Drug & supplement interaction

Cannabidiol (cbd) + Botulinum Toxin Type A

Botulinum Toxin Type A brand name: Botox.

No Known Interaction

Medically reviewed by Dr. Brian Staiger, PharmD, BCPS · Updated July 2026 · Pair last verified Sep 20, 2026

The bottom line No known interaction

We found no known interaction between Cannabidiol (cbd) and Botulinum Toxin Type A in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first.

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Interaction report

Cannabidiol (cbd) and Botulinum Toxin Type A

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Botulinum Toxin Type A and Cannabidiol (cbd) in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Cannabidiol (cbd) safety at a glance

Cannabidiol (cbd) overall Use caution CBD is generally well tolerated but can cause side effects and quality varies between products.

Pregnancy Possibly Unsafe When used orally. The US Food and Drug Administration (FDA) strongly advises against the use of cannabidiol during pregnancy. Cannabidiol products might contain... Read the full pregnancy detail

Breastfeeding Possibly Unsafe When used orally. The US Food and Drug Administration (FDA) strongly advises against the use of cannabidiol during pregnancy. Cannabidiol products might contain... Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Botulinum Toxin Type A and Cannabidiol (cbd)? Ask Dr. Brian Staiger, PharmD, BCPS directly ›

Keep it in perspective

Cannabidiol (cbd) Does Interact With Other Medications

Cannabidiol (cbd) has 1,051 moderate known drug interactions in our database — Botulinum Toxin Type A isn’t one of them. If you take anything else, check it against the full list below.

Moderate 1,051 No known interaction 1,779 (incl. Botulinum Toxin Type A)

Taking anything else?

Check Another of Your Medications Against Cannabidiol (cbd)

Covers the 2,830 medications we’ve checked against Cannabidiol (cbd). Pick one to open its full report.

What to actually watch for

What Cannabidiol (cbd) Itself Has Been Linked To

This is not an interaction — nothing below involves Botulinum Toxin Type A. It is the side-effect record for Cannabidiol (cbd) on its own, from the licensed Natural Medicines monograph. If something new turns up after you add Cannabidiol (cbd), this list is the first place to look. 4 entries are worth acting on rather than waiting out — marked below.

Dependence or withdrawal symptoms / Memory problems / Unsteadiness / Hallucinations / Confusion / Low mood Worth acting on Additional detail
“Orally, cannabidiol has been most commonly reported to cause somnolence, sedation, dizziness, agitation, and fatigue, with a significantly higher incidence when used in conjunction with clobazam. Hallucinations, delusions, confusion, and slurred speech have been reported in a Poison Control Center report.”

Cannabidiol (cbd) · Natural Medicines adverse-effect record, reported in cognitive function.
6 sources cited

61989. Carlini EA, Cunha JM. Hypnotic and antiepileptic effects of cannabidiol. J Clin Pharmacol 1981;21(8-9 Suppl):417S-27S. PubMed

100883. Laux LC, Bebin EM, Checketts D, et al. Long-term safety and efficacy of cannabidiol in children and adults with treatment resistant Lennox-Gastaut syndrome or Dravet syndrome: Expanded access program results. Epilepsy Res. 2019;154:13-20. PubMed

102323. Klotz KA, Grob D, Hirsch M, Metternich B, Schulze-Bonhage A, Jacobs J. Efficacy and Tolerance of Synthetic Cannabidiol for Treatment of Drug Resistant Epilepsy. Front Neurol. 2019 Dec 10;10:1313. PubMed

103031. Chesney E, Oliver D, Green A, et al. Adverse effects of cannabidiol: a systematic review and meta-analysis of randomized clinical trials. Neuropsychopharmacology. 2020. PubMed

104884. Leehey MA, Liu Y, Hart F, et al. Safety and Tolerability of Cannabidiol in Parkinson Disease: An Open Label, Dose-Escalation Study. Cannabis Cannabinoid Res. 2020;5(4):326-336. PubMed

105493. Berger BA, Stolz U, Colvin J, Otten EJ. Epidemiology of cannabidiol related cases reported in the National Poison Data System - 2019-2020. Am J Emerg Med. 2021;48:218-223. PubMed
A slow heartbeat / Shortness of breath Worth acting on Additional detail
“Orally, cannabidiol oil has been associated with rare respiratory depression and increased odds of pneumonia. In a case report, a 56-year-old obese male presented to the emergency room with severe respiratory depression 3 hours after consuming two packages of gummies labeled to contain cannabidiol 370 mg. Symptoms included respiratory acidosis, slurred speech, bradycardia, and vomiting.”

Cannabidiol (cbd) · Natural Medicines adverse-effect record, reported in cancer.
6 sources cited

103029. Bass J, Linz DR. A Case of Toxicity from Cannabidiol Gummy Ingestion. Cureus. 2020;12(4):e7688. PubMed

103031. Chesney E, Oliver D, Green A, et al. Adverse effects of cannabidiol: a systematic review and meta-analysis of randomized clinical trials. Neuropsychopharmacology. 2020. PubMed

106631. Patel AD, Mazurkiewicz-Beldzinska M, Chin RF, et al. Long-term safety and efficacy of add-on cannabidiol in patients with Lennox-Gastaut syndrome: Results of a long-term open-label extension trial. Epilepsia 2021;62(9):2228-2239. PubMed

106633. Scheffer IE, Halford JJ, Miller I, et al. Add-on cannabidiol in patients with Dravet syndrome: Results of a long-term open-label extension trial. Epilepsia 2021;62(10):2505-2517. PubMed

110247. Hardy J, Greer R, Huggett G, Kearney A, Gurgenci T, Good P. Phase IIb Randomized, Placebo-Controlled, Dose-Escalating, Double-Blind Study of Cannabidiol Oil for the Relief of Symptoms in Advanced Cancer (MedCan1-CBD). J Clin Oncol 2022. PubMed

61759. Rog, D. J., Nurmikko, T. J., Friede, T., and Young, C. A. Randomized, controlled trial of cannabis-based medicine in central pain in multiple sclerosis. Neurology 9-27-2005;65(6):812-819. PubMed
Seizures Worth acting on Additional detail
“Orally, cannabidiol has caused dry mouth in some patients in clinical research. In children and adults, cannabidiol oil has caused mild to moderate diarrhea, decreased appetite, weight loss, nausea, and vomiting. Diarrhea, decreased appetite, and weight loss or weight gain have been reported at a higher frequency with doses greater than 15-20 mg/kg daily.”

Cannabidiol (cbd) · Natural Medicines adverse-effect record, reported in constipation.
6 sources cited

89700. Consroe P, Sandyk R, Snider SR. Open label evaluation of cannabidiol in dystonic movement disorders. Int J Neurosci 1986;30(4):277-82. PubMed

105559. Velayudhan L, McGoohan K, Bhattacharyya S. Safety and tolerability of natural and synthetic cannabinoids in adults aged over 50 years: A systematic review and meta-analysis. PLoS Med. 2021;18(3):e1003524. PubMed

109177. Berger M, Li E, Rice S, et al. Cannabidiol for treatment-resistant anxiety disorders in young people: An open-label trial. J Clin Psychiatry 2022;83(5):21m14130. PubMed

110245. Dahlgren MK, Lambros AM, Smith RT, Sagar KA, El-Abboud C, Gruber SA. Clinical and cognitive improvement following full-spectrum, high-cannabidiol treatment for anxiety: open-label data from a two-stage, phase 2 clinical trial. Commun Med (Lond) 2022;2(1): PubMed

110249. Zubcevic K, Petersen M, Bach FW, et al. Oral capsules of tetra-hydro-cannabinol (THC), cannabidiol (CBD) and their combination in peripheral neuropathic pain treatment. Eur J Pain 2022.

97017. Devinsky O, Cross JH, Laux L, et al. Trial of cannabidiol for drug-resistant seizures in the Dravet Syndrome. N Engl J Med. 2017 May 25;376(21):2011-2020. PubMed
Raised blood pressure Worth acting on Additional detail
“Orally, cannabidiol has been associated with cardiovascular effects in some reports. In one clinical study, some patients experienced hypotension, orthostatic hypotension, and lightheadedness. Also, cannabidiol has also been linked to tachycardia and hypertension.”

Cannabidiol (cbd) · Natural Medicines adverse-effect record, reported in hypertension.
6 sources cited

89700. Consroe P, Sandyk R, Snider SR. Open label evaluation of cannabidiol in dystonic movement disorders. Int J Neurosci 1986;30(4):277-82. PubMed

105493. Berger BA, Stolz U, Colvin J, Otten EJ. Epidemiology of cannabidiol related cases reported in the National Poison Data System - 2019-2020. Am J Emerg Med. 2021;48:218-223. PubMed

110248. 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

61832. Consroe, P., Laguna, J., Allender, J., Snider, S., Stern, L., Sandyk, R., Kennedy, K., and Schram, K. Controlled clinical trial of cannabidiol in Huntington's disease. Pharmacol Biochem.Behav. 1991;40(3):701-708. PubMed

89675. Bergamaschi MM, Queiroz RH, Chagas MH, et al. Cannabidiol reduces the anxiety induced by simulated public speaking in treatment-naïve social phobia patients. Neuropsychopharmacology 2011;36(6):1219-26. PubMed

89909. Zuardi AW, Cosme RA, Graeff FG, Guimaraes FS. Effects of ipsapirone and cannabidiol on human experimental anxiety. J Psychopharmacol 1993;7(1 Suppl):82-8. PubMed

Showing the 10 most notable of 33 recorded effects — ranked by how unusual each one is across medicines generally, with serious effects weighted up.

Everything above comes from the Natural Medicines adverse-effect record for Cannabidiol (cbd) — expand a row for the licensed statement it rests on. We haven’t matched Botulinum Toxin Type A to its FDA label in our system yet, so we can’t compare its own side-effect list here — the leaflet that comes with your prescription is the authoritative list for Botulinum Toxin Type A.

Special populations

Cannabidiol (cbd) in Pregnancy & Breastfeeding

Pregnancy And Lactation Possibly Unsafe

When used orally. The US Food and Drug Administration (FDA) strongly advises against the use of cannabidiol during pregnancy. Cannabidiol products might contain delta-9-tetrahydrocannabinol (THC) or other contaminants such as pesticides, heavy metals, bacteria, and fungus, which can be dangerous to the child. Also, animal research shows that high levels of cannabidiol can damage the reproductive system of male offspring.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

Overlapping uses

What Botulinum Toxin Type A Is Prescribed For, and What Cannabidiol (cbd) Has Been Studied For

These two come up together because they touch the same health topic — not because they do the same job. Botulinum Toxin Type A is a prescription medicine with approved uses on its FDA label. Cannabidiol (cbd) is a supplement: what follows is what researchers have looked at it for, and how strong that evidence is.

Botulinum Toxin Type A is prescribed for: Botox is approved to treat a wide range of conditions in adults and some children. These include overactive bladder (OAB) with urge incontinence, urinary incontinence caused by nerve-related bladder overactivity (in adults and in children aged 5 and older), prevention of headaches in adults with chronic migraine (15 or more headache days per month), muscle stiffness (spasticity) in patients aged 2 and older, cervical dystonia (abnormal head position and neck pain), severe underarm sweating (primary axillary hyperhidrosis) when topical treatments haven't worked, eyelid spasms (blepharospasm) in patients aged 12 and older, and crossed eyes (strabismus) in patients aged 12 and older. BOTOX Cosmetic is a separate product containing the same active ingredient but with its own approved cosmetic uses. Both products are given by injection and are not interchangeable with other botulinum toxin products.

Read the rest of what Botulinum Toxin Type A is prescribed for

Botox has not been shown to work for episodic migraine (14 or fewer headache days per month), and its safety for excessive sweating in body areas other than the underarms has not been established.

Cannabidiol (cbd) has been studied for:

Dystonia studied, not established Cannabidiol (cbd) has been studied for this. Natural Medicines rates the evidence: Insufficient Reliable Evidence To Rate Read what the research shows

Cannabidiol (cbd) for dystonia

It is unclear if oral cannabidiol is beneficial for dystonia of various etiologies.

Effectiveness ratings and the research summaries above are the verbatim record from the Natural Medicines database, which grades evidence from “Effective” down to “Insufficient Reliable Evidence To Rate”. A rating below the top of that scale means researchers have looked at it — not that it works, and never that it can stand in for a prescribed medicine. Do not stop or replace Botulinum Toxin Type A on your own; if you are taking Cannabidiol (cbd) for the same health topic, tell your prescriber, especially if the medicine is being adjusted to a target.

From our Q&A

Questions About Cannabidiol (cbd) or Botulinum Toxin Type A

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Cannabidiol (cbd) or Botulinum Toxin Type A, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Can Ashwagandha Make Botox Less Effective? Answered by Dr. Brian Staiger, PharmD · July 2026 ›

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

How much people look this up

Where Cannabidiol (cbd) and Botulinum Toxin Type A 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.

Supplement Cannabidiol (cbd)

Top half

#496 of 1,452 supplements looked up here in the last 7 days

29 days ago today

Medication Botulinum Toxin Type A

Top half

#727 of 2,830 medications looked up here in the last 7 days

29 days ago today

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.

Where does our data come from?

Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Cannabidiol (cbd) reference on this page ↓
Freshness: we automatically re-check this combination every week — this pair was last verified September 20, 2026. The Cannabidiol (cbd) and Botulinum Toxin Type A records this page draws on were last updated July 10, 2026.
What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.

Data structure & sourcing designed and verified by Dr. Brian Staiger, PharmD, BCPS.

Supplement

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.

Cannabis sativa · Cannabaceae · Flowers, leaves, and stalks of the hemp plant (extracted compound) · Oils and tinctures, capsules, gummies, topical creams, vape liquids, and a prescription solution

An interaction check asks whether these two react with each other — it does not ask whether Cannabidiol (cbd) is a good idea for someone in your situation. Here is what our Cannabidiol (cbd) record says about it on its own.

Cannabidiol (cbd): dosing

There is no single standard dose of CBD for general supplement use. The right amount can depend on the product, the reason for use, and the person. Because of this, it is best to follow the directions on the product label and start with a low amount.The only well-established dosing comes from the prescription CBD medicine used for seizures, which is carefully dosed by a doctor based on body weight. They can help you decide whether it is appropriate for you and review your other medicines for possible problems.

From our Cannabidiol (cbd) monograph — the full record covers uses, side effects and every documented interaction.

Read the full Cannabidiol (cbd) monograph & all interactions

Medication

About OnabotulinumtoxinA Injection

What Is OnabotulinumtoxinA Injection Used For?

Brand name: Botox

Botox is approved to treat a wide range of conditions in adults and some children. These include overactive bladder (OAB) with urge incontinence, urinary incontinence caused by nerve-related bladder overactivity (in adults and in children aged 5 and older), prevention of headaches in adults with chronic migraine (15 or more headache days per month), muscle stiffness (spasticity) in patients aged 2 and older, cervical dystonia (abnormal head position and neck pain), severe underarm sweating (primary axillary hyperhidrosis) when topical treatments haven't worked, eyelid spasms (blepharospasm) in patients aged 12 and older, and crossed eyes (strabismus) in patients aged 12 and older.

BOTOX Cosmetic is a separate product containing the same active ingredient but with its own approved cosmetic uses. Both products are given by injection and are not interchangeable with other botulinum toxin products. Botox has not been shown to work for episodic migraine (14 or fewer headache days per month), and its safety for excessive sweating in body areas other than the underarms has not been established.

Most-Reported Side Effects for Botulinum Toxin Type A

From FAERS, the FDA’s public side-effect reporting system (12,344 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Headache 1,596 reports

Drug intolerance 1,333 reports

Nausea 1,266 reports

Migraine 1,176 reports

Dizziness 1,126 reports

See full OnabotulinumtoxinA Injection drug information

Keep checking

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.

0Major

1,051Moderate

0Minor

1,778No known interaction

1,051 Moderate 1,778 No interaction

Moderate

1,051 interactions

Showing 60 of 1,051 moderate interactions — see all 1,051 on the Cannabidiol (cbd) page.

No interaction 1,778 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.

Showing the 60 most looked-up of 1,778 medications checked with no known interaction — see the full Cannabidiol (cbd) list.

See the full Cannabidiol (cbd) interactions page

See every supplement checked against Botulinum Toxin Type A, ranked by severity

Evidence & sources

Cannabidiol (cbd) References

The 93 references that drive our Cannabidiol (cbd) monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

Rog, D. J., Nurmikko, T. J., Friede, T., and Young, C. A. Randomized, controlled trial of cannabis-based medicine in central pain in multiple sclerosis. Neurology 9-27-2005;65(6):812-819. PubMed
Perras, C. Sativex for the management of multiple sclerosis symptoms. Issues Emerg.Health Technol. 2005;(72):1-4.
Rog, D. J., Nurmikko, T. J., and Young, C. A. Oromucosal delta9-tetrahydrocannabinol/cannabidiol for neuropathic pain associated with multiple sclerosis: an uncontrolled, open-label, 2-year extension trial. Clin Ther. 2007;29(9):2068-2079.
Consroe, P., Laguna, J., Allender, J., Snider, S., Stern, L., Sandyk, R., Kennedy, K., and Schram, K. Controlled clinical trial of cannabidiol in Huntington's disease. Pharmacol Biochem.Behav. 1991;40(3):701-708. PubMed
Lynch, M. E. and Campbell, F. Cannabinoids for treatment of chronic non-cancer pain; a systematic review of randomized trials. Br.J.Clin.Pharmacol. 2011;72(5):735-744. PubMed
Richards, B. L., Whittle, S. L., and Buchbinder, R. Neuromodulators for pain management in rheumatoid arthritis. Cochrane.Database.Syst.Rev. 2012;1:CD008921. PubMed
Carlini EA, Cunha JM. Hypnotic and antiepileptic effects of cannabidiol. J Clin Pharmacol 1981;21(8-9 Suppl):417S-27S. PubMed
Bergamaschi MM, Queiroz RH, Chagas MH, et al. Cannabidiol reduces the anxiety induced by simulated public speaking in treatment-naïve social phobia patients. Neuropsychopharmacology 2011;36(6):1219-26. PubMed
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.
Yamaori S, Maeda C, Yamamoto I, Watanabe K. Differential inhibition of human cytochrome P450 2A6 and 2B6 by major phytocannabinoids. Forensic Toxicol 2011;29:117-24. DOI
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
Yamaori S, Ebisawa J, Okushima Y, et al. Potent inhibition of human cytochrome P450 3A isoforms by cannabidiol: role of phenolic hydroxyl groups in the resorcinol moiety. Life Sci 2011;88(15-16):730-6. PubMed
Harvey DJ. Absorption, distribution, and biotransformation of the cannabinoids. Marijuana and Medicine. 1999;91-103. DOI
Bornheim LM, Everhart ET, Li J, Correia MA. Characterization of cannabidiol-mediated cytochrome P450 inactivation. Biochem Pharmacol 1993;45(6):1323-31. PubMed
Consroe P, Sandyk R, Snider SR. Open label evaluation of cannabidiol in dystonic movement disorders. Int J Neurosci 1986;30(4):277-82. PubMed
Zuardi AW, Cosme RA, Graeff FG, Guimaraes FS. Effects of ipsapirone and cannabidiol on human experimental anxiety. J Psychopharmacol 1993;7(1 Suppl):82-8. 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.
Duran M, Pérez E, Abanades S, et al. Preliminary efficacy and safety of an oromucosal standardized cannabis extract in chemotherapy-induced nausea and vomiting. Br J Clin Pharmacol. 2010;70(5):656-63. PubMed
Devinsky O, Cross JH, Laux L, et al. Trial of cannabidiol for drug-resistant seizures in the Dravet Syndrome. N Engl J Med. 2017 May 25;376(21):2011-2020. PubMed
Gaston TE, Bebin EM, Cutter GR, Liu Y, Szaflarski JP; UAB CBD Program. Interactions between cannabidiol and commonly used antiepileptic drugs. Epilepsia. 2017 Sep;58(9):1586-92. PubMed
Hess EJ, Moody KA, Geffrey AL, et al. Cannabidiol as a new treatment for drug-resistant epilepsy in tuberous sclerosis complex. Epilepsia. 2016 Oct;57(10):1617-24. PubMed
97021 Jadoon KA, Ratcliffe SH, Barrett DA, et al. Efficacy and safety of cannabidiol and tetrahydrocannabivarin on glycemic and lipid parameters in patients with type 2 diabetes: a randomized, double-blind, placebo-controlled, parallel group pilot study. PubMed
Devinsky O, Marsh E, Friedman D, et la. Cannabidiol in patients with treatment-resistant epilepsy: an open-label interventional trial. Lancet Neurol. 2016 Mar;15(3):270-8.
Geffrey AL, Pollack SF, Bruno PL, Thiele EA. Drug-drug interaction between clobazam and cannabidiol in children with refractory epilepsy. Epilepsia. 2015 Aug;56(8):1246-51. PubMed
Kaplan EH, Offermann EA, Sievers JW, Comi AM. Cannabidiol treatment for refractory seizures in Sturge-Weber Syndrome. Pediatr Neurol. 2017 Jun;71:18-23.e2. PubMed
Devinsky O, Patel AD, Cross JH, et al. Effect of Cannabidiol on Drop Seizures in the Lennox-Gastaut Syndrome. N Engl J Med. 2018 May 17;378(20):1888-1897. PubMed
Thiele EA, Marsh ED, French JA, et al. Cannabidiol in patients with seizures associated with Lennox-Gastaut syndrome (GWPCARE4): a randomised, double-blind, placebo-controlled phase 3 trial. Lancet. 2018 Mar 17;391(10125):1085-1096.
Schoedel KA, Szeto I, Setnik B, et al. Abuse potential assessment of cannabidiol (CBD) in recreational polydrug users: A randomized, double-blind, controlled trial. Epilepsy Behav. 2018 Nov;88:162-171. doi: 10.1016/j.yebeh.2018.07.027. Epub 2018 Oct 2. PubMed
Drug Enforcement Administration, Department of Justice. Schedules of Controlled Substances: Placement in Schedule V of Certain FDA-Approved Drugs Containing Cannabidiol; Corresponding Change to Permit Requirements. Final order. Fed Regist. 2018 Sep 28;83(
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)
Product information for Marinol. AbbVie. North Chicago, IL 60064. August 2017. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/018651s029lbl.pdf.
Klotz KA, Hirsch M, Heers M, Schulze-Bonhage A, Jacobs J. Effects of cannabidiol on brivaracetam plasma levels. Epilepsia. 2019;60(7):e74-e77. PubMed
Laux LC, Bebin EM, Checketts D, et al. Long-term safety and efficacy of cannabidiol in children and adults with treatment resistant Lennox-Gastaut syndrome or Dravet syndrome: Expanded access program results. Epilepsy Res. 2019;154:13-20. PubMed
Leino AD, Emoto C, Fukuda T, Privitera M, Vinks AA, Alloway RR. Evidence of a clinically significant drug-drug interaction between cannabidiol and tacrolimus. Am J Transplant. 2019;19(10):2944-2948. PubMed
Martin RC, Gaston TE, Thompson M, et al. Cognitive functioning following long-term cannabidiol use in adults with treatment-resistant epilepsy. Epilepsy Behav. 2019;97:105-110. PubMed
FDA Consumer Updates: What You Should Know About Using Cannabis, Including CBD, When Pregnant or Breastfeeding. U. S. Food and Drug Administration (FDA). October 2019. Available at: https://www.fda.gov/consumers/consumer-updates/what-you-should-know-about
Wiemer-Kruel A, Stiller B, Bast T. Cannabidiol Interacts Significantly with Everolimus-Report of a Patient with Tuberous Sclerosis Complex. Neuropediatrics. 2019. PubMed
Klotz KA, Grob D, Hirsch M, Metternich B, Schulze-Bonhage A, Jacobs J. Efficacy and Tolerance of Synthetic Cannabidiol for Treatment of Drug Resistant Epilepsy. Front Neurol. 2019 Dec 10;10:1313. PubMed
Madden K, Tanco K, Bruera E. Clinically Significant Drug-Drug Interaction Between Methadone and Cannabidiol. Pediatrics. 2020;e20193256. PubMed
Bass J, Linz DR. A Case of Toxicity from Cannabidiol Gummy Ingestion. Cureus. 2020;12(4):e7688. PubMed
Ben-Menachem E, Gunning B, Arenas Cabrera CM, et al. A Phase II Randomized Trial to Explore the Potential for Pharmacokinetic Drug-Drug Interactions with Stiripentol or Valproate when Combined with Cannabidiol in Patients with Epilepsy. CNS Drugs. 2020;34 PubMed
Chesney E, Oliver D, Green A, et al. Adverse effects of cannabidiol: a systematic review and meta-analysis of randomized clinical trials. Neuropsychopharmacology. 2020. PubMed
Darweesh RS, Khamis TN, El-Elimat T. The effect of cannabidiol on the pharmacokinetics of carbamazepine in rats. Naunyn Schmiedebergs Arch Pharmacol. 2020. PubMed
de Carvalho Reis R, Almeida KJ, da Silva Lopes L, de Melo Mendes CM, Bor-Seng-Shu E. Efficacy and adverse event profile of cannabidiol and medicinal cannabis for treatment-resistant epilepsy: Systematic review and meta-analysis. Epilepsy Behav. 2020;102:1 PubMed
Ebrahimi-Fakhari D, Agricola KD, Tudor C, Krueger D, Franz DN. Cannabidiol Elevates Mechanistic Target of Rapamycin Inhibitor Levels in Patients With Tuberous Sclerosis Complex. Pediatr Neurol. 2020;105:59-61. PubMed
Morrison G, Crockett J, Blakey G, Sommerville K. A Phase 1, Open-Label, Pharmacokinetic Trial to Investigate Possible Drug-Drug Interactions Between Clobazam, Stiripentol, or Valproate and Cannabidiol in Healthy Subjects. Clin Pharmacol Drug Dev. 2019;8(8 PubMed
McNamara NA, Dang LT, Sturza J, et al. Thrombocytopenia in pediatric patients on concurrent cannabidiol and valproic acid. Epilepsia. 2020. PubMed
Taylor L, Crockett J, Tayo B, Checketts D, Sommerville K. Abrupt withdrawal of cannabidiol (CBD): A randomized trial. Epilepsy Behav. 2020;104(Pt A):106938. PubMed
Cortopassi J. Warfarin dose adjustment required after cannabidiol initiation and titration. Am J Health Syst Pharm. 2020;77(22):1846-1851. PubMed
Singh RK, Dillon B, Tatum DA, Van Poppel KC, Bonthius DJ. Drug-Drug Interactions Between Cannabidiol and Lithium. Child Neurol Open. 2020;7:2329048X20947896. PubMed
Arkell TR, Vinckenbosch F, Kevin RC, Theunissen EL, McGregor IS, Ramaekers JG. Effect of Cannabidiol and ?9-Tetrahydrocannabinol on Driving Performance: A Randomized Clinical Trial. JAMA. 2020;324(21):2177-2186.
Cole TB, Saitz R. Cannabis and Impaired Driving. JAMA. 2020;324(21):2163-2164. PubMed
Leehey MA, Liu Y, Hart F, et al. Safety and Tolerability of Cannabidiol in Parkinson Disease: An Open Label, Dose-Escalation Study. Cannabis Cannabinoid Res. 2020;5(4):326-336. PubMed
Oruganti P, Betcher S, Wakade Z, Ding X, Abegunde AT. Cannabidiol Oil-Associated Microscopic Colitis. Cureus. 2020;12(9):e10528. PubMed
Parihar V, Rogers A, Blain AM, Zacharias SRK, Patterson LL, Siyam MA. Reduction in Tamoxifen Metabolites Endoxifen and N-desmethyltamoxifen With Chronic Administration of Low Dose Cannabidiol: A CYP3A4 and CYP2D6 Drug Interaction. J Pharm Pract. 2020:8971 PubMed
Watkins PB, Church RJ, Li J, Knappertz V. Cannabidiol and Abnormal Liver Chemistries in Healthy Adults: Results of a Phase I Clinical Trial. Clin Pharmacol Ther. 2020. PubMed
Anderson LL, Doohan PT, Oldfield L, et al. Citalopram and Cannabidiol: In Vitro and In Vivo Evidence of Pharmacokinetic Interactions Relevant to the Treatment of Anxiety Disorders in Young People. J Clin Psychopharmacol. 2021. PubMed
Berger BA, Stolz U, Colvin J, Otten EJ. Epidemiology of cannabidiol related cases reported in the National Poison Data System - 2019-2020. Am J Emerg Med. 2021;48:218-223. PubMed
Gaston TE, Ampah SB, Martina Bebin E, et al. Long-term safety and efficacy of highly purified cannabidiol for treatment refractory epilepsy. Epilepsy Behav. 2021;117:107862. PubMed
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
Velayudhan L, McGoohan K, Bhattacharyya S. Safety and tolerability of natural and synthetic cannabinoids in adults aged over 50 years: A systematic review and meta-analysis. PLoS Med. 2021;18(3):e1003524. PubMed
Crippa JAS, Zuardi AW, Guimarães FS, et al. Burnout and Distress Prevention With Cannabidiol in Front-line Health Care Workers Dealing With COVID-19 (BONSAI) Trial Investigators. Efficacy and Safety of Cannabidiol Plus Standard Care vs Standard Care Alone
Patel AD, Mazurkiewicz-Beldzinska M, Chin RF, et al. Long-term safety and efficacy of add-on cannabidiol in patients with Lennox-Gastaut syndrome: Results of a long-term open-label extension trial. Epilepsia 2021;62(9):2228-2239. PubMed
Scheffer IE, Halford JJ, Miller I, et al. Add-on cannabidiol in patients with Dravet syndrome: Results of a long-term open-label extension trial. Epilepsia 2021;62(10):2505-2517. PubMed
Davis BH, Beasley TM, Amaral M, et al. Pharmacogenetic Predictors of Cannabidiol Response and Tolerability in Treatment-Resistant Epilepsy. Clin Pharmacol Ther 2021;110(5):1368-1380. 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
Thiele EA, Bebin EM, Filloux F, et al. Long-term cannabidiol treatment for seizures in patients with tuberous sclerosis complex: An open-label extension trial. Epilepsia 2021. PubMed
Kaufmann R, Aqua K, Lombardo J, Lee M. Observed Impact of Long-term Consumption of Oral Cannabidiol on Liver Function in Healthy Adults. Cannabis Cannabinoid Res 2021. PubMed
Busse JW, Vankrunkelsven P, Zeng L, et al. Medical cannabis or cannabinoids for chronic pain: a clinical practice guideline. BMJ 2021;374:n2040. PubMed
Gardener H, Wallin C, Bowen J. Heavy metal and phthalate contamination and labeling integrity in a large sample of US commercially available cannabidiol (CBD) products. Sci Total Environ 2022;851(Pt 1):158110. PubMed
Atieh J, Maselli D, Breen-Lyles M, et al. Cannabidiol for functional dyspepsia with normal gastric emptying: A randomized controlled trial. Am J Gastroenterol 2022;117(8):1296-1304. PubMed
Berger M, Li E, Rice S, et al. Cannabidiol for treatment-resistant anxiety disorders in young people: An open-label trial. J Clin Psychiatry 2022;83(5):21m14130. PubMed
Souza JDS, Fassoni-Ribeiro M, Batista RM, et al. Case report: Cannabidiol-induced skin rash: A case series and key recommendations. Front Pharmacol 2022;13:881617. PubMed
McCartney D, Suraev AS, Doohan PT, et al. Effects of cannabidiol on simulated driving and cognitive performance: A dose-ranging randomised controlled trial. J Psychopharmacol 2022. PubMed
Anderson LL, Arnold JC, McGregor IS, Nation TR. A potential drug-gene-drug interaction between cannabidiol, CYP2D6*4, and fluoxetine: A case report. J Clin Psychopharmacol 2022;42(4):422-424. PubMed
Berry-Kravis E, Hagerman R, Budimirovic D, et al. A randomized, controlled trial of ZYN002 cannabidiol transdermal gel in children and adolescents with fragile X syndrome (CONNECT-FX). J Neurodev Disord 2022;14(1):56. PubMed
Souza JDR, Pacheco JC, Rossi GN, et al. Adverse Effects of Oral Cannabidiol: An Updated Systematic Review of Randomized Controlled Trials (2020-2022). Pharmaceutics 2022;14(12):2598. PubMed
Dahlgren MK, Lambros AM, Smith RT, Sagar KA, El-Abboud C, Gruber SA. Clinical and cognitive improvement following full-spectrum, high-cannabidiol treatment for anxiety: open-label data from a two-stage, phase 2 clinical trial. Commun Med (Lond) 2022;2(1): PubMed
Hardy J, Greer R, Huggett G, Kearney A, Gurgenci T, Good P. Phase IIb Randomized, Placebo-Controlled, Dose-Escalating, Double-Blind Study of Cannabidiol Oil for the Relief of Symptoms in Advanced Cancer (MedCan1-CBD). J Clin Oncol 2022. PubMed
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
Zubcevic K, Petersen M, Bach FW, et al. Oral capsules of tetra-hydro-cannabinol (THC), cannabidiol (CBD) and their combination in peripheral neuropathic pain treatment. Eur J Pain 2022.
Zamarripa CA, Spindle TR, Surujunarain R, et al. Assessment of orally administered ?9-tetrahydrocannabinol when coadministered with cannabidiol on ?9-tetrahydrocannabinol pharmacokinetics and pharmacodynamics in healthy adults: A randomized clinical trial PubMed
Treyer A, Reinhardt JK, Eigenmann DE, Oufir M, Hamburger M. Phytochemical comparison of medicinal cannabis extracts and study of their CYP-mediated interactions with coumarinic oral anticoagulants. Med Cannabis Cannabinoids. 2023;6(1):21-31. PubMed
Ammendolia I, Mannucci C, Cardia L, et al. Pharmacovigilance on cannabidiol as an antiepileptic agent. Front Pharmacol 2023;14:1091978. 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.
Fazlollahi A, Zahmatyar M, ZareDini M, et al. Adverse Events of Cannabidiol Use in Patients With Epilepsy: A Systematic Review and Meta-analysis. JAMA Netw Open 2023;6(4):e239126. PubMed
Georgieva D, Langley J, Hartkopf K, et al. Real-world, long-term evaluation of the tolerability and therapy retention of Epidiolex® (cannabidiol) in patients with refractory epilepsy. Epilepsy Behav 2023;141:109159. PubMed
Katz DT, Fifi A, Milesi-Halle A, Saps M. A Rare Case of Cannabinoid Hyperemesis Syndrome Secondary to Cannabidiol for Refractory Epilepsy. JPGN Rep 2023;4(1):e280. PubMed
Kaufmann R, Harris Bozer A, Jotte ARK, Aqua K. The Effects of Long-Term Self-Dosing of Cannabidiol on Drowsiness, Testosterone Levels, and Liver Function. Med Cannabis Cannabinoids 2023;6(1):32-40. PubMed
Lo LA, Christiansen A, Eadie L, et al. Cannabidiol-associated hepatotoxicity: A systematic review and meta-analysis. J Intern Med 2023;293(6):724-752. PubMed
Patel M, Middleton JP, Goodkin HP, Barnes B, McGowan E, Eid R. Persistent Diarrhea and Eosinophilic Esophagitis Resulting From Chronic Cannabidiol Usage for Refractory Epilepsy. JPGN Rep 2022;3(4):e253. PubMed
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. PubMed

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Cannabidiol (cbd) and Botulinum Toxin Type A Together: Common Questions

Is it safe to take Cannabidiol (cbd) with Botulinum Toxin Type A?

We do not list a known interaction between Cannabidiol (cbd) and Botulinum Toxin Type A. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.

Are Cannabidiol (cbd) and Botulinum Toxin Type A used for the same thing?

They overlap in purpose, which usually means the real question is whether you need both rather than whether they are safe together. This page lists the shared uses and how strong the evidence is for Cannabidiol (cbd) in each. That is a conversation for your prescriber, especially if Botulinum Toxin Type A is being adjusted to a target.

Does Cannabidiol (cbd) interact with any other medications?

Yes. Cannabidiol (cbd) has 1,051 documented drug interactions in our database — Botulinum Toxin Type A is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.