Can You Take CBD Oil While on Blood Thinners?
Summary
CBD oil can interact with some blood thinners, especially warfarin, and may increase bleeding risk. If you take any anticoagulant or antiplatelet medicine, check with your prescriber or pharmacist before using CBD, even “low dose” products.
The Bottom Line
CBD is not automatically unsafe with every blood thinner, but the combination deserves extra caution.
Research reviewed by the NIH describes case reports where people taking warfarin had evidence of a drug interaction after using cannabidiol products, which can increase anticoagulant effect and bleeding risk. According to the NIH review on cannabinoid drug interactions, these case reports show the potential for interactions between warfarin and cannabidiol containing products (NIH, pmc.ncbi.nlm.nih.gov).
The practical issue is that CBD can affect how your liver processes certain medicines. If your blood thinner level rises, you may not notice until you bruise easily or start bleeding.
Important: Do not start, stop, or change CBD while taking warfarin unless your clinician is aware. Warfarin dosing is guided by INR testing, and changes in supplements or botanicals can shift INR.
Why CBD and Blood Thinners Can Be a Risky Mix
Blood thinners are used to reduce clotting, for example to prevent stroke in atrial fibrillation or treat deep vein thrombosis. They work by different pathways, and that matters for interactions.
CBD is metabolized in the liver and can influence enzymes that also process many prescription drugs. The NIH review of cannabinoid drug interactions notes potential interactions and highlights warfarin case reports specifically, which is a key reason clinicians take this combination seriously (NIH, pmc.ncbi.nlm.nih.gov).
Even if you have used CBD before, adding a blood thinner changes the safety picture. Likewise, switching CBD brands can change your exposure because products vary in CBD amount and may contain other cannabinoids.
Who Should Be Extra Cautious (or Avoid CBD Until You Ask)
Some people have a higher downside if anticoagulant effect increases even a little.
If You Still Want to Use CBD: Safer Steps to Discuss
The goal is not perfection, it is predictability.
Start by bringing the actual product to your appointment or pharmacy consult. Label claims are not always reliable, and some products contain THC or other cannabinoids that could further complicate interactions.
Next, ask what monitoring plan makes sense for your specific blood thinner. For warfarin, that usually means an INR check after any meaningful change (starting CBD, stopping CBD, or changing dose or brand). The NIH review’s warfarin case reports are a reminder that monitoring is not optional when a plausible interaction exists (NIH, pmc.ncbi.nlm.nih.gov).
Pro Tip: If your clinician agrees to a trial, keep everything else steady for 2 to 4 weeks, including alcohol intake and over the counter pain relievers. Consistency makes it easier to interpret INR or bleeding symptoms.
Also consider why you want CBD in the first place. If it is for sleep, anxiety, or recovery from Exercise, non drug strategies may reduce the need for CBD or allow a lower dose. If it is for neuropathy or other chronic symptoms, your clinician can help rule out contributors like uncontrolled diabetes (see a Diabetes Food List for diet basics) and discuss evidence based treatments.
Warning Signs: When to Stop and Get Medical Help
Bleeding problems can start subtly.
Contact your clinician promptly if you notice new easy bruising, frequent nosebleeds, bleeding gums, heavier menstrual bleeding, pink or brown urine, or black or tarry stools. These can be signs that anticoagulant effect is too strong.
Seek urgent care or emergency help for coughing or vomiting blood, severe headache, sudden weakness or confusion, a fall with head impact, or any bleeding that will not stop. If you are on warfarin, tell the team about any recent CBD use because it may help them interpret INR changes. The NIH review underscores that interactions have been observed in real world cases with warfarin and cannabidiol products (NIH, pmc.ncbi.nlm.nih.gov).
Sources & References
- Potential Drug Interactions Between Cannabinoids and Its ... - NIH - National Institutes of Health
Frequently Asked Questions
- Does topical CBD (creams, balms) interact with blood thinners?
- Topical CBD is less likely to cause a whole body interaction because much less typically reaches the bloodstream, but absorption can vary by product and how it is used. If you are on warfarin or have a high bleeding risk, it is still worth checking with a pharmacist, especially if you also use oral CBD.
- Is hemp seed oil the same as CBD oil if I take blood thinners?
- Hemp seed oil is made from seeds and usually contains little to no cannabidiol, while CBD oil is derived from cannabinoid containing parts of the plant. The interaction concern discussed by the NIH relates to cannabidiol products, particularly with warfarin (NIH, pmc.ncbi.nlm.nih.gov).
- Can CBD change my INR if I take warfarin?
- It can. The NIH review reports case reports suggesting a potential interaction between warfarin and cannabidiol containing products, which could raise INR and bleeding risk (NIH, pmc.ncbi.nlm.nih.gov). If your clinician approves CBD, you usually need an INR plan before you start.
- What over the counter products raise bleeding risk along with blood thinners?
- Common examples include NSAIDs (like ibuprofen or naproxen), high dose aspirin, and some herbal supplements. Because CBD products can also interact with medications, it is safest to review your full list with a pharmacist to avoid stacking multiple bleeding risks.
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