Over the past few years, the FDA has issued several warning letters to companies that market new, unapproved drugs that supposedly contain cannabidiol (CBD). As part of these actions, the FDA analyzed the chemical content of cannabinoid compounds in some of the products, and it was found that many did not contain the levels of CBD they claimed to contain. It's important to note that these products are not approved by the FDA for the diagnosis, cure, mitigation, treatment, or prevention of any disease. Consumers should be careful when buying and using any of these products.
CBD can cause dose-related liver damage. The concomitant use of CBD and other medications such as leflunomide, lomitapide, mipommersen, pexidartinib, teriflunomide, and valproate may increase the risk of liver damage and is known to damage the liver. Physicians should warn patients with elevated basal transaminase levels about possible worsening of liver function with CBD administration. It is important to monitor bilirubin and transaminase levels before and during treatment.
Discontinuation of CBD or discontinuation of concomitant use have reduced elevations. In patients with moderate or severe liver damage, slow dose adjustment and adjustment is recommended.