If you’ve come down with a cold, there are a few side effects and benefits you should know about before combining your cold medication with CBD oil. In our latest question and answer, the pharmacist discusses whether or not CBD (cannabidiol) oil interacts with NyQuil. Marijuana should not be used with NyQuil because its two active ingredients, doxylamine, and dextromethorphan, have drug interactions with cannabis.
Cold Medicine and CBD Oil: Potential Side Effects and Benefits
If you’re dealing with a bad cold you may find yourself reaching for something in the medicine cabinet, but before you do, you may want to find out how CBD oil can help.
Cannabidiol (CBD) is one of 100+ cannabinoids found in the cannabis plant, and unlike the cannabinoid, tetrahydrocannabinol (THC), it does not produce the mind-altering “high” associated with whole marijuana consumption.
CBD oil can, however, reduce inflammation and boost the immune system, making it an ideal supplement when you’re feeling under the weather.
If you want to combine CBD oil with your cold medication, or want to better understand how CBD oil can help relieve the symptoms of your cold, here’s what you need to know.
Interactions Between CBD and Cold Medicine
There are some cold medications that can react negatively with CBD oil.
The biggest risk comes from combining two compounds that share a comparable function. While the relaxing properties of CBD oil alone may be mild, when you add another product that produces a similar sedative effect, the results can be amplified to an undesirable degree.
Cough medicines in particular often contain ingredients that promote sleep. As CBD oil can also have a calming effect, the combined outcome can be sedation that’s stronger than you may have been prepared for. While this may not be an issue at night time, it is an important consideration if you are taking CBD oil and cold medicine during the day and during activities that require you to be awake and alert (e.g. while driving).
Additionally, CBD oil slows down the cytochrome P450 (CP450) system, which is made up of a collection of enzymes in the liver that process many different medications. The CP450 system breaks down certain compounds, including some ingredients found in common cold medicines, allowing the body to more easily clear them or make use of them. Since CBD oil slows this system, medications may remain in the body for longer periods, making side effects more likely.
With that in mind, there are a few ingredients found in cold medications you should look for if you’re also taking CBD oil. For your reference, here’s a table outlining the most common active ingredients in cold medicine and the potential outcome when taken with CBD oil.
|Ingredient||Possible interaction when combined with CBD oil|
|Pheniramine – Found in flu and combination cold medicines (e.g. Theraflu and Scot-Tussin products)||May increase the risk of side effects and potential for drowsiness when used with CBD oil|
|Phenylephrine – Found in decongestants (e.g. Neo-Synephrine; Sudafed PE Congestion; Vazculep)||Increased risk of high resting heart rate when used with CBD oil|
|Pseudoephedrine – Found in decongestants (e.g. Sudafed Congestion; SudoGest; Sudafed 12-Hour; Entex)||Increases risk of serotonin syndrome when used with CBD oil|
|Naproxen – Found in anti-inflammatory medications (e.g. Aleve and Naprosyn)||May make CBD oil less effective|
|Acetaminophen – Found in pain relievers (e.g. Tylenol)||No known interactions|
|Chlorpheniramine – Found in a variety of antihistamines (allergy reducers)||May increase the risk of side effects and potential for drowsiness when used with CBD oil|
|Doxylamine – Found in some anti-anxiety and sedation medications (e.g. SleepAid; Unisom Sleep Tabs; Equate Sleep Aid)||May increase the drowsy or calming effects of CBD oil|
|Guaifenesin – Found in expectorants (e.g. Mucinex; Robitussin Chest Congestion; Robafen; Tussin)||No known interactions|
If you begin to notice unwanted effects after using CBD oil with any cold medication, do not continue with the combination and speak to your doctor.
CBD Oil for Treating Cold Symptoms
The next time you’re sick, before reaching for your cold medication, consider using CBD oil. Not only is CBD oil well-tolerated with a good safety profile, it can have positive effects on many of the most common cold symptoms. In addition, because of cannabidiol’s antibacterial properties, CBD oil can keep a cold at bay by helping your immune system fight the intruder at the source.
CBD for Congestion
One of the most annoying cold symptoms is nasal congestion. While research is not yet conclusive, there is evidence to suggest that CBD oil may be useful in clearing blocked sinuses. By targeting inflammation, CBD can calm the membranes that line your nasal passages, decreasing congestion and opening up the airways.
CBD for Fevers
There are many reasons you might develop a fever when you’re sick. It may be caused by your body fighting a viral infection, like the common cold, or a sign of inflammation somewhere in the body. If the fever is brought on by a virus, early research has suggested that cannabinoids could play a role in stopping its progression.
Alternatively, if the fever is part of a larger inflammatory reaction, the use of CBD oil can trigger an anti-inflammatory response through its action on your body’s endocannabinoid system.
CBD for coughs and sneezes
Research has shown that CBD oil not only has anti-inflammatory properties, but also has muscle-relaxant qualities. This is particularly of interest if you’re suffering from a persistent cough, as CBD oil may reduce the inflamed airway and relax the muscles to reduce coughing.
CBD oil may also block histamines, the compounds responsible for inducing bouts of coughing and sneezing. While CBD oil hasn’t been proven to be as effective as the antihistamine ingredients in cold medication, it does offer the potential for a more natural treatment.
How to Safely Use CBD Oil and Cold Medicine Together
For starters, talk to your doctor. Although CBD oil is largely side effect-free and well-tolerated, there could be factors in your personal health history that warrant extra caution before using CBD.
Furthermore, if you wish to safely combine CBD oil and cold medication, avoid ingredients that may negatively interact (see the table in ‘Interactions Between CBD and Cold Medicine’ above). Also, keep in mind that any cold or flu medicines advertised as helping with sleep may have amplified effects when used with CBD oil.
It is suggested that you either take the combination before bed or spread their use over the day; for example take CBD oil in the morning and cold medicine at night. Alternatively, you can opt to combine non-drowsy cold medicine with your CBD oil. Just be aware of whether the medications contain any ingredients metabolized by the body’s cytochrome P-450 pathway to best avoid unpleasant side effects.
Safest CBD Oils to Take with Cold Medication
There is an incredible variety of CBD products available online and in-store, so how do you find the safest CBD oil?
Narrow down the options by first deciding the method you’d like to use to take your CBD oil. If you are suffering from a cold, it’s likely that your respiratory system isn’t operating at full capacity. For that reason, it’s best to ingest the CBD instead of inhaling it (i.e. via CBD vape or flower). Using CBD oil drops, tinctures, edibles, or capsules will cause the least disruption to your body as it is trying to heal.
When you’ve made the decision on how you’ll be taking your CBD oil, ensure you choose the safest product by doing your research into quality CBD brands.
The best companies use sustainably sourced hemp which has been organically grown without the use of herbicides, pesticides, or chemical additives. For peace of mind, check the product’s Certificate of Analysis (COA), which will show whether the CBD product contains any heavy metals or toxins. The COA will also indicate how much CBD and THC is in the product, amongst other cannabinoids and terpenes, so you’ll know if the dosage is accurate. Ideally, the COA should be published by a third-party laboratory, ensuring it is not subject to bias.
Remember, when it comes to your health, it’s worth taking the time to find the best quality CBD products.
Does CBD Interact With NyQuil?
In our latest question and answer, the pharmacist discusses whether or not CBD (cannabidiol) oil interacts with NyQuil.
Can you take CBD oil and NyQuil together?
There is no known interaction between cannabidiol (CBD) and NyQuil. They are generally considered to be safe to take together.
However, there are very few studies evaluating potential drug interactions between CBD and other medication. Nevertheless, in studies that have been done, there has been no indication that CBD interacts with any of the ingredients contained in NyQuil.
Cannabidiol (CBD) – NyQuil Interaction Information
NyQuil is a combination ingredient medication containing:
- Acetaminophen (analgesic)
- Dextromethorphan (cough suppressant)
- Doxylamine (sedating antihistamine)
NyQuil is most commonly used to treat the symptoms of cold and the flu while also providing a mild sedative effect due to the sedating antihistamine (doxylamine) contained in the product.
Cannabidiol, also known as CBD, is a major component of cannabis (i.e. marijuana). While THC (delta-9-tetrahydrocannabinol) is likely more well-known due to its psychoactive effects, CBD makes up almost 40% of cannabis extracts and has a wide range of effects and potential benefits when used medicinally.
Due to the relative recent nature of CBD use for medicinal purposes (at least legally), there is a distinct lack of studies when it comes to potential drug interactions between CBD and other medication.
Most recent studies do indicate that CBD potentially affects many different metabolizing enzymes in the body. In fact, studies have shown that CBD can inhibit the following liver metabolizing enzymes:
Metabolizing enzyme inhibition often leads to increased concentrations of drugs that are typical substrates for a particular enzyme.
Most studies that show CBD inhibition of metabolizing enzymes do so only in a lab setting (i.e. in vitro). Often times when humans are evaluated in regard to CBD inhibition of metabolizing enzymes, the effects aren’t significant.
In fact, many echo the following sentiment of the authors of a recent study:
“In extensive clinical application including complex drug regimens with opioids, tricyclic antidepressants, anticonvulsants, etc., no drug-drug interactions have been observed that would contraindicate or preclude use of [THC/CBD containing products] with any specific pharmaceutical, although additive sedative effects are always possible. “
As more studies are completed, we will get a better understanding of potential clinically significant interactions with CBD. One recent 2017 study reported several drug-drug interactions with CBD that involved certain anti-epileptic medications including Onfi & Topamax. It still isn’t known however, how significant these interactions are.
As mentioned above, there are no such studies that looked at CBD and potential interactions with any of the ingredients in NyQuil.
One possible area of concern in using CBD with NyQuil is an increased feeling of sedation when using both together. NyQuil is used partly for its sedative effects and many studies indicate that CBD can cause mild hypnotic or sedative effects. However, as NyQuil is generally only taken at night time, the additive sedation doesn’t appear to be much cause for concern.
Does Marijuana Interact with NyQuil?
Combining the cold medicine NyQuil with marijuana is not known to be dangerous, but the sedative effects of NyQuil may be enhanced if the two are combined. NyQuil contains two active ingredients, doxylamine, and dextromethorphan, shown to have a moderate drug-drug interaction with cannabis. Acetaminophen (Tylenol, paracetamol), also in NyQuil, is not known to have any adverse reaction when combined with cannabis.
What Is NyQuil?
NyQuil is a trademarked medication used for pain relief and treating cold symptoms like sore throat and is available as a liquid or liquicap. It is sometimes sold with DayQuil, so NyQuil is considered the nighttime medication.
Such cold medications (anti-tussives) usually contain one or a combination of analgesics, antihistamines, and decongestants.
Uses and How It Works
NyQuil is a cold medicine usually taken to relieve some of the symptoms of the common cold, influenza, or other similar upper respiratory tract conditions. It contains three active ingredients:
- Acetaminophen (Tylenol, paracetamol): An analgesic relieves pain and reduces fever. Acetaminophen relieves inflammatory pain via the CB1 receptor, inhibiting the uptake and degradation of anandamide. The liver metabolizes acetaminophen into the cannabinoid, N-arachidonoylphenolamine.
- Dextromethorphan(Robitussin, Delsym): A cough suppressant with stimulant properties in lower doses and sedative properties in moderate to high doses. Dextromethorphan is in the morphinan and anti-tussive class of medications and has multiple mechanisms of action. Dextromethorphan acts as a nonselective serotonin reuptake inhibitor and a sigma-1 receptor agonist. Dextromethorphan is not only used for cough suppression but also for withdrawal associated with opioid use disorder and some instances of treatment-resistant major depressive disorder when combined with bupropion.
- Doxylamine (Unisom, Vicks Formula 44 in combination with Dextromethorphan) – an antihistamine used to treat sneezing, runny nose, itching, and inability to get to sleep. Doxylamine is an anti-cholinergic, meaning it blocks the action of the neurotransmitter called acetylcholine (ACh) at synapses in the central and peripheral nervous system (CNS and PNS). Anticholinergic drugs are often used to treat dizziness, GI disorders, insomnia, and various respiratory disorders (e.g., asthma, chronic obstructive pulmonary disorder or COPD, chronic bronchitis).
Potential Benefits and Risks of Mixing Cannabis and NyQuil
Although there seems to be no dangerous interaction between cannabis and NyQuil, both medications have sedative effects that can interact with each other.
- Cannabis-based medications such as cannabis oils and tinctures may reduce the need for NyQuil.
- Cannabis contains terpenes like pinene and eucalyptol, which have decongestant and soothing properties that could be useful for managing uncomplicated coronavirus infections.
- Cannabis has anti-inflammatory properties.
- Cannabinoids in cannabis, like cannabidiol (CBD) and tetrahydrocannabinol (THC), can desensitize liver enzymes metabolized through the cytochrome P450 pathway. This could potentially increase levels of doxylamine and dextromethorphan and increase the chances of adverse side effects such as dizziness, extreme drowsiness and sedation, nausea and vomiting, hypotension, hypertension (decrease or increase in blood pressure), sweating, fever, and many more.
- Smoking weed may cancel out NyQuil’s cough suppressant properties.
- Cannabinoids are immunomodulators that can dampen inflammation, and this can be useful in chronic conditions where inflammation is out of control (dysinflammation). Still, when battling infections in the short term, this may inhibit the immune system from doing its job.
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What to Do If You Need to Use Both NyQuil and Marijuana
Suppose you are suffering from a cold or flu and are using NyQuil. In that case, it is wise to reduce or even stop your cannabis use unless instructed otherwise (e.g., you are utilizing medical cannabis and CBD to reduce seizures or other health problems).
The Bottom Line
Although there are no known significant dangers when combining cannabis and NyQuil, it’s not a good idea for most people unless recommended by a doctor.
Two of the three active ingredients in NyQuil — doxylamine, and dextromethorphan — are listed as having a moderate drug-drug interaction with cannabis. This is because both have sedative effects that may increase when used together to treat temporary medical conditions in the body. Cannabis may also interfere with how the active ingredients in NyQuil are metabolized, increasing the chances of an adverse effect. Going beyond the recommended dose of NyQuil also causes several adverse effects, so it is best not to mix cannabis and NyQuil.
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Article written by
Dipak Hemraj Head of Research and Education
Dipak Hemraj is a published author, grower, product maker, and Leafwell’s resident cannabis expert. From botany & horticulture to culture and economics, he wishes to help educate the public on why cannabis is medicine (or a “pharmacy in a plant”) and how it can be used to treat a plethora of health problems. Dipak wants to unlock the power of the plant, and see if there are specific cannabinoid-terpene-flavonoid profiles suitable for different conditions.
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