CBD & Paracetamol: can we combine the two?

Paracetamol is the French reference molecule for fight fever and pain. Cannabidiol, on the other hand, is a natural relaxant, also used to fight pain, but also to relax and reduce anxiety. It is, however, attributed to a risk of drug interaction. Hence the question at hand here: can CBD and paracetamol be combined ?

CBD, paracetamol, ibuprofen: what are we talking about?

cbd ibuprofen paracetamol for min pain

Like paracetamol and ibuprofen, CBD can work against pain

Le CBD is a cannabinoid, a molecule naturally produced by cannabis that helps in particular to soothe pain, sleep better and reduce stress. Unlike its cousin the THC, it is neither addictive nor psychoactive and, therefore, 100% legal.

Le paracetamol, or acetaminophen, is the most widely used analgesic, especially against flu, headaches, dental pain or painful periods. It is found in pharmacies in the form of Doliprane, Efferalgan or Dafalgan. When it is sufficiently effective, it is the preferred painkiller, ahead ofibuprofen andaspirine which have more side effects.

CBD, like paracetamol and ibuprofen, therefore has painkilling properties. With the difference, and it is important, that cannabidiol is not recognized as a treatment in France (it is in other countries such as Canada, some US states including California or even Israel and the Switzerland). Since then, combine CBD and paracetamol, or another painkiller, seems like a reasonable idea. But is it really useful, or even dangerous?

Paracetamol and CBD: beware danger?

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Unlike paracetamol, CBD (cannabis extract) does not stress the liver

Dangers of paracetamol

Paracetamol is harmless when taken in reasonable doses and punctually. In case of overdose, and the general public is often unaware of it, it can nevertheless be very dangerous. It is also one of the drugs that causes the mostunintentional poisonings in the world.

In a normal situation, a person with pain takes paracetamol. With digestion, the molecule passes through the body and the pain gradually decreases or disappears. The liver then takes over to eliminate what remains of the molecule. However, in the event of an overdose, the liver is overwhelmed and can no longer properly help the body get rid of paracetamol. In rare cases, a lightning hepatitis can result: the liver is gradually destroyed and can no longer perform its vital functions. If not properly managed, such a pathology can lead to death.

To avoid this, a adapted dosage is essential. It does not depend on the age of the patient, but on his weight. Above 50 kilograms of body mass, it is therefore recommended not to exceed 1g of paracetamol per dose, to renew every 4 to 6 hours and without exceeding 4 grams per day. In the event of a liver problem (hepatic disease or alcohol dependence in particular), the liver saturates more quickly and the dosage must be adapted by the attending physician.

Dangers of CBD

Unlike paracetamol, we do not know no major liver problems related to taking cannabidiol. At most, and mainly in the event of a high dosage, we recognize that CBD has a risk of problèmes digestifs (stomach aches, diarrhoea), dry mouth see even drowsiness, but nothing fatal for health. His side effects known are therefore less important and less dangerous than those of paracetamol.

What about their association?

Combine paracetamol and CBD for enhanced effects?

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CBD does not act directly against fever, but helps to contain the pain between two doses of paracetamol

Taking paracetamol while respecting the dosages is not dangerous. Taking CBD is in the vast majority of cases harmless. But what happens when you consume the two together?

The idea is appealing to take advantage of combined effects of the two molecules. CBD does not present the same risks as paracetamol and even less than ibuprofen or aspirin. However, it does not act directly on the fever. Combine CBD and paracetamol, or at least alternate them, could thus make it possible toact more diffusely and regularly on pain (both molecules have this power), lower fever thanks to paracetamol, but do not risk overdosing and therefore liver problems by spacing out the doses more since the CBD could take over when necessary.

The first possible obstacle to this association seems to be the risk ofdrug interaction related to cannabidiol. However, the objection does not hold since the studies that have looked at the subject (a 2019 study [link in English] in particular) have no evidence of a link between the action of CBD and that of paracetamol. To date, there is therefore no reason to think that the combination of these two effective molecules against pain is contraindicated.

However, people with blood problems should take some precautions.

Does CBD thin the blood?

The same study that we were just citing highlighted in particular the risk of bleeding in case of combination of CBD and ibuprofen. We read more and more often that CBD thins the blood, like aspirin, which can have serious consequences for people with blood problems.

In fact, the scientific studies available to date (here in particular) have never shown the ability of cannabidiol to thin the blood, but rather evoke its anticoagulant role. This is notably why it is being studied in the context of the development of new treatments intended for prevent blood clots from forming. In the event of a blood problem, it is therefore not recommended to take CBD, with or without paracetamol, and in any case essential to discuss the potential benefits and risks of the different molecules with your doctor.