Drug & supplement interaction

Cannabidiol (cbd) + Fluvastatin

Fluvastatin brand names: Lescol, Lescol XL.

Moderate Interaction
The bottom line Moderate

Fluvastatin falls into 3 drug categories that Cannabidiol (cbd) can interact with; the most serious is rated moderate. Theoretically, CYP2C19 inhibitors might increase cannabidiol levels.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions3
EvidenceD
What do Severity, Likelihood & Evidence mean?
Know someone taking this? Share
Interaction report

Cannabidiol (cbd) and Fluvastatin

These two interact in 3 distinct ways. Each one is explained separately below.

Why Are There 3 Interactions?

Cannabidiol (cbd) interacts with whole categories of medication. Fluvastatin falls into 3 of those categories, so it can interact with Cannabidiol (cbd) in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 2C19 (CYP2C19) INHIBITORS

1 of 3

Why this applies to Fluvastatin

Fluvastatin falls under CYTOCHROME P450 2C19 (CYP2C19) INHIBITORS — the group Cannabidiol (cbd) interacts with.

Theoretically, CYP2C19 inhibitors might increase cannabidiol levels.
Cannabidiol is a substrate of CYP2C19 enzymes. Theoretically, drugs that inhibit CYP2C19 enzymes might increase levels of cannabidiol, increasing its effects and adverse effects.
Severity Moderate Likelihood Possible Evidence D

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.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the key thing to notice: in this case it's the fluvastatin affecting the CBD, not the other way around. Fluvastatin can mildly block an enzyme called CYP2C19, and that same enzyme helps your body break down CBD. So if you take them together, your CBD levels could theoretically run a little higher, which might mean more of CBD's usual effects like drowsiness, lightheadedness, an upset stomach, or feeling unusually tired.

I want to be honest that this is theoretical, based on how these compounds behave in the lab, not on real-world reports of problems. Fluvastatin is also a fairly weak inhibitor here. Still, since CBD products vary so much in strength and quality, it's worth mentioning to your pharmacist or doctor, especially if you notice more sleepiness than usual.

References
  1. 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)
Moderate

CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES

2 of 3

Fluvastatin also falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES.

Cannabidiol may increase levels of drugs metabolized by CYP2C9.
In vitro and animal research shows that cannabidiol inhibits CYP2C9. In human studies, cannabidiol has been associated with an increase in plasma levels of topiramate and losartan, CYP2C9 substrates. Concomitant use of cannabidiol with CYP2C9 substrates may increase the risk for adverse effects from these substrates.
Severity Moderate Likelihood Probable Evidence A

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..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist for your cholesterol pill. Fluvastatin is cleared mainly by a liver enzyme called CYP2C9, and CBD can slow that enzyme down. When the enzyme is working slower, fluvastatin can't break down as quickly, so its level in your blood may creep up higher than expected.

For an active statin like fluvastatin, more drug usually means a bigger chance of the typical statin side effects, things like muscle aches, soreness or weakness, and occasionally changes in liver blood tests. This isn't a reason to panic, and the rise is often modest, but the science behind it is reasonably solid. Since CBD products vary so much in strength, it's worth a quick chat with your pharmacist or doctor before combining them so they can keep an eye on how you feel.

References
  1. Harvey DJ. Absorption, distribution, and biotransformation of the cannabinoids. Marijuana and Medicine. 1999;91-103. DOI
  2. Bornheim LM, Everhart ET, Li J, Correia MA. Characterization of cannabidiol-mediated cytochrome P450 inactivation. Biochem Pharmacol 1993;45(6):1323-31. PubMed
  3. 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
  4. 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
  5. 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
  6. Bansal S, Zamarripa CA, Spindle TR, et al. Evaluation of Cytochrome P450-Mediated Cannabinoid-Drug Interactions in Healthy Adult Participants. Clin Pharmacol Ther 2023.
Moderate

CYTOCHROME P450 2C8 (CYP2C8) SUBSTRATES

3 of 3

Fluvastatin also falls under CYTOCHROME P450 2C8 (CYP2C8) SUBSTRATES.

Theoretically, cannabidiol might increase levels of drugs metabolized by CYP2C8.
In vitro research shows that cannabidiol inhibits CYP2C8. However, this interaction has yet to be reported in humans. Until more is known, use with caution. Theoretically, concomitant use of cannabidiol with CYP2C8 substrates might increase the risk for adverse effects from these substrates.
Severity Moderate Likelihood Possible Evidence D

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.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist with CBD and your fluvastatin (Lescol). Fluvastatin is an active medicine already, not a prodrug, and your liver clears it partly through an enzyme called CYP2C8. Lab tests suggest CBD may slow that enzyme down. If that happened in real life, more fluvastatin could linger in your body, which could nudge up the usual statin side effects like muscle aches, soreness or, rarely, liver irritation.

I want to be honest about the strength here: this comes from test-tube research only and has not actually been seen in people, so it's more of a theoretical caution than a proven problem. Still, since CBD product strengths vary so much, it's worth a quick chat with your pharmacist or doctor before combining them. Don't stop your statin on your own.

References
  1. 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)

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • 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.
Evidence the quality of the studies behind the rating (graded A–D)
  • 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.

Keep it in perspective

Cannabidiol (cbd) Also Interacts With Other Medications

Cannabidiol (cbd) has 1,050 moderate known drug interactions in our database — the Fluvastatin one above is among them. If you take anything else, check it against the full list below.

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.

Everything else you take

See Every Supplement That Interacts With Fluvastatin

This page covers Cannabidiol (cbd) only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Fluvastatin page lists 128 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Apple (major), Beer (major), Grapefruit (major) and Siberian Cocklebur (major).

By severity: 7 major · 97 moderate · 24 minor.

Open the Fluvastatin interaction page

How much people look this up

Where Cannabidiol (cbd) and Fluvastatin 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

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

29 days ago today
Medication Fluvastatin
Steady interest

#2,030 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.

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.

Read the full Cannabidiol (cbd) monograph & all interactions
Medication

About Fluvastatin

What Is Fluvastatin Used For?

Brand names: Lescol, Lescol XL

Fluvastatin capsules are used alongside a low-cholesterol diet to lower total cholesterol, LDL-C (bad cholesterol), triglycerides, and a protein called apolipoprotein B, while raising HDL-C (good cholesterol), in adults with primary hypercholesterolemia (high cholesterol) or mixed dyslipidemia (multiple abnormal blood fat levels). Fluvastatin capsules are also approved for children and adolescents aged 10–16 with hereditary high cholesterol (heterozygous familial hypercholesterolemia) when diet alone hasn't worked enough.

In adults who already have clinically evident coronary heart disease (CHD), both fluvastatin capsules and fluvastatin sodium extended-release tablets (including Lescol XL) are used to slow the buildup of plaque in coronary arteries and reduce the risk of needing coronary revascularization procedures (procedures to restore blood flow to the heart). Fluvastatin sodium extended-release tablets and Lescol XL are also approved to reduce LDL-C in adults with primary hyperlipidemia, and in patients aged 10 and older with hereditary high cholesterol who specifically require the higher daily dose.

See full Fluvastatin 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
1,050Moderate
0Minor
1,779No known interaction
Moderate

1,050 interactions

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
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

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

Keep exploring
Pharmacist Counseling Corner

Taking Cannabidiol (cbd) and Fluvastatin Together: Common Questions

Can you take Cannabidiol (cbd) with Fluvastatin?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 3 interactions listed for Cannabidiol (cbd) and Fluvastatin?
Fluvastatin belongs to more than one drug category, and Cannabidiol (cbd) interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Cannabidiol (cbd) and Fluvastatin interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

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

Still Have a Question About Fluvastatin and Cannabidiol (cbd)?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

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.