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Does CBD Interact With Ivermectin (Stromectol)?

Information on risks & possible interactions between CBD & ivermectin.

Article By
Daily CBD , last updated on October 21, 2021

Ivermectin (Stromectol) is a powerful antiparasitic medication with a long list of side effects — including nausea and inflammation.

Some people who take this medication combine it with anti-nausea or anti-inflammatory supplements or medications — such as CBD or other cannabinoids. But is this combination safe?

Can CBD and ivermectin be combined? Here, we’ll explore all the potential drug interactions between CBD and ivermectin.

Illustration of an ivermectine tablet.

Does CBD Interact With Ivermectin (Stromectol)?

CBD may slow the breakdown and elimination of ivermectin (Stromectol) by competing for similar metabolic pathways in the liver.

However, the level of risk with this interaction is minimal, and no major side effects have been reported from this combination.

CBD works by acting on the endocannabinoid system (ECS). It mainly works on the CB2 and serotonin 5-HT1A receptors. CBD’s exact mechanism of action on parasites has not been determined yet. On the other hand, ivermectin works by binding to the glutamate-gated chloride channels of the organisms and causing their death.

Other Names for Ivermectin

Ivermectin is sold under many different names. All share the same risk and potential interactions.

Other names for ivermectin include:

  • Stromectol
  • Soolantra
  • Sklice

Similar Medications: CBD & Avermectins

Ivermectin is classified as an avermectin. CBD and avermectins all share similar risks for interaction and side effects.

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

  • Selamectin
  • Doramectin
  • Eprinomectin
  • Abamectin

Is It Safe to Take CBD & Ivermectin (Stromectol) Together?

The safety of using CBD and ivermectin together is not well studied — however, no significant side effects are expected.

If you want to take CBD and ivermectin together, consult your doctor first, get yourself assessed, and then follow their suggestions.

To lessen the chances of interaction, the best way to take these drugs is to finish the complete course of one medication first and then start the other one — rather than using both simultaneously.

Always speak to your doctor about CBD first if you’re taking ivermectin for any reason.

Is CBD a Viable Alternative to Ivermectin (Stromectol)?

CBD and ivermectin are entirely different substances. CBD is not considered a viable alternative to ivermectin for the purpose of eliminating parasitic worms.

Cannabis has a long history of being used as a traditional antiparasitic medication in some parts of India and Uganda.

CBD may also help to lower the inflammation caused by these parasites, but there are no indications CBD possesses direct antiparasitic effects.

What Is Ivermectin (Stromectol)?

Ivermectin (Stromectol) is a medication used to treat parasite infections. It belongs to the avermectin group of drugs.

It also treats diseases like head lice, scabies, river blindness, onchocerciasis, strongyloidiasis, trichuriasis, ascariasis, and lymphatic filariasis.

Ivermectin is usually taken as an oral pill but is also applied for some conditions like rosacea.

Ivermectin Specs:

Drug Name Ivermectin  
Trade Name Stromectol, Agimect, Escapil, Soolantra, Sklice  
Other Names (other generics) 22,23-dihydroavermectin
CYP Metabolism CYP3A4 (minimal)
Interaction With CBD Metabolic competition
Risk of Interaction Mild  

What Does Ivermectin (Stromectol) Do?

Ivermectin (Stromectol) works by hindering the nerve and the muscle functions of parasitic worms. This drug has an attraction to the glutamate-gated chloride ion channels in the bodies of these parasites. This binding action causes an increase in the permeability of the cell membranes, causing an easy flow of chloride ions.

This causes hyperpolarization in the cell body of the parasites. It then leads to the paralysis of the parasite and, eventually, death. It is safe for use in mammals as the blood-brain barrier prevents the entry of ivermectin into the nervous system, as long as it’s in low doses.

Ivermectin may also impair the normal intrauterine development of the microfilariae of Onchocerca volvulus. It may inhibit their birth and lead to the death of these organisms. It is a very effective antiparasitic drug.

Side Effects of Ivermectin

  • Abdominal pain
  • Asthenia
  • Blurred vision
  • Conjunctival hemorrhage (with onchocerciasis)
  • Diarrhea
  • Dizziness
  • Eosinophilia
  • Eye damage
  • Fever
  • Headache
  • Hepatitis
  • Hyperthermia
  • Hypotension
  • Insomnia
  • Leukopenia
  • Liver enzyme dysfunction
  • Lymphadenopathy
  • Mazzotti reaction (with onchocerciasis)
  • Mild conjunctivitis
  • Nausea
  • Peripheral and facial edema
  • Pruritus
  • Rash
  • Sleepiness
  • Transient tachycardia
  • Tremor
  • Urticaria
  • Vertigo
  • Vomiting
  • Weakness

Types of Drug Interactions With CBD

CBD may alleviate many conditions; however, like most medically relevant substances, CBD’s chemical nature makes it liable to interact with many other drugs.

There are three ways that CBD can interact with other drugs:

1. Agonistic Interaction

This interaction can occur due to the medicines that have the same effect on the body. They work on the same receptors on the body leading to effects in the same direction.

Examples of medications that could cause agonistic interaction with CBD are:

  • Antihypertensive Medications — These include beta-blockers, central agonists, diuretics, ACE inhibitors, alpha-blockers, calcium channel blockers, and angiotensin II receptor blockers. CBD can cause low blood pressure if taken alongside these medications.
  • Antidiabetic medications — These include SGLT-2 inhibitors, sulfonylureas, and insulin, alpha-glucosidase inhibitors, GLP-1 receptor agonists, meglitinides, and DPP-4 inhibitors. CBD could decrease blood sugar beyond normal if used with these medications.
  • Anti-anxiety medications — These include drugs like benzodiazepines and barbiturates. CBD could make them last longer in the body.

2. Antagonistic Interaction

This is the opposite of the agonistic interaction. It happens when two drugs have effects opposite of each other. If taken together, one drug would cross out the effects of the other, causing a decreased efficacy of the second drug.

Drugs that have antagonistic interaction with CBD are:

  • Immunosuppressants — These include azathioprine, mycophenolate cyclosporine, methotrexate, etc. CBD’s immune-stimulating properties may cause these drugs to lose their efficiency.
  • Stimulants — These include amphetamine, modafinil. CBD can cause them to be less productive.
  • Immunomodulators — These include antihistamines like carbinoxamine, desloratadine, levocetirizine. CBD could enhance their sedative action.
  • Asthma Medications — These include drugs like montelukast, ipratropium bromide, albuterol, fluticasone, and theophylline. CBD may limit their abilities, especially that of theophyllines.

3. Metabolic Inhibition

Some medications need similar enzymes to break down the drug molecules. It leads to both drugs competing against each other, causing their metabolism to decrease.

These include medications like

  • Opiate analgesics — These include morphine, codeine, hydrocodone. CBD could make them last longer in the bloodstream and create complications.
  • Antidepressants — CBD can make these drugs last longer in the body by diminishing their metabolism. Antidepressants include trazodone, mirtazapine, vortioxetine, and vilazodone, and others.
  • Blood thinners — CBD could cause an increment in the action of warfarin, enoxaparin, heparin, and others that could be very unsafe.
  • NSAIDs — These include ibuprofen, naproxen, and high-dose aspirin. CBD could make them last longer in the body, increasing their side effects.
Hemp farmer holding Cbd oil made of Cannabis sativa plant in a dropper and bottle.

Key Takeaways: Is It Safe to Take Ivermectin With CBD?

CBD and ivermectin (Stromectol) may interact with each other leading to their slow metabolism. This could cause them to last longer in the body and cause more damage.

However, research regarding this is minimal. To prevent the chances of interaction, take these medications only under the strict supervision of your doctor.

The best way to prevent any chances of interaction is to finish the duration of one drug dosage before starting the other. If you want to take both of them, it may be better to have adequate time intervals in between while taking both these medications.

Do not overdose. If you get any side effects, contact your doctor immediately. Always stay on alert while taking these medications together.

More CBD-Drug Interactions

More CBD-Drug Interactions

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