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Does CBD Interact With Estazolam (Prosom)?

CBD may potentiate the sedative effects of estazolam (Prosom).

This combination is considered high risk and should be avoided.

Article By
Daily CBD , last updated on February 4, 2022

Estazolam is a sedative drug belonging to the benzodiazepine class. It has anticonvulsant, sedative, muscle relaxant, and anxiolytic properties.  This medication is mainly used to treat insomnia. 

The cannabinoid cannabidiol (CBD) can interact with estazolam if taken together. 

CBD is an anxiolytic and sedative itself, and it can also potentiate (increase) estazolam’s effects. This makes it more potent, but it can also lead to an increased risk of side effects — some of which are severe. 

Illustration of estazolam tablets

Does CBD Interact With Estazolam (Prosom)?

Yes. CBD may interact with estazolam. 

CBD can heighten estazolam’s hypnotic properties. This can make the drug more effective but can also increase the risk of serious side effects.  

CBD may also interfere with the way estazolam is metabolized — leading to elevations in blood plasma and increasing the risk of side effects and overdose. The more frequently these substances are combined, the higher the risk. 

CBD interacts with estazolam in two ways: 

A) CBD Can Increase Estazolam’s Effects (Agonistic Interaction)

CBD is an agonist to estazolam. Both substances have an inhibitory effect on the central nervous system. This means the combined action of both substances may be too strong — leading to side effects, some of which are potentially dangerous. 

CBD and estazolam have different mechanisms of action, however. CBD interacts with the endocannabinoid system and 5HT receptors to cause relaxation and sedation. Estazolam works through the gamma-aminobutyric acid-A (GABAA) receptors.

B) CBD Can Slow Down Estazolam’s Elimination (Metabolic Competition)

The P450 enzymes metabolize the drugs in the body. The enzyme CYP3A4 metabolizes estazolam in the body. This same enzyme metabolizes CBD too. 

Sometimes when two drugs use the same enzymes for metabolism, they may end up competing against each other for attention. This action can cause one or both drugs to have a slowed metabolism.

Since estazolam and CBD are metabolized by the same enzyme, their overall metabolism and elimination can slow down when taken together. This could lead to an excess accumulation of estazolam in the body, causing it to become more potent but also making it liable to cause more side effects. The result could mean that the person is more susceptible to side effects like headaches, excessive sleepiness, dizziness, etc. 

The half-life of estazolam varies from 10 to 24 hours.

Similar Medications: CBD & Benzodiazepines

Estazolam is classified as a benzodiazepine. CBD and benzodiazepines all share similar risks for interaction and side effects and should be avoided unless otherwise specified by your prescribing physician. 

Here’s a list of similar medications that share a similar level of risk when combined with CBD:

  • Alprazolam (Xanax)
  • Chlordiazepoxide (Librium)
  • Clonazepam (Klonopin)
  • Clorazepate (Tranxene)
  • Diazepam (Valium)
  • Flurazepam (Dalmane)
  • Lorazepam (Ativan)
  • Midazolam (Versed)
  • Oxazepam (Serax)
  • Temazepam (Restoril)
  • Triazolam (Halcion)
  • Quazepam (Doral)

Is It Safe to Take CBD & Estazolam (Prosom) Together?

No. It isn’t safe to take CBD and estazolam together.

While it’s unlikely for CBD and estazolam to result in side effects, the severity of some of the potential risks makes this combination worth avoiding.

Is CBD A Viable Alternative to Estazolam (Prosom)?

CBD may be a good alternative to estazolam in mild cases of sleep disorders or anxiety but may not be a suitable alternative for severe acute anxiety or insomnia.

Many experts recommend CBD or other non-prescription alternatives first before moving up to benzodiazepines. CBD is also a safer option for long-term use than estazolam, which can become habit-forming and addictive in as little as two weeks of consistent use. 

If you’re already using estazolam, speak to your doctor before switching to CBD. Your doctor will be able to assess your symptoms, underlying diagnosis, and other medications to determine whether CBD is a suitable alternative or not.

The anxiolytic (anxiety-reducing) and sleep-supportive actions of CBD are well known at this point [2]. Numerous studies are already available supporting these effects in large-scale clinical trials.

Two CBD-derived medications (Sativex and Epidiolex) have received approval for treating two seizure disorders, Lennox-Gastaut syndrome and Dravet syndrome. 

What is Estazolam (Prosom)? 

Estazolam is a sleep-inducing drug from the family of benzodiazepines, used in the treatment of insomnia, muscle convulsions, and anxiety. Estazolam is said to be more potent than other benzodiazepines for this action, such as diazepam. 

Estazolam is a federally controlled substance (C-IV), as it can be abused or lead to dependence. It’s available as a prescription-only drug in most countries.  

Estazolam (ProSom) Specs:

Drug Name  Estazolam
Trade Name Prosom, Esilgan, Zolacare
Other Names Desmethylalprazolam
Classification  Benzodiazepines
CYP Metabolism  CYP3A4
Interaction With CBD Metabolic competition, Agonist
Risk of Interaction  High

What Does Estazolam (Prosom) Do?

Estazolam works by binding nonspecifically to benzodiazepine receptors. These receptors affect the transmission of electrical activity in the nervous system. By slowing nerve impulses, estazolam affects muscle contraction, mental stimulation, sleep, memory, and more. 

Benzodiazepine receptors are said to be coupled to gamma-aminobutyric acid-A (GABAA) receptors. This causes an enhancement in the effects of gamma-aminobutyric acid (GABA) because of the increase in GABA’s affinity for the GABA receptor. 

When the inhibitory neurotransmitter GABA binds to its receptor site, it opens the chloride channel, causing a hyperpolarization of the cell membrane that prevents further excitation of the cell. It can depress all levels of the central nervous system, including the limbic and reticular formation. 

Side Effects of Estazolam (Prosom)

Estazolam can cause dependence and addiction. Long-term use can cause complete drug dependence and rebound insomnia, and stopping the drug abruptly can cause withdrawal symptoms. Hence this medication should only be used for only a short duration. 

Estazolam’s dosage is adjusted and administered along with non-pharmaceutical measures to treat insomnia. Its use must be monitored very carefully.  

Side effects of estazolam (Prosom)

  • Abnormal coordination
  • Abnormal thinking
  • Angioedema
  • Asthenia
  • Dizziness
  • Euphoria
  • Fever
  • Flushing palpitation
  • Hangover
  • Hangover effect
  • Headache
  • Hostility
  • Hypokinesia
  • Muscle spasm
  • Myalgia
  • Neck pain
  • Neuromuscular weakness
  • Rash
  • Seizure
  • Sleep disorder
  • Somnolence
  • Urticaria

Can You Overdose on Estazolam? 

Yes, it’s possible to overdose on benzodiazepines. 

The risk of overdose increases substantially when combining benzodiazepines with other medications, illicit drugs, or alcohol. 

Overdosing on estazolam may produce symptoms such as confusion, slow breathing, drowsiness, coma, lack of coordination, vomiting, loss of consciousness, lapses in memory, confusion, and slurred speech. It should never be consumed with alcohol. 

Contraindications For Estazolam

Estazolam is not appropriate for everybody — certain underlying medical conditions, habits, or other medications may make it dangerous to use estazolam. 

It’s important to be open and transparent with your doctor so they can assess your individual level of risk before prescribing estazolam or other benzodiazepine medications. 

Contraindications of estazolam include: 

  • Alcohol consumption (any amount)
  • Depressed neuroses, psychotic reactions
  • Hypersensitivity
  • Myasthenia gravis
  • Narrow-angle glaucoma
  • Pregnancy and lactation
  • Severe respiratory depression
CBD oil dropper, CBD capsules and hemp leaf over white background

Key Takeaways: Is it Safe to Take Estazolam (Prosom) With CBD?

It may be unsafe to use CBD with estazolam as they have a moderate to high risk of interaction.

CBD may slow the metabolism of estazolam and potentiate some of its effects. Both could lead to an increased risk of side effects ranging from mild to severe. 

These two drugs should only be used in combination after consulting with your prescribing physician. Seek medical attention if you experience a loss of consciousness, vomiting, fatigue or lethargy, severe headache, or any other abnormal reactions. 


  1. Blessing, E. M., Steenkamp, M. M., Manzanares, J., & Marmar, C. R. (2015). Cannabidiol as a potential treatment for anxiety disorders. Neurotherapeutics, 12(4), 825-836. 
  2. Shannon, S., Lewis, N., Lee, H., & Hughes, S. (2019). Cannabidiol in anxiety and sleep: a large case series. The Permanente Journal, 23.

Learn More About CBD-Drug Interactions

Learn More About CBD-Drug Interactions

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