Drug & supplement interaction

Cannabidiol (cbd) + Telotristat Etiprate

Telotristat Etiprate brand name: Xermelo.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Cannabidiol (cbd) has a moderate interaction with Telotristat Etiprate. Theoretically, CYP3A4 inducers might decrease cannabidiol levels.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
Know someone taking this? Share
Facebook Post Reddit Email
On this page
Interaction report

Cannabidiol (cbd) and Telotristat Etiprate

Here is the interaction we found between these two, with the evidence behind it.

Moderate

CYTOCHROME P450 3A4 (CYP3A4) INDUCERS

Why this applies to Telotristat Etiprate

Telotristat Etiprate falls under CYTOCHROME P450 3A4 (CYP3A4) INDUCERS — the group Cannabidiol (cbd) interacts with.

Theoretically, CYP3A4 inducers might decrease cannabidiol levels.
Cannabidiol is a substrate of CYP3A4 enzymes. Theoretically, drugs that induce CYP3A4 enzymes might reduce the levels and effects of cannabidiol.
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 the interaction runs in one direction: it's your telotristat (Xermelo) that may affect the CBD, not the other way around. Telotristat can act as a mild speed-up signal (an inducer) for a liver enzyme called CYP3A4, and CBD happens to be broken down by that same enzyme. In theory, that means your body could clear the CBD a bit faster, leaving lower levels and a weaker effect from whatever you're using it for.

Keep in mind this is theoretical, based on how the drugs work on paper rather than real-world reports, so I wouldn't lose sleep over it. Telotristat is the medicine doing important work to control your carcinoid-related diarrhea, so don't change anything on your own. Just give your pharmacist or oncology team a heads-up that you're using CBD.

Contact Dr. Brian directly if you have additional questions on this interaction
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 Telotristat Etiprate one above is one of them. If you take anything else, check it against the full list below.

Moderate 1,050 No known interaction 1,780 (incl. Telotristat Etiprate)
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 Telotristat Etiprate

This page covers Cannabidiol (cbd) only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Telotristat Etiprate page lists 36 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Alkanna (moderate), Alpine Ragwort (moderate), Boneset (moderate) and Borage (moderate).

By severity: 1 major · 26 moderate · 9 minor.

From our pharmacist’s overview on the Telotristat Etiprate page

“Telotristat etiprate (Xermelo) works in the gut to calm the severe diarrhea of carcinoid syndrome, and the lone major-rated interaction among its 36 flagged supplements strikes at that point. Activated charcoal can soak up the drug before it reaches the bloodstream, and 17 of the entries, mostly bulking fibers and charcoal products, ca…”

Reviewed by 2 · Jul 18, 2026

Open the Telotristat Etiprate interaction page

How much people look this up

Where Cannabidiol (cbd) and Telotristat Etiprate 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

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

29 days ago today
Medication Telotristat Etiprate
Steady interest

#2,061 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 Telotristat

What Is Telotristat Used For?

Brand name: Xermelo

Xermelo (telotristat) tablets are approved to treat carcinoid syndrome diarrhea in adults. Carcinoid syndrome is a set of symptoms caused by certain tumors — called neuroendocrine tumors — that release excess serotonin into the body, triggering frequent, often severe diarrhea.

Xermelo is used in combination with somatostatin analog (SSA) therapy — a class of injected medications commonly used to control carcinoid syndrome — in patients whose diarrhea is still not adequately controlled by SSA therapy alone.

See full Telotristat 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
1,050 Moderate 1,779 No 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

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 1,779 medications checked with no known interaction — see the full Cannabidiol (cbd) list.

See the full Cannabidiol (cbd) interactions page
See every supplement checked against Telotristat Etiprate, ranked by severity
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
Cannabidiol (cbd) monograph › Uses, safety, and every drug interaction in one place Telotristat Etiprate supplement interactions › Every supplement checked against Telotristat Etiprate, ranked by severity Telotristat drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Cannabidiol (cbd) and Telotristat Etiprate Together: Common Questions

Can you take Cannabidiol (cbd) with Telotristat Etiprate?
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.
How serious is the Cannabidiol (cbd) and Telotristat Etiprate 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 Telotristat Etiprate 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.