CBD and Lansoprazole (e.g. Prevacid, Lanzor, Lansoprazole-ratiopharm)
David ReichUpdated:Key points at a glance:
CBD may influence the metabolism of lansoprazole via the enzymes CYP2C19 and CYP3A4. This could affect blood levels of the medicine and the likelihood of side effects. If you are considering CBD, start with a low amount of around five to ten milligrams per day and increase gradually if needed. Take CBD at a different time to your proton pump inhibitor, ideally leaving a gap of two to three hours. Be attentive to possible effects such as headaches, diarrhoea, tiredness or changes in heartburn symptoms. Higher daily amounts of CBD (over 100 to 300 milligrams) and the use of multiple medicines at the same time should always be discussed with a doctor.
Many readers arrive with this very question: Can I take CBD together with lansoprazole – and if so, how can I do this as safely as possible? Below you will find a concise answer, background information on possible CBD–lansoprazole interactions, and practical steps for use. Basic information on cannabinoids and the endocannabinoid system can be found in our guide articles. Products such as CBD oil should always be chosen with a clear mg/ml indication and an analysis certificate.
Can I combine CBD with lansoprazole?
CBD and lansoprazole can influence each other because both are processed in the liver. The main concern is that CBD may slow down the breakdown of lansoprazole, which could increase its levels and side effects in some people – especially at higher CBD intakes.
CBD may inhibit the metabolism of lansoprazole (via CYP2C19/CYP3A4). Use low amounts at first, keep a time gap between products and monitor how you feel. Discuss higher CBD intakes or multiple medicines with a doctor.
- CBD may inhibit the liver enzymes CYP2C19 and CYP3A4 that break down lansoprazole – the potential for interaction is considered higher at higher CBD intakes.
- Start low (around 5–10 mg/day), increase slowly and keep a 2–3 hour gap from taking lansoprazole.
- Pay attention to headaches, diarrhoea, tiredness or more intense/new‑onset heartburn.
- Discuss intakes above about 100–300 mg/day – and any use alongside several prescription medicines – with a doctor.
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How likely is a CBD–lansoprazole interaction? (CYP2C19/CYP3A4 explained)
Lansoprazole belongs to the group of proton pump inhibitors (PPIs) and is mainly broken down by the liver enzymes CYP2C19 and CYP3A4. CBD may inhibit these enzymes depending on the amount used. This means that, when taken together, higher lansoprazole levels in the body are theoretically possible, which could increase the likelihood of typical side effects such as headaches, diarrhoea or tiredness.
In studies and case reports on CBD drug interactions, clinically relevant inhibition of liver enzymes has mainly been observed with higher CBD intakes (above roughly 100–300 mg/day). Lower so‑called “wellness” amounts (around 10–40 mg/day) are considered less likely to be an issue, but should still be discussed with a healthcare professional – especially in people who are more sensitive, have liver problems or who take additional prescription medicines.
| Substance | Metabolism | Potential interaction | Note |
|---|---|---|---|
| Lansoprazole | CYP2C19, CYP3A4 | Possibly increased levels | Monitor: headaches, diarrhoea, tiredness |
| CBD | May inhibit CYP2C19/CYP3A4 (amount‑dependent) | Above about 100–300 mg/day more critical | Consider 2–3 hours’ separation |
Lansoprazole is broken down via CYP2C19 and CYP3A4. CBD may inhibit these liver enzymes, and higher CBD intakes are associated with a greater potential for interaction and side effects.
Practical steps if you use CBD with lansoprazole
If you and your doctor decide that CBD use alongside lansoprazole is appropriate, the following cautious approach may help to reduce potential risk of CBD–lansoprazole interactions:
- Start low: Begin with about 5–10 mg CBD in the evening for 3–4 days.
- Separate timing: Take CBD at least 2–3 hours apart from lansoprazole to reduce the chance of both being processed by the same liver enzymes at the same time.
- Increase slowly: If well tolerated, increase by 5–10 mg every 3–4 days, staying alert to side effects.
- Track symptoms: Keep a brief record of reflux, bowel movements, headaches, tiredness or any new symptoms.
- Talk to your doctor: Seek medical advice before taking higher CBD intakes (above about 100–300 mg/day), if you have liver conditions or if you use multiple medicines that rely on CYP2C19/CYP3A4 for metabolism.
Who should be particularly cautious with CBD and lansoprazole?
Extra care is advisable when combining CBD and lansoprazole in the following situations:
- People with liver conditions
- Older adults
- People taking multiple medicines, especially other CYP2C19/CYP3A4 substrates (e.g. clopidogrel, diazepam, citalopram, omeprazole)
- Pregnancy/breastfeeding
People with liver problems, older adults, those on several prescription medicines and anyone who is pregnant or breastfeeding should only combine CBD with lansoprazole after medical advice.
Warning signs and when to seek medical advice
Stop, pause or reassess CBD use together with lansoprazole and seek medical advice if you notice:
- Persistent or new severe diarrhoea, pronounced tiredness or severe headaches
- Reflux symptoms despite taking lansoprazole as directed
- Signs suggesting problems from long‑term PPI use (for example, discuss checking vitamin B12 or magnesium levels and possible increased susceptibility to infections with your doctor)
Side effects of CBD and lansoprazole at a glance
CBD
- Possible effects: tiredness, dry mouth, diarrhoea, changes in appetite
- Severity depends on amount and product; pay attention to quality, CBD concentration and precise dosing (mg/ml)
Lansoprazole
- Common: headaches, nausea, diarrhoea
- With long‑term use: possible risk of vitamin B12 and magnesium deficiency, increased susceptibility to infections and, rarely, kidney involvement – medical monitoring is advisable
Both CBD and lansoprazole are generally considered to be well tolerated but can cause side effects. Be particularly attentive to changes when you start CBD, increase the amount or use several medicines at the same time.
Conclusion: CBD and lansoprazole
CBD can be used alongside lansoprazole in some cases, but this calls for attention to possible interactions via the liver enzymes CYP2C19 and CYP3A4. In particular, with higher CBD intakes (above about 100–300 mg/day) or additional medicines, medical advice is recommended.
If you and your doctor decide to proceed, use a step‑by‑step approach: start with a low amount of CBD, keep a time gap between CBD and lansoprazole, record your symptoms and choose high‑quality products. More background on CBD interactions can be found in our guide.
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Disclaimer: This article is for information purposes only and does not replace medical advice. Do not change medicines or dosages without consulting your doctor. No claims are made regarding the treatment or cure of illnesses.