Cannabidiol (cbd) + Acetaminophen, Butalbital, Codeine
Acetaminophen, Butalbital, Codeine brand name: Bancap w/ Codeine.
Acetaminophen, Butalbital, Codeine falls into 5 drug categories that Cannabidiol (cbd) can interact with; the most serious is rated moderate. Theoretically, cannabidiol might have additive effects if used with other CNS depressants.
Read the full interaction reportCannabidiol (cbd) and Acetaminophen, Butalbital, Codeine
These two interact in 5 distinct ways. Each one is explained separately below.
Why Are There 5 Interactions?
Cannabidiol (cbd) interacts with whole categories of medication. Acetaminophen, Butalbital, Codeine falls into 5 of those categories, so it can interact with Cannabidiol (cbd) in 5 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).
CNS DEPRESSANTS
1 of 5Why this applies to Acetaminophen, Butalbital, Codeine
Acetaminophen, Butalbital, Codeine falls under CNS DEPRESSANTS — the group Cannabidiol (cbd) interacts with.
Preliminary clinical research, case reports, and animal studies suggest that high dose cannabidiol has sedative and hypnotic effects. Theoretically, concomitant use of cannabidiol with drugs with sedative and anesthetic properties may cause additive therapeutic and adverse effects.
Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
Here's the thing to keep in mind with Bancap w/ Codeine: two of its three ingredients, the butalbital (a barbiturate) and the codeine (an opioid), already slow down your central nervous system. CBD, especially at higher supplement doses, can add its own sedating effect on top of that. So the worry here isn't about CBD changing how your liver clears the drug, it's simply two calming effects stacking up.
Together they could leave you feeling more drowsy, foggy, dizzy, or lightheaded than usual, and in heavier doses that can mean slowed breathing. This is a theoretical concern drawn from how these things work, not a proven, common problem, so don't panic. Still, it's worth a quick chat with your pharmacist or doctor before combining them, and go easy on activities like driving until you know how you feel.
- Carlini EA, Cunha JM. Hypnotic and antiepileptic effects of cannabidiol. J Clin Pharmacol 1981;21(8-9 Suppl):417S-27S. PubMed
- Monti JM. Hypnoticlike effects of cannabidiol in the rat. Psychopharmacology (Berl) 1977;55(3):263-5. PubMed
- Pickens JT. Sedative activity of cannabis in relation to its delta'-trans-tetrahydrocannabinol and cannabidiol content. Br J Pharmacol 1981;72(4):649-56.
- Perez-Vilar S, Karami S, Long K, Leishear K. Cannabidiol exposures in the United States, National Poison Data System, July 2014-June 2021. Clin Toxicol (Phila) 2022. PubMed
CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES
2 of 5Acetaminophen, Butalbital, Codeine also falls under CYTOCHROME P450 2D6 (CYP2D6) SUBSTRATES.
In vitro research shows that cannabidiol inhibits CYP2D6. Theoretically, concomitant use of cannabidiol with CYP2D6 substrates might increase the risk for adverse effects from these substrates. However, a clinical crossover trial in healthy adults shows that cannabidiol does not inhibit dextromethorphan, a substrate of CYP2D6.
Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
Here's a twist worth knowing: the codeine in your Bancap is actually a prodrug. Your body uses an enzyme called CYP2D6 to turn codeine into morphine, which is what does the real pain relief. CBD has shown in lab studies that it can slow down that same enzyme. So in theory, if CBD blocks CYP2D6, less of your codeine gets converted to morphine, meaning you might get weaker pain relief than expected.
I want to be honest about how soft this evidence is. It's only theoretical, based on test-tube data, and a human study with a similar CYP2D6 drug showed no meaningful effect from CBD. So this likely won't be a big deal for most people, but if your pain isn't being controlled, mention the CBD to your pharmacist or doctor.
- Yamaori S, Okamoto Y, Yamamoto I, Watanabe K. Cannabidiol, a major phytocannabinoid, as a potent atypical inhibitor for CYP2D6. Drug Metab Dispos 2011;39(11):2049-56. PubMed
- Nasrin S, Watson CJW, Perez-Paramo YX, Lazarus P. Cannabinoid Metabolites as Inhibitors of Major Hepatic CYP450 Enzymes, with Implications for Cannabis-Drug Interactions. Drug Metab Dispos 2021;49(12):1070-1080. PubMed
- Bansal S, Zamarripa CA, Spindle TR, et al. Evaluation of Cytochrome P450-Mediated Cannabinoid-Drug Interactions in Healthy Adult Participants. Clin Pharmacol Ther 2023.
CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES
3 of 5Acetaminophen, Butalbital, Codeine also falls under CYTOCHROME P450 1A2 (CYP1A2) SUBSTRATES.
In vitro research shows that cannabidiol inhibits CYP1A2. Furthermore, clinical studies show that cannabidiol may inhibit the metabolism of caffeine, a CYP1A2 substrate. Two pharmacokinetic studies in healthy adults show that taking cannabidiol dosed 640 mg once up to 750 twice daily increases the area under the curve of caffeine. However, results are mixed over whether cannabidiol impacts peak serum levels of caffeine.
Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports..
Here's the thing to know about this combo pill. CBD can slow down a liver enzyme called CYP1A2, and that same enzyme helps clear out one of the three ingredients here. In plain terms, that ingredient could build up a little more than usual if you also take concentrated CBD. The bigger picture, though, is that this product already contains butalbital (a barbiturate) and codeine (an opioid), both of which cause drowsiness on their own.
So my main worry isn't really the enzyme math, it's the stacking of sedation. Together you could feel extra sleepy, foggy, dizzy, or short of breath. Please don't start or stop anything yourself. Just loop in your pharmacist or doctor first, especially since product strengths vary so much.
- Yamaori S, Kushihara M, Yamamoto I, Watanabe K. Characterization of major phytocannabinoids, cannabidiol and cannabinol, as isoform-selective potent inhibitors of human CYP1 enzymes. Biochem Pharmacol 2010;79(11):1691-8.
- Thai C, Tayo B, Critchley D. A Phase 1 Open-Label, Fixed-Sequence Pharmacokinetic Drug Interaction Trial to Investigate the Effect of Cannabidiol on the CYP1A2 Probe Caffeine in Healthy Subjects. Clin Pharmacol Drug Dev. 2021. PubMed
- Nasrin S, Watson CJW, Perez-Paramo YX, Lazarus P. Cannabinoid Metabolites as Inhibitors of Major Hepatic CYP450 Enzymes, with Implications for Cannabis-Drug Interactions. Drug Metab Dispos 2021;49(12):1070-1080. PubMed
- Bansal S, Zamarripa CA, Spindle TR, et al. Evaluation of Cytochrome P450-Mediated Cannabinoid-Drug Interactions in Healthy Adult Participants. Clin Pharmacol Ther 2023.
GLUCURONIDATED DRUGS
4 of 5Acetaminophen, Butalbital, Codeine also falls under GLUCURONIDATED DRUGS.
In vitro research shows that cannabidiol inhibits uridine diphosphoglucuronosyl transferase (UGT) 1A9 and UGT2B7, enzymes responsible for glucuronidation. Theoretically, this could decrease the clearance and increase levels of glucuronidated drugs.
Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
This combination pill has three parts, and CBD touches them in different ways. The lab concern here is that CBD may slow down certain enzymes (called UGTs) that help your body clear out the acetaminophen (Tylenol) portion. In theory, that could let acetaminophen linger a bit longer, which matters mostly because too much acetaminophen over time can stress the liver.
Keep in mind this is based only on test-tube research, not real people, so it may not amount to much in everyday use. Still, both CBD and acetaminophen are processed by the liver, so it's worth being mindful. The codeine and butalbital pieces can already cause drowsiness, and CBD may add to that sleepy feeling. Please check with your pharmacist or doctor before pairing them, and don't change anything on your own.
- Epidiolex (cannabidiol) prescribing information. Greenwich Biosciences, Inc., Carlsbad, CA, 2019. Available at: https://www.epidiolex.com/sites/default/files/EPIDIOLEX_Full_Prescribing_Information.pdf (accessed 5/9/2019)
CYTOCHROME P450 2E1 (CYP2E1) SUBSTRATES
5 of 5Acetaminophen, Butalbital, Codeine also falls under CYTOCHROME P450 2E1 (CYP2E1) SUBSTRATES.
In vitro research shows that cannabidiol inhibits CYP2E1. So far, this interaction has not been reported in humans.
Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
This combo pill has three parts, but the piece that touches this interaction is the acetaminophen (Tylenol) part. A small amount of acetaminophen gets handled by a liver enzyme called CYP2E1, which can turn a tiny fraction into a byproduct that is hard on the liver. Lab dish studies suggest CBD may slow CYP2E1 down. In theory, that could shift how acetaminophen is processed, but this has never actually been reported in real people, so I don't want to overstate it.
The bigger picture: both CBD and the codeine/butalbital side of this medicine can add to drowsiness. If you're using CBD alongside this, keep your acetaminophen within normal daily limits, avoid alcohol, and check in with your pharmacist or doctor first.
- Nasrin S, Watson CJW, Perez-Paramo YX, Lazarus P. Cannabinoid Metabolites as Inhibitors of Major Hepatic CYP450 Enzymes, with Implications for Cannabis-Drug Interactions. Drug Metab Dispos 2021;49(12):1070-1080. PubMed
What These Ratings Mean
Every interaction above is graded three ways — here’s the key to each label.
Clinically significant. Avoid the combination, or use only under close professional supervision.
Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.
Generally not serious. Be aware of it and mention it to your pharmacist.
- LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
- ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
- PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
- UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
- AHigh-quality meta-analysis (quantitative systematic review).
- BCase-control study.
- CConsensus.
- DAnecdotal evidence.
These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.
Cannabidiol (cbd) Also Interacts With Other Medications
Cannabidiol (cbd) has 1,050 moderate known drug interactions in our database — the Acetaminophen, Butalbital, Codeine one above is among them. If you take anything else, check it against the full list below.
Check Another of Your Medications Against Cannabidiol (cbd)
We haven’t checked that one against Cannabidiol (cbd) yet — ask our pharmacists directly.
Covers the 2,830 medications we’ve checked against Cannabidiol (cbd). Pick one to open its full report.
See Every Supplement That Interacts With Acetaminophen, Butalbital, Codeine
This page covers Cannabidiol (cbd) only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acetaminophen, Butalbital, Codeine page lists 240 supplements it has a documented interaction with, worst first, each one explained.
The most serious there right now: 1,4-butanediol (major), Activated Charcoal (major), Asarabacca (major), Beer (major) and Gamma-hydroxybutyrate (ghb) (major).
By severity: 9 major · 191 moderate · 40 minor.
Open the Acetaminophen, Butalbital, Codeine interaction page
Where Cannabidiol (cbd) and Acetaminophen, Butalbital, Codeine Sit Against Everything Else
Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.
#409 of 1,452 supplements looked up here in the last 7 days
#456 of 2,830 medications looked up here in the last 7 days
Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.
About Cannabidiol (cbd)
What is Cannabidiol (cbd)?
- Anxiety and stress
- Sleep problems
- Chronic pain
- Certain seizure disorders
- Inflammation
CBD is a compound from the cannabis (hemp) plant that does not cause a 'high.' It has strong evidence only for certain rare seizure disorders (as a prescription drug), while most other popular uses are still backed by limited or early research. Product quality varies a lot, so talk with your pharmacist or doctor before using it, especially if you take other medicines.
Other Drugs & Cannabidiol (cbd)
Browse every other medication we’ve checked against Cannabidiol (cbd) — both the ones with a known interaction and the ones without. Select any drug for the full detail.
No drugs match “”.
1,050 interactions
- Diclofenac Sodium ›
- Diltiazem ›
- Theophylline ›
- Nifedipine ›
- Ibuprofen ›
- Metronidazole ›
- Diphenhydramine ›
- Hydrocortisone ›
- Naproxen ›
- Erythromycin ›
- Estradiol ›
- Propranolol ›
- Lidocaine ›
- Norethindrone ›
- Testosterone ›
- Verapamil ›
- Levonorgestrel ›
- Prednisone ›
- Quinidine ›
- Cyclosporine ›
- Dexamethasone ›
- Flurazepam ›
- Glyburide ›
- Triazolam ›
- Zopiclone ›
- Bupropion ›
- Ciprofloxacin ›
- Colchicine ›
- Fentanyl ›
- Flurbiprofen ›
- Isotretinoin ›
- Orphenadrine ›
- Oxybutynin ›
- Oxycodone ›
- Phenytoin ›
- Prednisolone ›
- Tacrolimus ›
- Temazepam ›
- Apomorphine ›
- Budesonide ›
- Carbamazepine ›
- Clindamycin ›
- Dextromethorphan ›
- Diclofenac Potassium ›
- Doxorubicin ›
- Fluticasone ›
- Formoterol ›
- Indomethacin ›
- Miconazole ›
- Morphine Sulfate ›
- Nitrazepam ›
- Trimipramine ›
- Acetaminophen ›
- Amphetamine ›
- Buprenorphine ›
- Conjugated Estrogens ›
- Diazepam ›
- Everolimus ›
- Griseofulvin ›
- Ivabradine ›
Showing 60 of 1,050 moderate interactions — see all 1,050 on the Cannabidiol (cbd) page.
No interaction 1,779 drugs checked — show the list
We also checked Cannabidiol (cbd) against these medications and found no known interaction in our sources. Open any page to confirm.
- Levothyroxine ›
- Methylphenidate ›
- Ivermectin ›
- Aspirin ›
- Rosuvastatin ›
- Tirzepatide ›
- Docusate ›
- Hydroxyurea ›
- Valacyclovir ›
- Metformin ›
- Sumatriptan ›
- Semaglutide ›
- Levothyroxine, Liothyronine ›
- Methotrexate ›
- Amoxicillin ›
- Lisinopril ›
- Azithromycin ›
- Doxycycline ›
- Acyclovir ›
- Methylene Blue ›
- Candesartan Cilexetil ›
- Amoxicillin, Clavulanate Potassium ›
- Acetylsalicylic Acid ›
- Insulin Degludec, Liraglutide ›
- Calcium Oxybate, Magnesium Oxybate, Potassium Oxybate, Sodium Oxybate ›
- Aluminum Hydroxide, Aspirin, Magnesium Hydroxide ›
- Ezetimibe ›
- Cyclopentolate ›
- Cephalexin ›
- Atenolol, Chlorthalidone ›
- Avatrombopag Maleate ›
- Thyroid Hormone ›
- Carbidopa, Levodopa ›
- Mannitol ›
- Bendroflumethiazide, Rauwolfia Serpentina ›
- Levodopa ›
- Canagliflozin, Metformin ›
- Enalapril Maleate ›
- Spironolactone ›
- Aspirin, Butalbital ›
- Acarbose ›
- Ceftolozane Sulfate, Tazobactam Sodium ›
- Alginic Acid, Aluminum Hydroxide ›
- Mitomycin ›
- Atenolol ›
- Flutemetamol F-18 ›
- Hydrocortisone, Clioquinol, Pramoxine ›
- Efgartigimod Alfa-fcab ›
- Charcoal (otc Drug) ›
- Levothyroxine Sodium ›
- Magnesium Hydroxide (otc Drug) ›
- Atropine Methyl Nitrate, Digestive Enzymes ›
- Daunorubicin, Cytarabine ›
- Peginterferon Alfa-2a, Ribavirin ›
- Articaine, Epinephrine ›
- Alpha-1 Proteinase Inhibitor ›
- Minoxidil ›
- Aminolevulinic Acid Hydrochloride ›
- Sodium Bicarbonate (otc Drug) ›
- Cytomegalovirus Immune Globulin ›
Showing the 60 most looked-up of 1,779 medications checked with no known interaction — see the full Cannabidiol (cbd) list.
Sources & How We Checked
Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.
- Natural Medicines (Therapeutic Research Center) — Evidence-graded clinical reference for vitamins, herbs and supplements — the basis for our interaction data.
- MedlinePlus, U.S. National Library of Medicine — NIH consumer drug information, used for the medication overviews.
- NIH Dietary Supplement Label Database (DSLD) — Official supplement product labels.
Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.
Parts of this content are provided by the Therapeutic Research Center, LLC.
DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
© 2021 Therapeutic Research Center, LLC
Acetaminophen, Butalbital, Codeine Is Linked to Lower Levels of One Nutrient
Natural Medicines records Acetaminophen, Butalbital, Codeine as a medicine that can lower these. This is not an interaction with Cannabidiol (cbd) — it is a separate effect of the medicine, and it is a reason some people are advised to supplement rather than to avoid one:
Read the full Acetaminophen, Butalbital, Codeine nutrient depletion report ›
Depletion records come from the licensed Natural Medicines database. Do not start a supplement on the strength of this page — ask your pharmacist or doctor whether it applies to you.
Taking Cannabidiol (cbd) and Acetaminophen, Butalbital, Codeine Together: Common Questions
Can you take Cannabidiol (cbd) with Acetaminophen, Butalbital, Codeine?
Why are there 5 interactions listed for Cannabidiol (cbd) and Acetaminophen, Butalbital, Codeine?
How serious is the Cannabidiol (cbd) and Acetaminophen, Butalbital, Codeine interaction?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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