Drug & supplement interaction

Cannabinol (cbn) + Sulfamethoxazole, Trimethoprim

Sulfamethoxazole, Trimethoprim brand names: Bactrim, Bactrim DS, Cotrim DS, Septra, Septra DS, and others.

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

Sulfamethoxazole, Trimethoprim falls into 2 drug categories that Cannabinol (cbn) can interact with; the most serious is rated moderate. Theoretically, CYP2C9 inhibitors might increase the levels and clinical effects of cannabinol.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions2
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Cannabinol (cbn) and Sulfamethoxazole, Trimethoprim

These two interact in 2 distinct ways. Each one is explained separately below.

Why Are There 2 Interactions?

Cannabinol (cbn) interacts with whole categories of medication. Sulfamethoxazole, Trimethoprim falls into 2 of those categories, so it can interact with Cannabinol (cbn) in 2 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CYTOCHROME P450 2C9 (CYP2C9) INHIBITORS

1 of 2

Why this applies to Sulfamethoxazole, Trimethoprim

Sulfamethoxazole, Trimethoprim falls under CYTOCHROME P450 2C9 (CYP2C9) INHIBITORS — the group Cannabinol (cbn) interacts with.

Theoretically, CYP2C9 inhibitors might increase the levels and clinical effects of cannabinol.
In vitro research shows that CYP2C9 enzymes are involved in the 11-hydroxylation of cannabinol. So far, this interaction has not been reported in humans.
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: this isn't really about Bactrim building up in your body. It's the other way around. One of the ingredients, trimethoprim, can gently block a liver enzyme called CYP2C9, and lab studies suggest that same enzyme helps break down CBN. So in theory, taking them together could slow how fast you clear the CBN, leaving a bit more of it around. That might mean stronger CBN effects like extra drowsiness, grogginess, or lightheadedness.

I want to be honest, though: this is purely test-tube science, and it has never actually been reported in real people. So it's a low-level concern, not an alarm. Since CBN sleep products vary a lot in quality, just give your pharmacist or doctor a heads-up before combining them.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Watanabe K, Yamaori S, Funahashi T, Kimura T, Yamamoto I. Cytochrome P450 enzymes involved in the metabolism of tetrahydrocannabinols and cannabinol by human hepatic microsomes. Life Sci. 2007;80(15):1415-9. PubMed
Moderate

CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES

2 of 2

Sulfamethoxazole, Trimethoprim also falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES.

Theoretically, cannabinol might increase the levels and clinical effects of CYP2C9 substrates.
In vitro research shows that cannabinol potently inhibits CYP2C9 enzymes. So far, this interaction has not been reported in humans.
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 basic idea: your liver uses an enzyme called CYP2C9 to help break down the sulfamethoxazole part of Bactrim. In a test tube, CBN has been shown to block that enzyme fairly strongly. If that same effect happened in people, the antibiotic could clear more slowly and build up a bit, which in theory might nudge up the chance of common Bactrim side effects like nausea, rash, sun sensitivity, or, less often, changes in potassium levels.

The important caveat: this is only laboratory data, and it has never actually been reported in a real person. So it's more of a theoretical heads-up than a proven problem. Still, since CBN products vary so much, I'd run it by your pharmacist or doctor before combining the two.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. 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.

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

Cannabinol (cbn) Also Interacts With Other Medications

Cannabinol (cbn) has 388 moderate known drug interactions in our database — the Sulfamethoxazole, Trimethoprim one above is among them. If you take anything else, check it against the full list below.

Moderate 388 No known interaction 2,442 (incl. Sulfamethoxazole, Trimethoprim)
Taking anything else?

Check Another of Your Medications Against Cannabinol (cbn)

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

Everything else you take

See Every Supplement That Interacts With Sulfamethoxazole, Trimethoprim

This page covers Cannabinol (cbn) only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Sulfamethoxazole, Trimethoprim page lists 174 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), Arsenic (major), Beer (major) and Cesium (major).

By severity: 11 major · 139 moderate · 24 minor.

From our pharmacist’s overview on the Sulfamethoxazole, Trimethoprim page

“The supplement I check first with sulfamethoxazole and trimethoprim (Bactrim, Septra) is PABA, because it feeds bacteria the exact compound this antibiotic works by blocking and can cancel the treatment outright. It is one of 11 major-rated entries among 174 supplements and herbs on file here, a count that calls for genuine care.”

Reviewed by 2 · Jul 18, 2026

Open the Sulfamethoxazole, Trimethoprim interaction page

How much people look this up

Where Cannabinol (cbn) and Sulfamethoxazole, Trimethoprim 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 Cannabinol (cbn)
Top half

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

29 days ago today
Medication Sulfamethoxazole, Trimethoprim
Top 10%

#178 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 Cannabinol (cbn)

What is Cannabinol (cbn)?

  • Sleep support
  • Relaxation
  • Pain or discomfort
  • Appetite-related concerns

Cannabinol (CBN) is a minor cannabinoid found in the cannabis plant, often marketed as a 'sleep' aid, but solid human research is very limited. Because it comes from cannabis and product quality varies widely, talk with your pharmacist or doctor before trying it, and avoid it during pregnancy and breastfeeding.

Read the full Cannabinol (cbn) monograph & all interactions
Keep checking

Other Drugs & Cannabinol (cbn)

Browse every other medication we’ve checked against Cannabinol (cbn) — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
388Moderate
0Minor
2,441No known interaction
388 Moderate 2,441 No interaction
Moderate

388 interactions

Showing 60 of 388 moderate interactions — see all 388 on the Cannabinol (cbn) page.

No interaction 2,441 drugs checked — show the list

We also checked Cannabinol (cbn) against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,441 medications checked with no known interaction — see the full Cannabinol (cbn) list.

See the full Cannabinol (cbn) interactions page
See every supplement checked against Sulfamethoxazole, Trimethoprim, 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
Cannabinol (cbn) monograph › Uses, safety, and every drug interaction in one place Sulfamethoxazole, Trimethoprim supplement interactions › Every supplement checked against Sulfamethoxazole, Trimethoprim, ranked by severity 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 Cannabinol (cbn) and Sulfamethoxazole, Trimethoprim Together: Common Questions

Can you take Cannabinol (cbn) with Sulfamethoxazole, Trimethoprim?
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 2 interactions listed for Cannabinol (cbn) and Sulfamethoxazole, Trimethoprim?
Sulfamethoxazole, Trimethoprim belongs to more than one drug category, and Cannabinol (cbn) 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 Cannabinol (cbn) and Sulfamethoxazole, Trimethoprim 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

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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.