{"guncelleme":"2026-10-21","ilaclar":[{"key":"varfarin","etiket":"Warfarin","grup":"Blood thinners"},{"key":"apiksaban","etiket":"Apixaban (DOAC)","grup":"Blood thinners"},{"key":"rivaroksaban","etiket":"Rivaroxaban (DOAC)","grup":"Blood thinners"},{"key":"dabigatran","etiket":"Dabigatran (DOAC)","grup":"Blood thinners"},{"key":"edoksaban","etiket":"Edoxaban (DOAC)","grup":"Blood thinners"},{"key":"klopidogrel","etiket":"Clopidogrel","grup":"Blood thinners"},{"key":"klobazam","etiket":"Clobazam","grup":"Epilepsy medicines"},{"key":"valproat","etiket":"Valproate (valproic acid)","grup":"Epilepsy medicines","markalar":["Depakin","Convulex"]},{"key":"rufinamid","etiket":"Rufinamide","grup":"Epilepsy medicines"},{"key":"topiramat","etiket":"Topiramate","grup":"Epilepsy medicines"},{"key":"zonisamid","etiket":"Zonisamide","grup":"Epilepsy medicines"},{"key":"eslikarbazepin","etiket":"Eslicarbazepine","grup":"Epilepsy medicines"},{"key":"stiripentol","etiket":"Stiripentol","grup":"Epilepsy medicines"},{"key":"brivarasetam","etiket":"Brivaracetam","grup":"Epilepsy medicines"},{"key":"karbamazepin","etiket":"Carbamazepine","grup":"Epilepsy medicines","markalar":["Tegretol"]},{"key":"lamotrijin","etiket":"Lamotrigine","grup":"Epilepsy medicines","markalar":["Lamictal","Pinral"]},{"key":"antiepileptik_diger","etiket":"Other epilepsy medicines","grup":"Epilepsy medicines"},{"key":"fluoksetin","etiket":"Fluoxetine (SSRI)","grup":"Antidepressants","markalar":["Prozac","Depreks","Fulsac"]},{"key":"paroksetin","etiket":"Paroxetine (SSRI)","grup":"Antidepressants","markalar":["Paxil","Seroxat","Xetanor"]},{"key":"sitalopram","etiket":"Citalopram (SSRI)","grup":"Antidepressants","markalar":["Cipram","Citol","Relaxol"]},{"key":"essitalopram","etiket":"Escitalopram (SSRI)","grup":"Antidepressants","markalar":["Cipralex","Citoles","Eslorex"]},{"key":"sertralin","etiket":"Sertraline (SSRI)","grup":"Antidepressants","markalar":["Lustral","Selectra","Serdep"]},{"key":"mirtazapin","etiket":"Mirtazapine","grup":"Antidepressants","markalar":["Remeron","Zestat"]},{"key":"snri","etiket":"SNRIs (venlafaxine, duloxetine, etc.)","grup":"Antidepressants","markalar":["Efexor XR","Cymbalta"]},{"key":"trisiklik","etiket":"Tricyclic antidepressants","grup":"Antidepressants"},{"key":"amitriptilin","etiket":"Amitriptyline (tricyclic)","grup":"Antidepressants","markalar":["Laroxyl"]},{"key":"bupropion","etiket":"Bupropion","grup":"Antidepressants","markalar":["Wellbutrin XL","Zyban"]},{"key":"trazodon","etiket":"Trazodone","grup":"Antidepressants","markalar":["Desyrel","Trittico"]},{"key":"vortioksetin","etiket":"Vortioxetine","grup":"Antidepressants","markalar":["Brintellix"]},{"key":"agomelatin","etiket":"Agomelatine","grup":"Antidepressants","markalar":["Valdoxan"]},{"key":"alprazolam","etiket":"Alprazolam","grup":"Anxiety and sleep medicines","markalar":["Xanax","Ansiox","Stabina"]},{"key":"klonazepam","etiket":"Clonazepam","grup":"Anxiety and sleep medicines","markalar":["Rivotril","Rivoclon"]},{"key":"diazepam","etiket":"Diazepam","grup":"Anxiety and sleep medicines","markalar":["Diazem","Nervium"]},{"key":"benzodiazepin","etiket":"Other benzodiazepines (lorazepam, etc.)","grup":"Anxiety and sleep medicines"},{"key":"uyku_ilaci","etiket":"Sleeping pills and other sedatives (zolpidem, etc.)","grup":"Anxiety and sleep medicines"},{"key":"hidroksizin","etiket":"Hydroxyzine","grup":"Anxiety and sleep medicines","markalar":["Atarax"]},{"key":"buspiron","etiket":"Buspirone","grup":"Anxiety and sleep medicines","markalar":["Buspon"]},{"key":"gabapentin","etiket":"Gabapentin","grup":"Anxiety and sleep medicines","markalar":["Gabateva","Neruda"]},{"key":"pregabalin","etiket":"Pregabalin","grup":"Anxiety and sleep medicines","markalar":["Lyrica"]},{"key":"ketiapin","etiket":"Quetiapine","grup":"Antipsychotics and mood stabilizers","markalar":["Seroquel","Ketilept","Cedrina"]},{"key":"olanzapin","etiket":"Olanzapine","grup":"Antipsychotics and mood stabilizers","markalar":["Zyprexa","Oferta","Olfrex"]},{"key":"aripiprazol","etiket":"Aripiprazole","grup":"Antipsychotics and mood stabilizers","markalar":["Abilify","Abizol","Aripa"]},{"key":"risperidon","etiket":"Risperidone","grup":"Antipsychotics and mood stabilizers","markalar":["Risperdal","Rileptid","Neoris"]},{"key":"klozapin","etiket":"Clozapine","grup":"Antipsychotics and mood stabilizers","markalar":["Clonex","Leponex"]},{"key":"antipsikotik","etiket":"Other antipsychotics (haloperidol, etc.)","grup":"Antipsychotics and mood stabilizers","markalar":["Norodol"]},{"key":"lityum","etiket":"Lithium","grup":"Antipsychotics and mood stabilizers","markalar":["Lithuril","Litomaks"]},{"key":"metilfenidat","etiket":"Methylphenidate","grup":"ADHD medicines","markalar":["Ritaline","Concerta","Medikinet"]},{"key":"atomoksetin","etiket":"Atomoxetine","grup":"ADHD medicines","markalar":["Strattera","Attex","Atominex"]},{"key":"metadon","etiket":"Methadone","grup":"Opioid pain relievers"},{"key":"opioid","etiket":"Other opioids (morphine, oxycodone, fentanyl, tramadol, etc.)","grup":"Opioid pain relievers"},{"key":"takrolimus","etiket":"Tacrolimus","grup":"Immunosuppressants"},{"key":"siklosporin","etiket":"Cyclosporine","grup":"Immunosuppressants"},{"key":"everolimus","etiket":"Everolimus","grup":"Immunosuppressants"},{"key":"sirolimus","etiket":"Sirolimus","grup":"Immunosuppressants"},{"key":"mikofenolat","etiket":"Mycophenolate","grup":"Immunosuppressants"},{"key":"tamoksifen","etiket":"Tamoxifen","grup":"Cancer medicines"},{"key":"kemoterapi","etiket":"Chemotherapy / cancer medicines (general)","grup":"Cancer medicines"},{"key":"immunoterapi","etiket":"Immunotherapy (checkpoint inhibitors, e.g., nivolumab)","grup":"Cancer medicines"},{"key":"enzalutamid","etiket":"Enzalutamide","grup":"Cancer medicines"},{"key":"mitotan","etiket":"Mitotane","grup":"Cancer medicines"},{"key":"digoksin","etiket":"Digoxin","grup":"Heart, blood vessel and cholesterol medicines"},{"key":"statin","etiket":"Statins (cholesterol medicines)","grup":"Heart, blood vessel and cholesterol medicines"},{"key":"losartan","etiket":"Losartan","grup":"Heart, blood vessel and cholesterol medicines"},{"key":"tansiyon_ilaci","etiket":"Blood pressure medicines (general)","grup":"Heart, blood vessel and cholesterol medicines"},{"key":"propranolol","etiket":"Propranolol","grup":"Heart, blood vessel and cholesterol medicines","markalar":["Dideral"]},{"key":"parasetamol","etiket":"Acetaminophen (paracetamol)","grup":"Pain relievers (non-opioid)"},{"key":"nsaii","etiket":"NSAIDs (ibuprofen, naproxen, celecoxib, etc.)","grup":"Pain relievers (non-opioid)"},{"key":"rifampin","etiket":"Rifampin (rifampin)","grup":"Other"},{"key":"sari_kantaron","etiket":"St. John's wort","grup":"Other"},{"key":"ketokonazol","etiket":"Ketoconazole","grup":"Other"},{"key":"ppi","etiket":"PPI stomach medicines (omeprazole, lansoprazole, etc.)","grup":"Other"},{"key":"teofilin","etiket":"Theophylline","grup":"Other"},{"key":"tizanidin","etiket":"Tizanidine","grup":"Other"},{"key":"levotiroksin","etiket":"Levothyroxine (thyroid hormone)","grup":"Other"},{"key":"oral_kontraseptif","etiket":"Birth control pill","grup":"Other"},{"key":"diyabet_ilaci","etiket":"Diabetes medicines","grup":"Other"},{"key":"karaciger_etkileyen_ilac","etiket":"Other medicines that can affect the liver","grup":"Other"},{"key":"recete_ilac_genel","etiket":"Any prescription medicine","grup":"Other"}],"durumlar":[{"key":"gebelik","etiket":"Pregnancy or planning a pregnancy"},{"key":"emzirme","etiket":"Breastfeeding"},{"key":"yas_18_alti","etiket":"Under 18"},{"key":"yas_18_24","etiket":"Age 18–24"},{"key":"yas_65_ustu","etiket":"Age 65 and over"},{"key":"karaciger_hastaligi","etiket":"Liver disease (moderate/severe)"},{"key":"uzun_sureli_yuksek_doz","etiket":"Long-term or high-dose use"},{"key":"gunluk_10mg_ustu","etiket":"More than 10 mg of CBD a day as a food/supplement"},{"key":"gunluk_2mg_ustu","etiket":"More than 2 mg of CBD a day as a food/supplement"},{"key":"alkol","etiket":"Alcohol use"},{"key":"thc_iceren_urun","etiket":"Using products that contain THC (including full-spectrum)"},{"key":"arac_makine","etiket":"Driving or operating machinery"},{"key":"lisansli_sporcu","etiket":"Licensed competitive athlete (doping test)"},{"key":"uyusturucu_testi","etiket":"Workplace/driver drug test"},{"key":"bagisiklik_baskilanmis","etiket":"Weakened immune system / organ transplant"},{"key":"planli_ameliyat","etiket":"Planned surgery or procedure"},{"key":"psikoz_oykusu","etiket":"History of psychosis, or psychosis/schizophrenia in the family"},{"key":"bipolar","etiket":"Bipolar disorder"},{"key":"depresyon_intihar_oykusu","etiket":"History of depression or suicidal thoughts"},{"key":"kanser_tedavisi","etiket":"Cancer diagnosis / receiving cancer treatment"},{"key":"epilepsi","etiket":"Epilepsy"},{"key":"glokom","etiket":"Glaucoma (raised eye pressure)"},{"key":"dusuk_tansiyon","etiket":"Low blood pressure"},{"key":"susam_alerjisi","etiket":"Allergy to sesame or to product ingredients"}],"kurallar":[{"id":"K01","kaynak_kural_id":"ETK-001","tur":"ilac","siddet":"yuksek","tetikleyiciler":["varfarin"],"baslik":"Warfarin","uyari":"If you take warfarin, tell your doctor before starting CBD. Case reports have described INR rising and the warfarin dose needing to be lowered; more frequent INR monitoring is recommended.","kaynak":"PMID 29387536; PMID 33016308; PMID 30326170"},{"id":"K02","kaynak_kural_id":"ETK-002","tur":"ilac","siddet":"dusuk","tetikleyiciler":["apiksaban","rivaroksaban","dabigatran","edoksaban"],"baslik":"DOAC blood thinners","uyari":"If you take a blood thinner, tell your doctor about CBD. There are no clinical data on interactions between these medicines and CBD; there is only a general warning in the package leaflet.","kaynak":"https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=8bf27097-4870-43fb-94f0-f3d0871d1eec"},{"id":"K03","kaynak_kural_id":"ETK-003","tur":"ilac","siddet":"orta","tetikleyiciler":["klopidogrel"],"baslik":"Clopidogrel","uyari":"If you take clopidogrel, talk to your doctor. The drug's package leaflet states that CBD may reduce the effectiveness of this medicine; no clinical cases have been reported.","kaynak":"https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=8bf27097-4870-43fb-94f0-f3d0871d1eec"},{"id":"K04","kaynak_kural_id":"ETK-004","tur":"ilac","siddet":"yuksek","tetikleyiciler":["klobazam"],"baslik":"Clobazam","uyari":"If you take clobazam, CBD can raise the medicine's active metabolite about 3-fold and can increase drowsiness. Do not start without talking to your neurologist.","kaynak":"FDA Epidiolex label §7.2, §12.3 (05/2026); EMA prescribing information §4.5; Geffrey 2015 (PMID 26114620)"},{"id":"K05","kaynak_kural_id":"ETK-005","tur":"ilac","siddet":"yuksek","tetikleyiciler":["valproat"],"baslik":"Valproate and the liver","uyari":"Liver enzyme elevations were more common when CBD was used together with valproate. Your doctor should monitor your liver tests.","kaynak":"DailyMed Epidiolex label 5.1; PMID 28782097"},{"id":"K06","kaynak_kural_id":"ETK-006","tur":"ilac","siddet":"orta","tetikleyiciler":["rufinamid","topiramat","zonisamid","eslikarbazepin","stiripentol","brivarasetam","antiepileptik_diger"],"baslik":"Other epilepsy medicines","uyari":"With epilepsy medicines, CBD can change the blood levels of some of them. Your doctor may monitor your drug levels and side effects.","kaynak":"PMID 28782097; PMID 33541771; PMID 37593907; PMID 31211851; PMID 30791225"},{"id":"K07","kaynak_kural_id":"ETK-007","tur":"ilac","siddet":"orta","tetikleyiciler":["rifampin","karbamazepin","sari_kantaron","enzalutamid","mitotan"],"baslik":"Strong enzyme inducers","uyari":"These medicines can lower the level of CBD in the blood: with rifampin it fell by about one third. There are no direct measurements with others such as carbamazepine; the prescribing information expects a similar drop. Tell your doctor.","kaynak":"DailyMed Epidiolex label 7.1; EMA Epidyolex SmPC 4.5"},{"id":"K08","kaynak_kural_id":"ETK-008","tur":"ilac","siddet":"yuksek","tetikleyiciler":["takrolimus"],"baslik":"Tacrolimus","uyari":"If you take tacrolimus, CBD can markedly raise the medicine's blood level: in a controlled study in healthy volunteers taking approved CBD, the total amount of tacrolimus in the blood rose about 3-fold; a similar rise was reported in a patient taking CBD for epilepsy. The tacrolimus prescribing information recommends close monitoring of blood levels with CBD, and lowering the dose if needed. Do not start without talking to your transplant team.","kaynak":"PMID 39601108; PMID 31012522; PMID 29579828; Tacrolimus prescribing information §5.17 and §7.3; https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=7f667de1-9dfa-4bd6-8ba0-15ee2d78873b"},{"id":"K09","kaynak_kural_id":"ETK-009","tur":"ilac","siddet":"yuksek","tetikleyiciler":["everolimus","sirolimus"],"baslik":"Everolimus, sirolimus","uyari":"In a controlled study in healthy volunteers taking approved CBD, the blood level of everolimus rose about 2.5-fold; in patients with TSC (tuberous sclerosis complex), everolimus and sirolimus levels rose in most patients when CBD was added. The prescribing information for both medicines recommends close monitoring of blood levels with CBD, and lowering the dose if needed. Do not start without talking to your doctor; your drug level should be monitored.","kaynak":"EMA Epidyolex SmPC 4.5; PMID 37132402; PMID 31924480; Everolimus (Afinitor) prescribing information §2.11 and §7.1; https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=2150f73a-179b-4afc-b8ce-67c85cc72f04; Everolimus (Zortress) prescribing information §5.22 and §7.1; https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=e082a024-7850-400b-a5c2-2a140612562a; Sirolimus prescribing information §5.21 and §7.5; https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ad39eb60-1fa0-4722-8ba1-523194921c2a"},{"id":"K10","kaynak_kural_id":"ETK-010","tur":"ilac","siddet":"dusuk","tetikleyiciler":["siklosporin"],"baslik":"Cyclosporine","uyari":"If you take cyclosporine, tell your transplant team about CBD. In a small study, cyclosporine levels stayed stable; data are limited.","kaynak":"PMID 29579828"},{"id":"K11","kaynak_kural_id":"ETK-011","tur":"ilac","siddet":"orta","tetikleyiciler":["mikofenolat"],"baslik":"Mycophenolate","uyari":"CBD raised the total amount of mycophenolic acid in the blood by about one third (35%); at a higher CBD dose, the rise is estimated to be 58%. Tell your doctor.","kaynak":"EMA Epidyolex SmPC 4.5"},{"id":"K12","kaynak_kural_id":"ETK-012","tur":"ilac","siddet":"orta","tetikleyiciler":["digoksin"],"baslik":"Digoxin","uyari":"If you take digoxin, talk to your doctor. The package leaflet says CBD may raise the level of this medicine and recommends monitoring the level; no clinical cases have been reported.","kaynak":"EMA Epidyolex SmPC 4.5"},{"id":"K13","kaynak_kural_id":"ETK-013","tur":"ilac","siddet":"orta","tetikleyiciler":["fluoksetin","paroksetin"],"baslik":"SSRIs (fluoxetine, paroxetine)","uyari":"In a young person taking fluoxetine, worsening insomnia, restlessness and obsessive symptoms were reported after CBD oil was added (a single case). The reported case of a child taking paroxetine involved smoked marijuana, not CBD. Tell your doctor or pharmacist.","kaynak":"PMID 35652796; PMID 39719830"},{"id":"K14","kaynak_kural_id":"ETK-014","tur":"ilac","siddet":"dusuk","tetikleyiciler":["snri","trisiklik"],"baslik":"SNRIs and tricyclic antidepressants","uyari":"There are no clinical data on interactions between CBD and SNRIs or tricyclics other than amitriptyline (see the separate warning for amitriptyline). Still tell your doctor about all the medicines you take.","kaynak":"PMID 38868665"},{"id":"K15","kaynak_kural_id":"ETK-015","tur":"ilac","siddet":"orta","tetikleyiciler":["benzodiazepin","uyku_ilaci","gabapentin","pregabalin","alprazolam","klonazepam","diazepam","hidroksizin"],"baslik":"Benzodiazepines, sleep medicines and sedatives","uyari":"Drowsiness and sedation may increase together with CBD. Talk to your doctor before using them together.","kaynak":"DailyMed Epidiolex label 7.4; EMA Epidyolex SmPC 4.4"},{"id":"K16","kaynak_kural_id":"ETK-016","tur":"ilac","siddet":"orta","tetikleyiciler":["metadon","opioid"],"baslik":"Methadone and other opioids","uyari":"In a child, a high methadone level was found and drowsiness developed while CBD was being used; two weeks after CBD was stopped, the level fell to less than half and the symptoms resolved. In small controlled studies with morphine and buprenorphine, no clear change in drug levels was seen; with a single intravenous dose of fentanyl, there was no respiratory depression. Drowsiness may increase together with opioids. Tell the doctor who manages your pain or addiction treatment.","kaynak":"PMID 32444381; PMID 41622700; PMID 41467610; PMID 25748562; FDA Epidiolex label §7.4 (05/2026)"},{"id":"K17","kaynak_kural_id":"ETK-017","tur":"ilac","siddet":"orta","tetikleyiciler":["lityum"],"baslik":"Lithium","uyari":"In a 13-year-old patient who had taken the same dose of lithium for a long time, lithium toxicity developed a few weeks after CBD was started (blood level 2.4 mmol/L; earlier levels 1–1.3); it resolved when lithium was stopped. The patient was also taking other medicines and drinking little fluid; CBD's role was rated \"possible\", and the cause is not known. Do not start without talking to your psychiatrist.","kaynak":"PMID 32851114; PMID 39719830"},{"id":"K18","kaynak_kural_id":"ETK-018","tur":"ilac","siddet":"dusuk","tetikleyiciler":["antipsikotik","ketiapin","olanzapin","aripiprazol","risperidon","klozapin"],"baslik":"Antipsychotics","uyari":"No published study has measured antipsychotic blood levels with CBD. In schizophrenia studies, CBD (600–1000 mg a day) added for 6 weeks to the antipsychotic being taken was generally well tolerated; in one study, drowsiness was more common in those taking CBD. Drowsiness may increase when they are taken together; tell your doctor.","kaynak":"PMID 29241357; PMID 29619533; FDA Epidiolex label §7.4 (05/2026)"},{"id":"K19","kaynak_kural_id":"ETK-019","tur":"ilac","siddet":"dusuk","tetikleyiciler":["levotiroksin"],"baslik":"Levothyroxine","uyari":"In children with epilepsy taking levothyroxine, CBD blood levels were higher (about 2-fold in one study). If you take a thyroid medicine, tell your doctor.","kaynak":"PMID 33280111; PMID 37631333"},{"id":"K20","kaynak_kural_id":"ETK-020","tur":"ilac","siddet":"dusuk","tetikleyiciler":["ppi"],"baslik":"Stomach protectors (PPIs)","uyari":"CBD can raise the blood level of omeprazole; no clinical importance has been reported. If you take it long term, tell your pharmacist.","kaynak":"PMID 37313955; EMA Epidyolex SmPC 4.5"},{"id":"K21","kaynak_kural_id":"ETK-021","tur":"ilac","siddet":"orta","tetikleyiciler":["teofilin","tizanidin"],"baslik":"Theophylline, tizanidine","uyari":"CBD can raise the blood levels of these medicines; the prescribing information for approved CBD recommends considering a dose reduction. The tizanidine prescribing information itself asks that it not be combined with weak CYP1A2 inhibitors such as CBD; low blood pressure, a slowed heart rate or excessive drowsiness may occur. Tell your doctor.","kaynak":"FDA Epidiolex label §7.2 (05/2026); EMA Epidyolex SmPC 4.5; PMID 33951339; Tizanidine prescribing information §7.2; https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=60c27d35-7349-4fc6-86ad-70fffdbe3e08"},{"id":"K22","kaynak_kural_id":"ETK-022","tur":"ilac","siddet":"orta","tetikleyiciler":["tamoksifen"],"baslik":"Tamoxifen","uyari":"In one case, the active breakdown product of tamoxifen (endoxifen) was found to be lower while the person was taking 40 mg of CBD a day. In a small study of 15 patients taking tamoxifen, about 50 mg a day of THC-free CBD oil lowered endoxifen by 12.6% on average; the researchers did not consider this difference important at this dose, and the effect of higher doses is not known. Do not start without talking to your oncologist.","kaynak":"PMID 33191836; PMID 37543688"},{"id":"K23","kaynak_kural_id":"ETK-023","tur":"ilac","siddet":"dusuk","tetikleyiciler":["kemoterapi"],"baslik":"Chemotherapy and cancer medicines","uyari":"Data on interactions between CBD and cancer medicines are very limited. Talk to your oncologist before using it.","kaynak":"PMID 30776990; PMID 38478773"},{"id":"K24","kaynak_kural_id":"ETK-024","tur":"durum","siddet":"orta","tetikleyiciler":["alkol"],"baslik":"Alcohol","uyari":"Alcohol can raise the level of CBD in the blood, and together they can increase drowsiness.","kaynak":"DailyMed Epidiolex label 7.4, 12.3"},{"id":"K25","kaynak_kural_id":"ETK-025","tur":"urun","siddet":"orta","tetikleyiciler":["thc_iceren_urun"],"baslik":"Product containing THC","uyari":"High-dose CBD can raise the level of THC in the blood; THC's effects may become stronger.","kaynak":"PMID 37313955"},{"id":"K26","kaynak_kural_id":"ETK-026","tur":"ilac","siddet":"bilgi","tetikleyiciler":["statin","oral_kontraseptif"],"baslik":"Statins, birth control pills","uyari":"No published human study was found that looked at these medicines and CBD together. The European patient information for approved CBD lists simvastatin among the medicines to tell the doctor about, because doses may need adjusting. It is still recommended that you tell your doctor about all the medicines you take.","kaynak":"PMID 41633759; EMA Epidyolex patient information section 2; EMA Epidyolex SmPC 5.2; Birth control pill prescribing information §7.1; https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=58e85e02-93e7-42ba-b8f5-a36290c68423"},{"id":"K27","kaynak_kural_id":"ETK-027","tur":"genel","siddet":"orta","tetikleyiciler":["recete_ilac_genel"],"baslik":"People taking prescription medicines","uyari":"If you take medicines, talk to your doctor or pharmacist before starting CBD. The European and UK food authorities state that the safety of CBD in people taking medicines has not been established.","kaynak":"https://www.efsa.europa.eu/en/news/provisional-safe-level-cannabidiol-novel-food; FSS/FSA 12.10.2023"},{"id":"K28","kaynak_kural_id":"KC-001","tur":"durum","siddet":"yuksek","tetikleyiciler":["karaciger_hastaligi"],"baslik":"Liver disease","uyari":"In liver failure, CBD can reach blood levels 2.5–5 times higher. Do not use it without talking to your doctor.","kaynak":"DailyMed Epidiolex label 8.6"},{"id":"K29","kaynak_kural_id":"KC-002","tur":"durum","siddet":"orta","tetikleyiciler":["uzun_sureli_yuksek_doz"],"baslik":"Long-term or high-dose use","uyari":"Liver enzyme elevations were also seen in healthy adults (about 6% of participants at 5 mg/kg a day). If you will use it for a long time, talk with your doctor about liver tests.","kaynak":"PMID 40622698; PMID 33022751"},{"id":"K30","kaynak_kural_id":"KC-003","tur":"ilac","siddet":"orta","tetikleyiciler":["karaciger_etkileyen_ilac"],"baslik":"Another medicine that affects the liver","uyari":"CBD itself can also raise liver enzymes: in healthy adults taking 5 mg/kg of CBD a day for 4 weeks, enzymes rose above 3 times the normal limit in 5.6% of participants. There are not enough data to judge the risk together with other medicines that can affect the liver. Tell your doctor.","kaynak":"EMA Epidyolex SmPC 4.4 and 4.5; FDA Epidiolex label §5.1 and §7.3 (05/2026); PMID 40622698"},{"id":"K31","kaynak_kural_id":"DOZ-001","tur":"genel","siddet":"bilgi","tetikleyiciler":["gunluk_10mg_ustu"],"baslik":"UK food limit (10 mg/day)","uyari":"The UK food authority advises healthy adults to take no more than 10 mg of CBD a day from food.","kaynak":"FSS/FSA 12.10.2023; ACNFP/COT 2023"},{"id":"K32","kaynak_kural_id":"DOZ-002","tur":"genel","siddet":"bilgi","tetikleyiciler":["gunluk_2mg_ustu"],"baslik":"European provisional safe level (≈2 mg/day)","uyari":"The European Food Safety Authority set the provisional safe level for pure CBD supplements at about 2 mg a day (for a 70 kg adult).","kaynak":"https://www.efsa.europa.eu/en/news/provisional-safe-level-cannabidiol-novel-food"},{"id":"K33","kaynak_kural_id":"DOZ-003","tur":"genel","siddet":"bilgi","tetikleyiciler":[],"baslik":"Taking with or without food","uyari":"When taken with a fatty meal, the amount of CBD that reaches the blood can increase about 4-fold. Taking it the same way every day (always with food or always on an empty stomach) makes its effect more predictable.","kaynak":"PMID 30374683; EMA Epidyolex SmPC 5.2"},{"id":"K34","kaynak_kural_id":"POP-001","tur":"durum","siddet":"yuksek","tetikleyiciler":["gebelik"],"baslik":"Pregnancy","uyari":"CBD use is not recommended during pregnancy. Reproductive toxicity was seen in animal studies; human data are insufficient.","kaynak":"FDA consumer page 2019; EMA Epidyolex SmPC 4.6; EFSA 2022 (DOI 10.2903/j.efsa.2022.7322)"},{"id":"K35","kaynak_kural_id":"POP-002","tur":"durum","siddet":"yuksek","tetikleyiciler":["emzirme"],"baslik":"Breastfeeding","uyari":"CBD is not recommended while breastfeeding. No study has measured passage into breast milk in mothers using the approved CBD medicine or a pure CBD product; CBD or a THC breakdown product was measured in 5 of 54 milk samples from mothers who used marijuana.","kaynak":"EMA Epidyolex SmPC 4.6; FDA consumer page 2019; Bertrand 2018, PMID 30150212; LactMed Cannabidiol 2025, PMID 30601607"},{"id":"K36","kaynak_kural_id":"POP-003","tur":"yas","siddet":"yuksek","tetikleyiciler":["yas_18_alti"],"baslik":"Under 18","uyari":"In children and teens, CBD should be used only under a doctor's supervision. Food authorities do not recommend CBD for children.","kaynak":"FSS/FSA 12.10.2023; EFSA 09.02.2026"},{"id":"K37","kaynak_kural_id":"POP-004","tur":"yas","siddet":"bilgi","tetikleyiciler":["yas_18_24"],"baslik":"Age 18–24","uyari":"The European Food Safety Authority states that the safety of CBD supplements under age 25 has not been established.","kaynak":"https://www.efsa.europa.eu/en/news/provisional-safe-level-cannabidiol-novel-food"},{"id":"K38","kaynak_kural_id":"POP-005","tur":"yas","siddet":"orta","tetikleyiciler":["yas_65_ustu"],"baslik":"Age 65 and over","uyari":"There are few study data on CBD in older adults, and taking several medicines raises the chance of interactions. Start with a low dose and talk it over with your doctor.","kaynak":"DailyMed Epidiolex label 8.5"},{"id":"K39","kaynak_kural_id":"POP-006","tur":"durum","siddet":"orta","tetikleyiciler":["arac_makine"],"baslik":"Driving and using machines","uyari":"CBD can cause drowsiness in some people. Do not drive or use machines until you know how it affects you; products containing THC impair driving.","kaynak":"EMA Epidyolex SmPC 4.7; PMID 33258890"},{"id":"K40","kaynak_kural_id":"POP-007","tur":"durum","siddet":"orta","tetikleyiciler":["lisansli_sporcu"],"baslik":"Licensed athletes","uyari":"CBD is not on the WADA Prohibited List, but THC is banned in competition; the 2027 list also includes Δ8-THC, Δ10-THC and HHC among the examples of banned substances. Under the current 2026 list, all natural and synthetic cannabinoids other than CBD (e.g., CBG, CBDV) are banned; the list taking effect on January 1, 2027 redefines the ban as THC and cannabinoids with THC-like effects. Products that may contain THC or other cannabinoids carry a risk of a positive doping test.","kaynak":"WADA Prohibited List 2026 and 2027, S8; WADA TD2022DL and TD2027DL; PMID 29114823"},{"id":"K41","kaynak_kural_id":"POP-008","tur":"durum","siddet":"orta","tetikleyiciler":["uyusturucu_testi"],"baslik":"Drug test","uyari":"Pure CBD is not expected to make a urine test positive, but the chance is not zero: in 1 of 10 people taking 100 mg of pure CBD twice a day for two weeks, one urine sample was positive. Products containing small amounts of THC (even 0.5 mg of THC) can give a positive result with regular use. THC was found in about one in five of the products tested.","kaynak":"PMID 31682266; PMID 34089060; PMID 40704705; PMID 29114823"},{"id":"K42","kaynak_kural_id":"POP-009","tur":"durum","siddet":"orta","tetikleyiciler":["bagisiklik_baskilanmis"],"baslik":"People with weakened immune systems","uyari":"In the UK, people with weakened immune systems are considered a vulnerable group. Talk to your doctor before using CBD.","kaynak":"ACNFP/COT 12.10.2023 (gov.uk)"},{"id":"K43","kaynak_kural_id":"KAL-001","tur":"urun","siddet":"bilgi","tetikleyiciler":[],"baslik":"Label accuracy","uyari":"Only about one in three CBD products sold online had a label that matched the contents. Choose products that have a certificate of analysis from an independent lab.","kaynak":"PMID 29114823"},{"id":"K44","kaynak_kural_id":"YE-001","tur":"genel","siddet":"bilgi","tetikleyiciler":[],"baslik":"Common side effects","uyari":"The most common side effects are drowsiness, diarrhea, nausea and headache; they are usually mild and dose-related.","kaynak":"PMID 30374683; PMID 31288397"},{"id":"K45","kaynak_kural_id":"EK-sitalopram","tur":"ilac","siddet":"orta","tetikleyiciler":["sitalopram","essitalopram"],"baslik":"Citalopram, escitalopram","uyari":"CBD raised citalopram blood levels: a significant rise in a series of 6 patients; in healthy volunteers, citalopram exposure (AUC) rose by 43% after 12 days of approved CBD (2.5 mg/kg twice a day). If you take these medicines, talk to your doctor.","kaynak":"PMID 34121064; PMID 41622700"},{"id":"K46","kaynak_kural_id":"EK-amitriptilin","tur":"ilac","siddet":"orta","tetikleyiciler":["amitriptilin"],"baslik":"Amitriptyline","uyari":"In healthy volunteers, a single 30 mg dose of CBD oil raised the blood level (AUC) of amitriptyline by 13% and its peak level by 17%; the effect is said to possibly be larger with ongoing use. Tell your doctor or pharmacist.","kaynak":"PMID 41398552"},{"id":"K47","kaynak_kural_id":"EK-ssri-lab","tur":"ilac","siddet":"bilgi","tetikleyiciler":["mirtazapin"],"baslik":"Mirtazapine","uyari":"In the lab, CBD had very little effect on the breakdown of mirtazapine; this has not been measured in patients. Still tell your doctor about the medicines you take.","kaynak":"PMID 34121064"},{"id":"K48","kaynak_kural_id":"EK-parasetamol","tur":"ilac","siddet":"orta","tetikleyiciler":["parasetamol"],"baslik":"Acetaminophen and the liver","uyari":"In a knee osteoarthritis study, liver enzyme elevations were more common in people taking 600 mg of CBD together with 3 g a day of acetaminophen (paracetamol) than with placebo (15 vs. 5 patients). Enzyme elevations were also seen in healthy adults at a lower CBD dose (5 mg/kg a day). If you take acetaminophen regularly, talk with your doctor about liver tests.","kaynak":"PMID 38033459; PMID 40622698"},{"id":"K49","kaynak_kural_id":"EK-nsaii","tur":"ilac","siddet":"bilgi","tetikleyiciler":["nsaii"],"baslik":"NSAID pain relievers","uyari":"There is no documented meaningful interaction between CBD and these pain relievers; there are no direct studies either. The bleeding and kidney risks come from the NSAID itself.","kaynak":"FDA Epidiolex label §12.3 (05/2026); Celecoxib prescribing information §7; https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=2d6675e4-5859-4be2-8037-a20ce9f707aa"},{"id":"K50","kaynak_kural_id":"EK-ketokonazol","tur":"ilac","siddet":"dusuk","tetikleyiciler":["ketokonazol"],"baslik":"Ketoconazole","uyari":"In a study with the THC/CBD mouth spray, ketoconazole raised CBD levels about 2-fold; with approved CBD taken by mouth, a similar strong medicine (itraconazole) raised CBD by less than 10%. Tell your doctor or pharmacist.","kaynak":"PMID 23750331 (Stott 2013); FDA Epidiolex label §12.3 (05/2026); PMID 38794183"},{"id":"K51","kaynak_kural_id":"EK-tansiyon","tur":"ilac","siddet":"orta","tetikleyiciler":["tansiyon_ilaci","losartan","dusuk_tansiyon"],"baslik":"Blood pressure medicines and low blood pressure","uyari":"CBD can lower blood pressure by a few mmHg; if you take blood pressure medicine or your blood pressure is low, dizziness and a drop in blood pressure may occur. In a study with a single dose of a CBD-dominant cannabis extract, the blood level of losartan went up, but its conversion to the breakdown product that provides most of its effect went down; the net effect of this on blood pressure is not known. Talk to your doctor.","kaynak":"PMID 37093160; PMID 28614793; PMID 37313955; Losartan prescribing information §12.3; https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=9949448f-c3b9-44ee-94ed-c1aca8c90f39"},{"id":"K52","kaynak_kural_id":"EK-immunoterapi","tur":"ilac","siddet":"orta","tetikleyiciler":["immunoterapi"],"baslik":"Immunotherapy (checkpoint inhibitors)","uyari":"In some observational studies, cannabis users had a lower response to immunotherapy or shorter survival; other studies found no difference, and the results conflict. Cause and effect has not been proven, most studies were done with cannabis containing THC, and there are no data specific to pure CBD. Guidelines advise caution; do not start without talking to your oncologist.","kaynak":"PMID 30670598; PMID 32872248; PMID 35454955; PMID 38610922; PMID 39737331; PMID 36535195; PMID 40184324; PMID 38478773; PMID 36872397"},{"id":"K53","kaynak_kural_id":"EK-kanser","tur":"durum","siddet":"yuksek","tetikleyiciler":["kanser_tedavisi"],"baslik":"Cancer diagnosis and treatment","uyari":"CBD should not be used in place of cancer treatment; ASCO makes this a strong recommendation and does not recommend oral CBD at 300 mg a day or more for symptoms. While your cancer treatment is ongoing, be sure to talk with your oncologist about CBD.","kaynak":"PMID 38478773"},{"id":"K54","kaynak_kural_id":"EK-ameliyat","tur":"durum","siddet":"orta","tetikleyiciler":["planli_ameliyat"],"baslik":"Planned surgery","uyari":"Before surgery, tell your surgeon and anesthesia team about your cannabinoid use, including CBD; the guideline recommends asking all patients about it. This matters even more if you take a blood thinner; no specific time to stop CBD before surgery has been set.","kaynak":"PMID 36596580"},{"id":"K55","kaynak_kural_id":"EK-psikoz","tur":"durum","siddet":"yuksek","tetikleyiciler":["psikoz_oykusu"],"baslik":"History of psychosis","uyari":"Cases of psychosis and mania have been reported with products containing THC, and CBD does not consistently block THC's effects. If you have a history of psychosis, do not use products that contain THC; for CBD, too, talk to your doctor first.","kaynak":"PMID 30382443; PMID 34505186; PMID 31580839; PMID 29086614"},{"id":"K56","kaynak_kural_id":"EK-bipolar","tur":"durum","siddet":"yuksek","tetikleyiciler":["bipolar"],"baslik":"Bipolar disorder","uyari":"THC-dominant cannabis can worsen symptoms of mania in bipolar disorder. Safety data for pure CBD rest on a single small study, and a case of mania after high-dose CBD has been reported; do not start without talking to your psychiatrist.","kaynak":"PMID 41801216; PMID 37920963; PMID 40630971"},{"id":"K57","kaynak_kural_id":"EK-intihar","tur":"durum","siddet":"orta","tetikleyiciler":["depresyon_intihar_oykusu"],"baslik":"History of depression or suicidal thoughts","uyari":"The prescription CBD label carries the class warning about suicidal thoughts that applies to all epilepsy medicines, and in an autism study one case of suicidal thoughts was reported in the CBD group. CBD does not replace depression treatment; talk with your doctor.","kaynak":"FDA Epidiolex label §5.3 (05/2026); ClinicalTrials.gov NCT04745026"},{"id":"K58","kaynak_kural_id":"EK-epilepsi","tur":"durum","siddet":"yuksek","tetikleyiciler":["epilepsi"],"baslik":"Epilepsy","uyari":"Do not lower or stop your epilepsy medicines on your own; stopping the approved CBD medicine suddenly carries a risk of more seizures. There are reports of seizures increasing with unregulated CBD oils; make every change with your neurologist.","kaynak":"FDA Epidiolex label §2.5, §5.5; PMID 25845492; PMID 31550641"},{"id":"K59","kaynak_kural_id":"EK-ilac-birakma","tur":"genel","siddet":"bilgi","tetikleyiciler":[],"baslik":"Does not replace your medicines","uyari":"CBD does not replace your prescription medicines. Do not lower your medicine on your own or stop it suddenly; in studies, serious side effects were seen after medicines were stopped without supervision.","kaynak":"PMID 38478773; PMID 31736860"},{"id":"K60","kaynak_kural_id":"EK-glokom","tur":"durum","siddet":"orta","tetikleyiciler":["glokom"],"baslik":"Glaucoma","uyari":"In a small study, 40 mg of CBD temporarily raised the pressure inside the eye and did not lower it at any dose. If you have glaucoma, your eye doctor should monitor your eye pressure.","kaynak":"PMID 16988594"},{"id":"K61","kaynak_kural_id":"EK-diyabet","tur":"ilac","siddet":"bilgi","tetikleyiciler":["diyabet_ilaci"],"baslik":"Diabetes medicines","uyari":"CBD did not improve blood sugar or insulin results compared with placebo. Do not replace your diabetes medicines with CBD.","kaynak":"PMID 27573936; PMID 41167732"},{"id":"K62","kaynak_kural_id":"EK-susam","tur":"urun","siddet":"orta","tetikleyiciler":["susam_alerjisi"],"baslik":"Sesame and product ingredient allergy","uyari":"Some CBD products contain inactive ingredients such as sesame oil and ethanol; for prescription CBD, hypersensitivity to sesame oil is a contraindication. Check the product's ingredients.","kaynak":"EMA Epidyolex SmPC 4.3 and 4.4 and 6.1; ClinicalTrials.gov NCT04745026"},{"id":"K63","kaynak_kural_id":"EK-metilfenidat","tur":"ilac","siddet":"dusuk","tetikleyiciler":["metilfenidat"],"baslik":"Methylphenidate","uyari":"In healthy volunteers, 3 days of high-dose approved CBD (750 mg twice a day) raised the blood level of methylphenidate by about 9% on average; the researchers found this difference clinically unimportant. How large the effect is with long-term use, or with products containing THC, is not known. If you take an ADHD medicine, tell your doctor about CBD.","kaynak":"PMID 36467779; PMID 35512806"},{"id":"K64","kaynak_kural_id":"EK-cyp2d6","tur":"ilac","siddet":"bilgi","tetikleyiciler":["atomoksetin","vortioksetin"],"baslik":"Atomoxetine, vortioxetine","uyari":"No human study has looked at these medicines and CBD together. CBD slowed the main enzyme that breaks down both of them (CYP2D6) in the lab; however, in a study in healthy volunteers, this enzyme's activity did not change. Tell your doctor about the medicines you take.","kaynak":"PMID 21821735; PMID 37313955; Atomoxetine prescribing information §12.3; https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=309de576-c318-404a-bc15-660c2b1876fb; Vortioxetine prescribing information §12.3; https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=1a5b68e2-14d0-419d-9ec6-1ca97145e838"},{"id":"K65","kaynak_kural_id":"EK-bupropion","tur":"ilac","siddet":"dusuk","tetikleyiciler":["bupropion"],"baslik":"Bupropion","uyari":"In a study with approved CBD (7.5 mg/kg twice a day), the blood level of bupropion fell by about 20% and its active breakdown product did not change; the package leaflet does not consider this difference clinically significant. The effect of higher CBD doses is not known. Tell your doctor.","kaynak":"EMA Epidyolex SmPC 4.5; FDA Epidiolex label §12.3 (05/2026)"},{"id":"K66","kaynak_kural_id":"EK-cyp3a4","tur":"ilac","siddet":"dusuk","tetikleyiciler":["alprazolam","trazodon","buspiron"],"baslik":"Alprazolam, trazodone, buspirone","uyari":"No study has looked at these medicines and CBD together. The data on the enzyme that breaks them all down (CYP3A4) conflict: approved CBD (750 mg twice a day) did not affect this enzyme, while a single dose of a CBD-dominant extract raised the blood level of midazolam, which is broken down the same way, by 56%. Drowsiness and sedation may increase when they are taken together. Tell your doctor.","kaynak":"FDA Epidiolex label §7.4 and §12.3 (05/2026); PMID 37313955; Alprazolam prescribing information §12.3; https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=bb5cf72e-3a41-41a8-9a38-80f974eca33f; Trazodone prescribing information §12.3; https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=8eb85c26-a6cb-4a10-a990-ccc0b20aff08; Buspirone prescribing information (Drug Interactions); https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=b217f341-7d51-475d-887f-f16786164c7b"},{"id":"K67","kaynak_kural_id":"EK-agomelatin","tur":"ilac","siddet":"dusuk","tetikleyiciler":["agomelatin"],"baslik":"Agomelatine","uyari":"No study has looked at agomelatine and CBD together. Agomelatine is broken down almost entirely by the CYP1A2 enzyme; approved CBD raised the blood level (AUC) of caffeine, which is broken down the same way, about 2-fold. Both medicines can raise liver enzymes. Tell your doctor about CBD; it matters that they know this when looking at your liver tests.","kaynak":"PMID 33951339; FDA Epidiolex label §5.1, §7.2 (05/2026); EMA Valdoxan SmPC 4.5"},{"id":"K68","kaynak_kural_id":"EK-klozapin","tur":"ilac","siddet":"dusuk","tetikleyiciler":["klozapin"],"baslik":"Clozapine","uyari":"No study has looked at clozapine and CBD together. Clozapine is broken down mainly by CYP1A2, and also by CYP2D6 and CYP3A4; approved CBD raised the total amount in the blood of caffeine, which is broken down by CYP1A2, about 2-fold. The clozapine prescribing information recommends close monitoring of the patient, and lowering the clozapine dose if needed, when it is combined with weak or moderate CYP1A2 inhibitors such as caffeine and birth control pills. Do not start without talking to your psychiatrist.","kaynak":"PMID 33951339; FDA Epidiolex label §7.2 (05/2026); Clozapine prescribing information §2.7 and §7.1; https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=90876802-0e3a-44c9-9ff7-1754dfbe736a"},{"id":"K69","kaynak_kural_id":"EK-klonazepam","tur":"ilac","siddet":"bilgi","tetikleyiciler":["klonazepam"],"baslik":"Clonazepam","uyari":"In 45 people with epilepsy taking approved CBD, clonazepam blood levels did not change as the CBD dose went up. Still, drowsiness may increase when they are taken together; tell your doctor.","kaynak":"PMID 37593907"},{"id":"K70","kaynak_kural_id":"EK-diazepam","tur":"ilac","siddet":"dusuk","tetikleyiciler":["diazepam"],"baslik":"Diazepam","uyari":"No study has measured diazepam blood levels with CBD. One of the enzymes that break down diazepam (CYP2C19) is slowed by CBD: approved CBD raised the blood level of a clobazam breakdown product, which is broken down by this enzyme, about 3-fold. In epilepsy, the safety and effect of diazepam used as a nasal spray during a seizure did not change with CBD. Drowsiness may increase when they are taken together; tell your doctor.","kaynak":"FDA Epidiolex label §12.3 (05/2026); PMID 37313955; PMID 37210793; Diazepam prescribing information (Clinical pharmacology); https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=554baee5-b171-4452-a50a-41a0946f956c"},{"id":"K71","kaynak_kural_id":"EK-lamotrijin","tur":"ilac","siddet":"bilgi","tetikleyiciler":["lamotrijin"],"baslik":"Lamotrigine","uyari":"In 63 people with epilepsy taking approved CBD, lamotrigine blood levels did not change as the CBD dose went up; the European package leaflet says no dose adjustment is needed. Still tell your doctor about the medicines you take.","kaynak":"PMID 37593907; EMA Epidyolex SmPC 4.5"},{"id":"K72","kaynak_kural_id":"EK-propranolol","tur":"ilac","siddet":"bilgi","tetikleyiciler":["propranolol"],"baslik":"Propranolol","uyari":"No study has looked at propranolol and CBD together. In healthy volunteers, CBD slowed some of the enzymes that break down propranolol (CYP1A2, CYP2C19); whether propranolol levels change is not known. Because CBD can lower blood pressure by a few mmHg, watch for dizziness and tell your doctor.","kaynak":"PMID 37313955; PMID 28614793"},{"id":"K73","kaynak_kural_id":"EK-sertralin","tur":"ilac","siddet":"orta","tetikleyiciler":["sertralin"],"baslik":"Sertraline","uyari":"In a 78-year-old patient who had taken sertraline for 20 years, blood sodium dropped and forgetfulness developed in the months after over-the-counter CBD was added; it resolved after CBD and then sertraline were stopped (a single case; CBD's role was rated \"possible\"). In two adverse event reports from Poland, people taking CBD oil together with sertraline had diarrhea, vomiting, fever and severe fatigue. Tell your doctor or pharmacist.","kaynak":"PMID 36627907; PMID 39502532; PMID 34121064"}],"aciklama":"Warning rules are not personal dose recommendations. The 'siddet' (severity) scale: yuksek = a drug with a narrow therapeutic range and human evidence of clinical consequences; orta = a measured change in levels in humans, or a single case; dusuk = a small change or one of unclear clinical importance, or only a class warning on the label; bilgi = information. An empty 'tetikleyiciler' (triggers) list means a general rule shown to every user.","resmi_sinirlar":[{"kurum":"EFSA (2026)","mg_kg_gun":0.0275,"mg_gun":2,"aciklama":"Provisional safe level of 0.0275 mg/kg body weight/day ≈ 2 mg/day for a 70 kg adult. The value was derived by applying a total uncertainty factor of 400 (100 × 2 × 2) to a reference point calculated from liver findings in rats (BMDL10 11 mg/kg/day). Only for supplements of ≥98% purity that contain no nanoparticles, are produced safely and have had genotoxicity ruled out. Safety could not be established for people under 25, people who are pregnant or breastfeeding, and people taking medicines. Uncertainties remain about the liver and the nervous, endocrine, reproductive and immune systems. This is a food/supplement value; it should not be compared with prescription treatment doses.","kaynak":"https://www.efsa.europa.eu/en/news/provisional-safe-level-cannabidiol-novel-food; EFSA Journal 2026;24(2):e9862, DOI 10.2903/j.efsa.2026.9862, full text PMC12884199 (accepted 16.12.2025; published 09.02.2026)"},{"kurum":"EFSA NDA Panel (September 2026) — synthetic CBD","mg_kg_gun":0.026,"mg_gun":2,"aciklama":"Novel food opinion on chemically synthesized CBD of ≥98% purity: found safe under the proposed conditions of use — only as a supplement dissolved in MCT oil, at most 2 mg a day, for adults over 25 who are not pregnant or breastfeeding; safety could not be established in people taking medicines. The value was derived from a liver finding in female rats (BMDL10 10.5 mg/kg/day) with an uncertainty factor of 400. The opinion concerns a single application; the decision to authorize the product lies with the European Commission.","kaynak":"EFSA NDA Panel 2026; DOI 10.2903/j.efsa.2026.10154; PMID 42761670 (published 18.09.2026)"},{"kurum":"EFSA NDA Panel (2022)","mg_kg_gun":null,"mg_gun":null,"aciklama":"The safety of CBD as a novel food cannot be established at this time; effects on the liver, the digestive tract, the endocrine and nervous systems and psychological effects need to be clarified; animal studies showed significant reproductive toxicity. Its effect on drug metabolism and genotoxicity are also among the data gaps.","kaynak":"EFSA Journal 2022;20(6):7322, DOI 10.2903/j.efsa.2022.7322 (accepted 26.04.2022; full text PMC9172591)"},{"kurum":"UK FSA + FSS (2023)","mg_kg_gun":null,"mg_gun":10,"aciklama":"Healthy adults should limit CBD from food to 10 mg a day (≈ 4–5 drops of a 5% oil); the previous advice (February 2020) was 70 mg/day. Children, people who are pregnant or breastfeeding or planning a pregnancy, and people taking medicines without having consulted a doctor should not take CBD. Reason: adverse effects on the liver and thyroid with long-term use (FSS press page and FSA guidance page; reversible once stopped).","kaynak":"FSS/FSA press release 12.10.2023, https://www.foodstandards.gov.scot/news/food-standards-scotland-and-food-standards-agency-update-consumer-advice-for-cbd; FSA guidance https://www.gov.uk/government/publications/cannabidiol-cbd/cannabidiol-cbd"},{"kurum":"UK ACNFP + COT (2023)","mg_kg_gun":0.15,"mg_gun":10,"aciklama":"Provisional acceptable daily intake of 0.15 mg/kg/day ≈ 10 mg/day at 70 kg; ≥98% pure CBD, by mouth only. Main concerns: somnolence, liver; possible drug interactions above 70 mg/day (cannot be ruled out at lower doses). According to the committees’ 2025 summary report, the advice rests mostly on liver, thyroid, adrenal gland and kidney findings; the most sensitive effects are on the liver and thyroid.","kaynak":"ACNFP/COT joint position paper 12.10.2023, https://www.gov.uk/government/publications/provisional-cannabidiol-cbd-acceptable-daily-intake-adi/joint-position-paper-from-the-advisory-committee-on-novel-foods-and-processes-acnfp-committee-on-toxicity-cot-on-establishing-a-provisional-acce; ACNFP–COT CBD subgroup summary report 17.10.2025, https://www.gov.uk/government/publications/cannabidiol-cbd-subgroup-phase-1-summary-report/joint-acnfp-and-cot-cannabidiol-cbd-sub-group-phase-1-summary-report"},{"kurum":"US FDA (2019)","mg_kg_gun":null,"mg_gun":null,"aciklama":"'Strongly' advises against any use of CBD, THC and marijuana during pregnancy and breastfeeding.","kaynak":"FDA consumer page 16.10.2019, https://www.fda.gov/consumers/consumer-updates/what-you-should-know-about-using-cannabis-including-cbd-when-pregnant-or-breastfeeding"},{"kurum":"ASCO guideline (2024) — cancer","mg_kg_gun":null,"mg_gun":300,"aciklama":"In adults with cancer, oral CBD at ≥300 mg a day is not recommended for symptom burden outside a clinical trial (no proven efficacy; risk of reversible liver enzyme abnormalities; evidence quality low, recommendation weak). This is a professional guideline recommendation, not an official food limit.","kaynak":"PMID 38478773; DOI 10.1200/JCO.23.02596"}],"farmakokinetik":[{"konu":"Oral bioavailability","bilgi":"Absolute oral bioavailability on an empty stomach ~6% (an estimate; no detailed study measuring it directly has been published). No study has measured absolute bioavailability by the oral route (2018 systematic review).","kaynak":"Perucca & Bialer 2020, PMID 32504461; Millar 2018, PMID 30534073"},{"konu":"First-pass effect","bilgi":"~70–75% of the absorbed dose may be metabolized in the liver before it reaches the systemic circulation (an estimate).","kaynak":"Perucca & Bialer 2020, PMID 32504461"},{"konu":"Taken with food (high-fat)","bilgi":"With a high-fat, high-calorie meal, Cmax rises ~5-fold and AUC ~4-fold; variability decreases (Taylor 2018: Cmax 4.85-fold, AUC 4.2-fold).","kaynak":"FDA label 12.3; EMA SmPC 5.2; Taylor 2018, PMID 30374683"},{"konu":"Taken with food (low-fat / milk)","bilgi":"With a low-fat meal, Cmax ~4-fold and AUC ~3-fold; with cow’s milk, Cmax ~3-fold and AUC ~2.5-fold. EMA recommends keeping the timing relative to meals consistent (always fed or always fasting).","kaynak":"EMA SmPC 5.2"},{"konu":"Taken with food (meta-analysis)","bilgi":"Food increases how much CBD reaches the blood 2–5-fold.","kaynak":"Jang 2024, PMID 38850302"},{"konu":"With alcohol","bilgi":"Alcohol increases CBD AUC by 63% (Cmax by 93% on the FDA label).","kaynak":"EMA SmPC 5.2; FDA label 12.3"},{"konu":"Time to peak (Tmax)","bilgi":"2.5–5 hours at steady state; ~4–5 hours after a single dose.","kaynak":"FDA label 12.3; Taylor 2018, PMID 30374683"},{"konu":"Half-life","bilgi":"Terminal 56–61 hours (twice daily, 7 days); effective half-life 10–17 hours.","kaynak":"FDA label; EMA SmPC; Taylor 2018, PMID 30374683"},{"konu":"Reaching steady state","bilgi":"2–4 days with twice-daily dosing (Taylor 2018: ~2 days).","kaynak":"EMA SmPC 5.2; Taylor 2018, PMID 30374683"},{"konu":"Dose–exposure relationship","bilgi":"Less than dose-proportional increase (Cmax slope 0.73; AUC 0.64); absorption is saturable.","kaynak":"Taylor 2018, PMID 30374683; EMA SmPC"},{"konu":"Protein binding","bilgi":">94%.","kaynak":"FDA label 12.3"},{"konu":"Metabolism","bilgi":"In the liver by CYP2C19 and CYP3A4; UGT1A7, UGT1A9, UGT2B7. Active metabolite 7-OH-CBD; main circulating metabolite 7-COOH-CBD.","kaynak":"FDA label; Taylor 2018, PMID 30374683"},{"konu":"Excretion","bilgi":"Mainly in feces; a small amount through the kidneys.","kaynak":"FDA label"},{"konu":"Formulation differences","bilgi":"After 100 mg of oral CBD, urine Cmax was 1274 ng/mL with Epidiolex, 776 with capsules and 151 with syrup.","kaynak":"Sholler 2022, PMID 34089060"},{"konu":"Sublingual drops and capsules","bilgi":"No difference in blood levels between sublingual drops and capsules (the drops are most likely swallowed).","kaynak":"Johnson 2024, PMID 37733294"},{"konu":"Low blood levels even at high doses","bilgi":"After 800 mg of oral CBD, the median blood level at 130 minutes was 5.0 µg/L; even at 800–1600 mg, blood levels were in the µg/L range.","kaynak":"Schneider 2022, PMID 34086631"},{"konu":"Low-dose products","bilgi":"In studies of low doses (≤175 mg/day), plasma levels were 5–100 times lower than with a 20 mg/kg Epidiolex dose.","kaynak":"Warren 2026, PMID 42473010"},{"konu":"Liver impairment","bilgi":"In moderate/severe hepatic impairment, exposure rises 2.5–5.2-fold.","kaynak":"FDA label 8.6, 12.3"}],"titrasyon_ilkesi":{"metin":"In the sources, the \"start low, go slow\" principle appears only under a doctor’s supervision and in research protocols; this page contains no personal dose recommendation. For the approved CBD medicine, the starting dose and the steps for increasing it are written in the medicine’s prescribing information and are set by a doctor. An expert consensus written for medical cannabis in chronic pain also suggests starting at a low dose and increasing it every few days; this is expert opinion only and is meant for use under a doctor’s supervision. In clinical trials, too, participants started at a low dose and were brought up to the study’s target dose over several weeks; these are research protocols, not individualized recommendations. The upper limits that agencies have calculated for food supplements (EFSA in the European Union, the FSA in the UK) are safety limits, not plans for increasing the dose. Your doctor decides, together with the medicines you take, whether CBD is right for you and at what dose.","kanit_durumu":"Prescribing information for the approved medicine; expert opinion only for chronic pain (Delphi consensus); the others are study protocols","kaynak":"FDA, prescribing information of the approved CBD medicine §2; Bhaskar 2021, PMID 34215346; Millar 2019, PMID 31222854; FSS/FSA 12.10.2023; https://www.efsa.europa.eu/en/news/provisional-safe-level-cannabidiol-novel-food"},"urun_kalitesi":[{"bilgi":"84 products bought online (31 companies): 30.95% accurately labeled (±10%), 42.85% contained more CBD than labeled, 26.19% less. THC was found in 18/84 products (21.43%), up to 6.43 mg/mL.","kaynak":"Bonn-Miller 2017, PMID 29114823"},{"bilgi":"After 100 mg of pure CBD (oral/vaporized), only 1 of 218 urine samples was positive at the 20 ng/mL screening cutoff; none exceeded the 15 ng/mL confirmation cutoff.","kaynak":"Spindle 2020, PMID 31682266"},{"bilgi":"CBD-dominant product containing THC (100 mg CBD + 3.7 mg THC, vaporized): four samples positive on confirmation testing (THC-COOH >15 ng/mL); in a second study, 6 samples from 3 of 18 people were ≥15 ng/mL.","kaynak":"Spindle 2020, PMID 31682266; Sholler 2022, PMID 34089060"},{"bilgi":"MCT oil with 100 mg CBD twice a day for 14 days (60 healthy adults, groups of 10): in every group receiving THC (0.5–3.7 mg THC), at least one person had a positive urine test; in the CBD-only group, one urine sample was positive. THC in the blood was very low; no difference was seen in intoxication or attention tests. One of the authors is an employee of a CBD company.","kaynak":"Wolinsky 2026, PMID 40704705"},{"bilgi":"There is no evidence that pure CBD converts to Δ8/Δ9-THC by any route or in any formulation.","kaynak":"Sholler 2022, PMID 34089060"},{"bilgi":"No positive urine tests with topical products; however, THC ≥2 ng/mL in oral fluid in 9 participants.","kaynak":"Zamarripa 2024, PMID 38217086"},{"bilgi":"Pure oral CBD (15–1500 mg) did not produce THC-positive results on two roadside saliva tests.","kaynak":"McCartney 2022, PMID 34412166"},{"bilgi":"In users of a broad-spectrum CBD product (150 mg/day, 10 weeks), CBG and CBDV, which are prohibited under WADA’s 2026 list, were detected in urine (42% and 68% before exercise, 74% and 84% after); THC was not detected. CBDV was not listed on the product’s certificate of analysis.","kaynak":"Gillham 2026, PMID 40920736"},{"bilgi":"'Full-spectrum' (other cannabinoids, including THC), 'broad-spectrum' (THC is claimed to have been removed) and 'isolate' (pure CBD) are common industry terms; no binding regulatory definition was reported in the sources reviewed. Regulatory safety values were derived only for ≥98% pure CBD. ACNFP/COT groups products as A (≥98% pure CBD), B (CBD + cannabinoid mixture) and C (natural hemp extract) (secondary source).","kaynak":"EFSA 2026; ACNFP/COT 2023"},{"bilgi":"In Australia, 17 of 58 (29%) unregulated cannabis products used in children with epilepsy had ethanol or isopropanol above the limit (5000 ppm); one sample had bifenthrin (a pesticide) at 4.9 times the limit; no sample exceeded heavy metal limits (51 samples).","kaynak":"Suraev 2022, PMID 34954507"},{"bilgi":"The content and purity of over-the-counter CBD products used in pain studies are a problem; the content on the label may not match the actual content.","kaynak":"Moore 2024, PMID 37863344"},{"bilgi":"Dependence: Epidiolex is not a controlled substance; no withdrawal symptoms were seen after 28 days of 1500 mg/day.","kaynak":"FDA Epidiolex label 9.x"}],"dogrulanamayan":["The full text of Anderson 2022 (fluoxetine case) could not be accessed (paywalled, no abstract); case details are from the Chapin 2025 review: 17-year-old male, CBD oil; insomnia, restlessness, worsening OCD; causality 'probable'","The full text of Cáceres Guido 2021 (Epilepsia) could not be accessed; the direction of the interaction comes from the same group’s 2023 study: in children taking levothyroxine, CBD trough levels were higher (n=22, 7 of them on levothyroxine). Cause and effect and the mechanism have not been proven","Midazolam: no change with the approved CBD medicine (750 mg twice a day); a single dose of a CBD-dominant extract (640 mg CBD + 20 mg THC) increased AUC by 56%. No effect was seen in the THC-only arm (20 mg); the authors attribute the difference to possible CYP3A induction with continuous use, which has not been proven"]}