Cannabidiol (cbd) + Acetaminophen, Codeine, Methocarbamol
Acetaminophen, Codeine, Methocarbamol brand names: Acetaminophen, Codeine, Methocarbamol, Robaxacet 8.
Acetaminophen, Codeine, Methocarbamol 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, Codeine, Methocarbamol
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, Codeine, Methocarbamol 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, Codeine, Methocarbamol
Acetaminophen, Codeine, Methocarbamol 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.
This combination product packs two ingredients that already make people drowsy: codeine (an opioid pain reliever) and methocarbamol (a muscle relaxer). CBD can have its own calming, sleepy effect, especially at higher supplement doses. So the main concern here is simple addition. Putting CBD on top of these may leave you more sedated than you expect, with extra drowsiness, dizziness, slowed reactions, or that foggy, unsteady feeling.
Keep in mind this is a theoretical interaction based on how these drugs work, not on solid head-to-head studies, so it may not affect everyone the same way. Still, it's worth caution. Don't drive or do anything risky until you know how you react, and check with your pharmacist or doctor before pairing CBD with this medicine.
- 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, Codeine, Methocarbamol 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 about this combo product. The codeine portion is actually a prodrug, meaning your body has to convert it into morphine using an enzyme called CYP2D6 before it can ease your pain. CBD may block that same enzyme in the lab, so in theory it could leave you with less pain relief from the codeine, not more, since less of it turns into the active form.
I'll be honest though, this is only a theoretical concern based on test-tube data, and a human study with a similar CYP2D6 drug showed no real effect. So for most people this likely won't be a big deal. If you take CBD regularly and notice your pain isn't well controlled, mention it to your pharmacist or doctor before changing anything.
- 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, Codeine, Methocarbamol 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..
This combination product has three parts: acetaminophen (Tylenol), codeine, and methocarbamol (a muscle relaxer). The interaction on file is about CBD slowing down a liver enzyme called CYP1A2. Here's the honest part: codeine actually relies mostly on a different enzyme (CYP2D6) to turn into its active painkiller, and acetaminophen and methocarbamol aren't strongly tied to CYP1A2 either. So for this specific product, the CYP1A2 angle isn't a great fit, and the real-world effect is likely small.
Even so, both CBD and codeine can cause drowsiness, and together they may make you sleepier or more lightheaded than usual. Concentrated CBD doses matter more than tiny amounts. Please check with your pharmacist or doctor before combining them.
- 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, Codeine, Methocarbamol 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 packs three things: acetaminophen (Tylenol), codeine, and the muscle relaxant methocarbamol. CBD has been shown in lab studies to slow down certain UGT enzymes that help your body clear drugs through a process called glucuronidation. In theory, that could let some of these medicines linger a bit longer than usual.
What might that feel like? Possibly more drowsiness, dizziness, constipation, or grogginess, since both codeine and methocarbamol already cause sedation. One caution worth noting: high acetaminophen levels are hard on the liver, so it's wise not to overdo total Tylenol from all sources. This concern comes only from test-tube research, not real patients, so it's theoretical. Still, please check with your pharmacist or doctor before pairing them.
- 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, Codeine, Methocarbamol 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.
Here's what's going on with your Robaxacet-type combo. The piece that matters here is the acetaminophen, which is partly handled by a liver enzyme called CYP2E1. In test-tube studies, CBD appears to slow that enzyme down. The worry, in theory, is that acetaminophen could be processed differently, and one of its breakdown products is what stresses the liver when acetaminophen levels run high.
I want to be honest about the strength of this: it comes only from lab research, and it has not actually been seen in people. So I wouldn't lose sleep over it, but I also wouldn't ignore it, especially since extra acetaminophen from other cold or pain products adds up fast. Keep your daily acetaminophen reasonable, and check with your pharmacist or doctor before pairing this with CBD.
- 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, Codeine, Methocarbamol 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, Codeine, Methocarbamol
This page covers Cannabidiol (cbd) only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acetaminophen, Codeine, Methocarbamol page lists 243 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: 10 major · 193 moderate · 40 minor.
Open the Acetaminophen, Codeine, Methocarbamol interaction page
Where Cannabidiol (cbd) and Acetaminophen, Codeine, Methocarbamol 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.
#539 of 1,452 supplements looked up here in the last 7 days
#2,018 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 ›
- Docusate ›
- Tirzepatide ›
- Valacyclovir ›
- Hydroxyurea ›
- Sumatriptan ›
- Semaglutide ›
- Metformin ›
- Amoxicillin ›
- Lisinopril ›
- Methotrexate ›
- Doxycycline ›
- Acyclovir ›
- Azithromycin ›
- Levothyroxine, Liothyronine ›
- Methylene Blue ›
- Candesartan Cilexetil ›
- Amoxicillin, Clavulanate Potassium ›
- Cephalexin ›
- Cyclopentolate ›
- Mannitol ›
- Ezetimibe ›
- Acetylsalicylic Acid ›
- Carbidopa, Levodopa ›
- Spironolactone ›
- Dexmethylphenidate ›
- Levothyroxine Sodium ›
- Thyroid Hormone ›
- Levodopa ›
- Pizotifen ›
- Daptomycin ›
- Canagliflozin, Metformin ›
- Lenvatinib ›
- Hexobarbitone ›
- Flutemetamol F-18 ›
- Magnesium Hydroxide (otc Drug) ›
- Mitomycin ›
- Cefaclor ›
- Insulin Degludec, Liraglutide ›
- Pegunigalsidase Alfa-iwxj ›
- Atenolol ›
- Bentoquatam ›
- Alglucosidase Alpha ›
- Salbutamol Sulfate ›
- Hethylphenidate Hcl ›
- Factor 7a ›
- Minoxidil ›
- Vancomycin ›
- Tocainide ›
- Insulin Human, Sodium Chloride ›
- Phenylephrine ›
- Ribavirin Aerosol ›
- Azelaic Acid ›
- Hydroxychloroquine ›
- Bleomycin ›
- Casanthranol, Docusate ›
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, Codeine, Methocarbamol Is Linked to Lower Levels of One Nutrient
Natural Medicines records Acetaminophen, Codeine, Methocarbamol 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, Codeine, Methocarbamol 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, Codeine, Methocarbamol Together: Common Questions
Can you take Cannabidiol (cbd) with Acetaminophen, Codeine, Methocarbamol?
Why are there 5 interactions listed for Cannabidiol (cbd) and Acetaminophen, Codeine, Methocarbamol?
How serious is the Cannabidiol (cbd) and Acetaminophen, Codeine, Methocarbamol interaction?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
Still Have a Question About Acetaminophen, Codeine, Methocarbamol and Cannabidiol (cbd)?
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