Everolimus and Cannabidiol: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Cannabidiol
Everolimus
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Increased everolimus exposure
Interaction Deep Dive
Concomitant use of cannabidiol with everolimus (sensitive P-gp substrate and CYP3A4 substrate) may lead to increased everolimus exposure, which may result in more side effects than usual. When initiating cannabidiol in patients taking everolimus, monitor therapeutic drug levels of everolimus and adjust the dosage accordingly. When initiating everolimus in patients taking a stable dose of cannabidiol, a lower starting dose of everolimus is recommended, with therapeutic drug monitoring2. When everolimus is used concomitantly with cannabidiol (oral solution), reduce the dose as recommended. For the treatment of breast cancer, neuroendocrine tumors of pancreatic origin, renal cell carcinoma and tuberous sclerosis complex (TSC)-associated renal angiomyolipoma, reduce the dose to 5 mg once daily, may be increased to 7.5 mg once daily if tolerated. For the treatment of TSC-associated subependymal giant cell astrocytoma and TSC-associated partial-onset seizures, reduce the daily dose by 50%, change to every other day dosing if the reduced dose is lower than the lowest available strength. Resume dosage administered prior to cannabidiol initiation, once cannabidiol is discontinued for 3 days. Assess trough concentrations when initiating and discontinuing the inhibitor. The effects of other cannabidiol products on everolimus exposure are unknown 1.
Why it happens (mechanism)
Inhibition of P-gp-mediated efflux transport of everolimus
Literature reports
1 report — tap to read
a) Concomitant administration of cannabidiol 12.5 mg/kg twice daily with everolimus 5 mg in healthy, male, adult volunteers resulted in an approximately 2.5-fold increase in everolimus Cmax, AUC(0 to last), and AUC(0 to infinity) compared with everolimus alone. After reaching steady state with cannabidiol, everolimus Cmax, AUC(0 to last), and AUC(0 to infinity) were 45.7 nanograms (ng)/mL, 497 ng x hour/mL, and 529 ng x hour/mL on day 13, increased from 18.3 ng/mL, 195 ng x hour/mL, and 216 ng x hour/mL, respectively, with everolimus alone. Additionally, everolimus Tmax was delayed by a median of 0.75 hours, and t(1/2) was shortened to a mean of 33.2 hours (from 40 hours when dosed without cannabidiol). Systemic exposure of cannabidiol was not affected by concomitant administration of everolimus 3.
Common questions
Can I take Everolimus and Cannabidiol together?
Increased everolimus exposure Always confirm with your pharmacist or prescriber before making any change.
How serious is the Everolimus and Cannabidiol interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Everolimus or Cannabidiol need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (3)
- Product Information: AFINITOR® oral tablets, everolimus oral tablets. Novartis Pharmaceuticals Corporation, East Hanover, NJ, 2026. DailyMed
- Product Information: EPIDIOLEX(R) oral solution, cannabidiol oral solution. Jazz Pharmaceuticals, Inc. (per FDA), Palo Alto, CA, 2025. DailyMed
- Wray L, Berwaerts J, Critchley D, et al: Pharmacokinetic drug-drug interaction with coadministration of cannabidiol and everolimus in a phase 1 healthy volunteer trial. Clin Pharmacol Drug Dev 2023; 12(9):911-919. PubMed
Keep reading about Cannabidiol
Keep reading about Everolimus
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
Check another combination
Our instant two-drug interaction checker is almost here.
Still have questions about this combination?
Every question gets a real answer from a licensed pharmacist — free, and usually within a day.
Ask the pharmacist