Cannabidiol (cbd) + Acetaminophen, Dichlorophenazone, Isometheptane
Acetaminophen, Dichlorophenazone, Isometheptane brand name: Isocom.
Acetaminophen, Dichlorophenazone, Isometheptane falls into 4 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, Dichlorophenazone, Isometheptane
These two interact in 4 distinct ways. Each one is explained separately below.
Why Are There 4 Interactions?
Cannabidiol (cbd) interacts with whole categories of medication. Acetaminophen, Dichlorophenazone, Isometheptane falls into 4 of those categories, so it can interact with Cannabidiol (cbd) in 4 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).
CNS DEPRESSANTS
1 of 4Why this applies to Acetaminophen, Dichlorophenazone, Isometheptane
Acetaminophen, Dichlorophenazone, Isometheptane 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 headache medicine (sold as Isocom) contains three ingredients. One of them, dichloralphenazone, is a mild sedative, and the whole product can already make you feel a little drowsy or relaxed. CBD, especially at higher doses, may add to that sleepy effect.
So if you use CBD alongside this medicine, you might notice more drowsiness, dizziness, or feeling foggy than usual. It's worth being careful with driving or anything that needs full attention until you know how the pair affects you. Keep in mind this is a theoretical concern based on how these things work, not proven harm, and it's more likely with concentrated CBD products. Please check with your pharmacist or doctor before combining them.
- 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 1A2 (CYP1A2) SUBSTRATES
2 of 4Acetaminophen, Dichlorophenazone, Isometheptane 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 pill (Isocom) is a go-to for migraines, blending acetaminophen with isometheptene and a mild sedative. Here's the wrinkle with CBD: it can slow down a liver enzyme called CYP1A2, which helps process certain drugs. When that enzyme works more slowly, levels of an affected medicine can drift up a bit, which may mean a touch more drowsiness, dizziness, or grogginess from this product.
Honestly, the clearest evidence we have here is with caffeine, not with these exact ingredients, so the real-world effect may be modest, especially at typical CBD amounts. Still, since CBD products vary so much in strength, it's worth a quick chat with your pharmacist or doctor before pairing them, particularly if you already feel sleepy on this medicine.
- 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
3 of 4Acetaminophen, Dichlorophenazone, Isometheptane 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.
Isocom is a combination product containing acetaminophen (Tylenol), a mild sedative (dichloralphenazone), and isometheptene, used for tension and migraine headaches. The piece that matters here is the acetaminophen. Your body clears a good portion of acetaminophen through a process called glucuronidation, and lab studies suggest CBD can slow down some of the enzymes (UGT1A9 and UGT2B7) that handle that step.
In theory, that could let acetaminophen build up a bit higher than usual, which is a concern mainly for the liver if you are taking it regularly or alongside alcohol. I want to stress this is based only on test-tube research, so it is more of a 'be aware' than a 'be alarmed.' Still, it is worth a quick chat with your pharmacist or doctor before pairing CBD with this medicine.
- 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
4 of 4Acetaminophen, Dichlorophenazone, Isometheptane 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 combination pill (often sold as Isocom) is taken for headaches and migraines, and it contains acetaminophen, the same pain reliever found in Tylenol. The piece worth knowing here is that acetaminophen is partly broken down by a liver enzyme called CYP2E1. In lab studies (test tube, not people), CBD appears to slow that enzyme down. In theory, that could let a bit more acetaminophen linger in your system.
I want to be honest about how soft this evidence is. This has only been seen in the lab and has never actually been reported in real patients, so I wouldn't lose sleep over it. The bigger, well-known caution with acetaminophen is the liver, so don't go over the daily limit. If you regularly use CBD, just mention it to your pharmacist or doctor so they can keep an eye on things.
- 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, Dichlorophenazone, Isometheptane 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, Dichlorophenazone, Isometheptane
This page covers Cannabidiol (cbd) only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Acetaminophen, Dichlorophenazone, Isometheptane page lists 250 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 Ephedra (major).
By severity: 13 major · 196 moderate · 41 minor.
Open the Acetaminophen, Dichlorophenazone, Isometheptane interaction page
Where Cannabidiol (cbd) and Acetaminophen, Dichlorophenazone, Isometheptane 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.
#385 of 1,452 supplements looked up here in the last 7 days
#422 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 ›
- Aspirin ›
- Ivermectin ›
- Rosuvastatin ›
- Docusate ›
- Valacyclovir ›
- Hydroxyurea ›
- Sumatriptan ›
- Semaglutide ›
- Tirzepatide ›
- Metformin ›
- Amoxicillin ›
- Lisinopril ›
- Acyclovir ›
- Doxycycline ›
- Methotrexate ›
- Azithromycin ›
- Methylene Blue ›
- Levothyroxine, Liothyronine ›
- Cyclopentolate ›
- Candesartan Cilexetil ›
- Cephalexin ›
- Mannitol ›
- Pegunigalsidase Alfa-iwxj ›
- Daptomycin ›
- Hexobarbitone ›
- Levothyroxine Sodium ›
- Dexmethylphenidate ›
- Spironolactone ›
- Factor 7a ›
- Thyroid Hormone ›
- Carbidopa, Levodopa ›
- Mitomycin ›
- Minoxidil ›
- Levodopa ›
- Ezetimibe ›
- Cefaclor ›
- Lenvatinib ›
- Phenylephrine ›
- Vancomycin ›
- Hethylphenidate Hcl ›
- Dirithromycin ›
- Bentoquatam ›
- Amoxicillin, Clavulanate Potassium ›
- Procainamide ›
- Tenecteplase ›
- Hydroxychloroquine ›
- Azelaic Acid ›
- Triptorelin ›
- Dextrothyroxine ›
- Lomustine ›
- Acetylsalicylic Acid ›
- Pizotifen ›
- Tocainide ›
- Hydrochlorothiazide ›
- Rocuronium ›
- Succimer ›
- Mitomycin C ›
- Dabigatran ›
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, Dichlorophenazone, Isometheptane Is Linked to Lower Levels of One Nutrient
Natural Medicines records Acetaminophen, Dichlorophenazone, Isometheptane 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, Dichlorophenazone, Isometheptane 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, Dichlorophenazone, Isometheptane Together: Common Questions
Can you take Cannabidiol (cbd) with Acetaminophen, Dichlorophenazone, Isometheptane?
Why are there 4 interactions listed for Cannabidiol (cbd) and Acetaminophen, Dichlorophenazone, Isometheptane?
How serious is the Cannabidiol (cbd) and Acetaminophen, Dichlorophenazone, Isometheptane interaction?
Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy
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