Hemp Supplement Concerns With Amiodarone

In our latest question and answer, the pharmacist discusses concerns with taking a hemp supplement with amiodarone.

Question

I take amiodarone. Can I also use gummies derived from hemp with 0.3% THC? I only use one gummy a day. Thank you.

Asked by Poorme On Apr 14, 2024

Answered by
Medical Content Reviewed By HelloPharmacist Staff

Published Apr 15, 2024
Last updated May 16, 2024

Key points

  • There is no known interaction between amiodarone and hemp, but due to limited data, caution is advised when combining them. There have been anecdotal reports of cardiovascular side effects, but it is unknown if hemp was a culprit in these cases. Consult with your doctor for proper monitoring and evaluation if you decide to take them together.
  • Over-the-counter hemp products typically have low THC content, which is beneficial when considering amiodarone interactions. However, since hemp products can vary widely in composition, it's important to choose reputable brands.

Answer

Thanks for contacting us!

Our drug-herbal interaction check shows no interaction between amiodarone and hemp, but it is very important to point out that there just isn't a lot of data out there to go off of, so it's crucial to be cautious before combining them.

I certainly recommend talking to your doctor so you can be properly monitored and evaluated if you do decide to take them together. I go into some additional details about the potential interaction in the next section.

Hemp With Amiodarone Details

Over-the-counter hemp products tend to be very low in THC, which you referred to in your question as the product you are considering is only 0.3% THC. This is a good thing in this case because we do list an interaction between amiodarone and THC.

Aside from THC, a challenge with determining if hemp has drug interactions is that its composition can vary quite a lot. With hemp being a natural product, it contains a large number of compounds including:

  • Alpha-linolenic acid
  • Linoleic acid
  • Oleic acid
  • Beta-sitosterol
  • Campesterol
  • As many as 30 cannabinoids, including cannabiripsol, cannabitriols, cannabigerols, cannabidiols, cannabielsoin, cannabinols, tetrahydrocannabinols, cannabichromenes, and cannabicitran.

The source of hemp, how it is grown, cultivated, and processed can significantly impact its constituents. As one example, clinical studies show that hemp seed oil typically has no or very low levels of cannabinoids like THC and cannabidiol while hemp oil from flowers and leaves can contain THC and higher levels of cannabidiol and other compounds.

In regard to the interaction with amiodarone, again, I couldn't find any substantial evidence of one existing. However, there are anecdotal reports that warrant further study.

For example, one report documented that a 56-year-old woman experienced acquired long QT syndrome, torsades de pointes, and syncope after taking hemp oil supplements containing cannabidiol (CBD) and possibly cannabigerol (CBG). The exact dose that was taken is unclear, but she used up to six times the recommended dose for about 6 weeks, alongside a berberine supplement. It's uncertain whether this adverse effect was due to the hemp oil, berberine, or a combination of both.

As Amiodarone is an antiarrhythmic drug, this report caught my eye since hemp caused a type of arrhythmia in this individual. It certainly isn't substantial evidence that hemp will interact with amiodarone or put you more at risk for an arrhythmia, it's just something to take note of and should warrant further study.

Having said the above, most studies report hemp being fairly benign in regard to side effects and interactions.

In fact, when consumed in food quantities, hulled hemp seed, hemp seed protein powder, and hemp seed oil have the designation of 'generally recognized as safe (GRAS)' in the USA, but again, we lack data on hemp supplements and potential drug interactions.

It's possible when interactions or adverse effects have been reported, it was due to other factors, such as impure supplements, hemp that contained more THC than listed, other drugs or supplements, etc.

Hemp may have a place in therapy for you if the risks outweigh the benefits, but the challenge, of course, is we don't exactly know what the risks are.

As I mentioned in the first section, if you do want to take hemp and you believe it can benefit you, please talk to your doctor first before utilizing it so you can be evaluated and monitored. Amiodarone treats potentially dangerous medical conditions, such as life-threatening recurrent ventricular fibrillation, so it's important to avoid drugs and supplements that interact with it.

Final Words

I wanted to thank you again for writing in. I know this isn't a concrete answer, but it's just tough to do based on the lack of information out there. Be safe, talk to your doctor first, and I hope you can find a solution that works for your medical situation.

Thanks!

References

  • Cannabinoid profiling of hemp seed oil by liquid chromatography coupled to high-resolution mass spectrometry. Front Plant Sci. 2019;10:120, PubMed
  • Harmless herbs? A case report of acquired long QT syndrome and torsades de pointes in a patient taking herbal supplements. HeartRhythm Case Rep 2022;8(5):309-12, PubMed
  • Hemp ( Cannabis sativa L.) seed oil: analytical and phytochemical characterization of the unsaponifiable fraction, PubMed
  • Nutraceutical potential of hemp (Cannabis sativa L.) seeds and sprouts, PubMed
  • Center for Food Safety and Applied Nutrition. FDA Responds to Three GRAS Notices for Hemp Seed-Derived Ingredients for Use in Human Food., FDA
  • Clinicians' Guide to Cannabidiol and Hemp Oils, PubMed

About the Pharmacist

Dr. Brian Staiger, PharmD

Dr. Brian has been practicing pharmacy for over 13 years and has wide-ranging experiences in many different areas of the profession. From retail, clinical, program development, and administrative responsibilities, he's your knowledgeable and go-to source for all your pharmacy and medication-related questions! Dr. Brian Staiger also has herbalist training and educational certificates in the field of medical ethnobotany. Feel free to send him an email at [email protected]! You can also connect with Dr. Brian Staiger on LinkedIn.

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