabidiol (CBD). BMC Palliat Care. 2019;18(1):110. Published 2019 Dec 6. doi:10.1186/s12904-019-0494-6
  37. Bebee B, Taylor DM, Bourke E, et al. The CANBACK trial: a randomised, controlled clinical trial of oral cannabidiol for people presenting to the emergency department with acute low back pain. Med J Aust. 2021;214(8):370-375. doi:10.5694/mja2.51014
  38. Boggs DL, Surti T, Gupta A, et al. The effects of cannabidiol (CBD) on cognition and symptoms in outpatients with chronic schizophrenia a randomized placebo controlled trial. Psychopharmacology. 2018;235(7):1923-1932. doi:10.1007/s00213-018-4885-9
  39. Bergamaschi MM, Queiroz RHC, Zuardi AW, Crippa JAS. Safety and side effects of cannabidiol, a Cannabis sativa constituent. Curr Drug Saf. 2011;6(4):237-249. doi:10.2174/157488611798280924
  40. Bergamaschi MM, Queiroz RH, Zuardi AW, Crippa JA. Safety and side effects of cannabidiol, a Cannabis sativa constituent. Curr Drug Saf. 2011;6(4):237-249. doi:10.2174/157488611798280924
  41. Kanabus J, Bryła M, Roszko M, Modrzewska M, Pierzgalski A. Cannabinoids—Characteristics and Potential for Use in Food Production. Molecules. 2021;26(21):6723. doi:10.3390/molecules26216723
  42. No author. Epidiolex label
  43. Nachnani R, Raup-Konsavage WM, Vrana KE. The Pharmacological Case for Cannabigerol. The Journal of Pharmacology and Experimental Therapeutics. 2021;376(2):204-212. doi:10.1124/jpet.120.000340
  44. Clayton P, Subah S, Venkatesh R, Hill M, Bogoda N. Palmitoylethanolamide: A Potential Alternative to Cannabidiol [published online ahead of print, 2021 Nov 28]. J Diet Suppl. 2021;1-26. doi:10.1080/19390211.2021.2005733
  45. Sarris J, McIntyre E, Camfield DA. Plant-based medicines for anxiety disorders, part 2: a review of clinical studies with supporting preclinical evidence [published correction appears in CNS Drugs. 2013 Aug;27(8):675. Dosage error in article text]. CNS Drugs. 2013;27(4):301-319. doi:10.1007/s40263-013-0059-9
  46. Russo EB. Beyond Cannabis: Plants and the Endocannabinoid System. Trends Pharmacol Sci. 2016;37(7):594-605. doi:10.1016/j.tips.2016.04.005
  47. Cather JC, Cather JC. Cannabidiol primer for healthcare professionals. Proc (Bayl Univ Med Cent). 2020;33(3):376-379. Published 2020 Jul 6. doi:10.1080/08998280.2020.1775437
  48. VanDolah HJ, Bauer BA, Mauck KF. Clinicians’ Guide to Cannabidiol and Hemp Oils. Mayo Clin Proc. 2019;94(9):1840-1851. doi:10.1016/j.mayocp.2019.01.003
  49. Sharpe L, Sinclair J, Kramer A, de Manincor M, Sarris J. Cannabis, a cause for anxiety? A critical appraisal of the anxiogenic and anxiolytic properties. J Transl Med. 2020;18(1):374. Published 2020 Oct 2. doi:10.1186/s12967-020-02518-2
  50. Food and Drug Administration. Guidance for Industry, Q7A Good Manufacturing Practice Guidance for Active Pharmaceutical Ingredients.
  51. Macchi Silva VV, Ribeiro JLD. Obtaining laboratory accreditation – required activities. International Journal of Health Care Quality Assurance. 2019;32(1):71-83. doi:10.1108/ijhcqa-10-2017-0191
  52. Spindle TR, Cone EJ, Kuntz D, et al. Urinary Pharmacokinetic Profile of Cannabinoids Following Administration of Vaporized and Oral Cannabidiol and Vaporized CBD-Dominant Cannabis. Journal of Analytical Toxicology. 2019;44(2):109-125. doi:10.1093/jat/bkz080
  53. Office of the Commissioner. FDA Regulation of Cannabis and Cannabis-Derived Products, Including Cannabidiol (CBD). FDA. Published online January 22, 2021
  54. Franco V, Perucca E. Pharmacological and Therapeutic Properties of Cannabidiol for Epilepsy. Drugs. 2019;79(13):1435-1454. doi:10.1007/s40265-019-01171-4
  55. Johnson E, Kilgore M, Babalonis S. Label accuracy of unregulated cannabidiol (CBD) products: measured concentration vs. label claim. Journal of Cannabis Research. 2022;4(1). doi:10.1186/s42238-022-00140-1
  56. Maida V, Daeninck PJ. A user’s guide to cannabinoid therapies in oncology. Current Oncology. 2016;23(6):398. doi:10.3747/co.23.3487

By Megan Nunn, PharmD
Megan Nunn, PharmD, is a community pharmacist in Tennessee with over twelve years of experience in medication counseling and immunization.