Xarelto And CBD Oil

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If you've been prescribed warfarin (an anticoagulant) and are wondering if you can also take CBD oil, read this post before proceeding to know the risks of this drug interaction. Learn the risks, benefits, and possible side effects of taking CBD oil while on blood thinner medication. Contributor: Dr. Augustine Provencio, MD, ABFP TEST Xarelto Pill Box CBD and Xarelto explained. The anticoagulant Xarelto can treat clotting disorders,

CBD and Warfarin: Can You Safely Mix Them Together?

CBD oil is a natural remedy that contains the cannabinoid CBD extracted from the cannabis plant. It’s said to reduce inflammation, provide greater resistance to stress, and promote nerve health.

However, CBD oil may have an adverse drug interaction with anticoagulants such as warfarin.

Can you take CBD oil with warfarin? Read on to find out.

How Does CBD Affect Your Body?

Cannabidiol (CBD) is a compound that comes from the cannabis plant known for its health benefits. CBD oil can be extracted from hemp or marijuana plants. Hemp-based CBD oil is legal in all 50 states, while marijuana-derived CBD oil varies by state.

There are several ways in which CBD affects your body. To begin with, CBD is not addictive and does not cause any withdrawal symptoms. This means taking higher doses of CBD is okay as long as you don’t exceed your daily recommended amount or take too much at once.

Furthermore, CBD is non-psychoactive, meaning it doesn’t get you high, unlike tetrahydrocannabinol (THC), the other compound from the cannabis plant.

These are just some of the common reasons why people use CBD oil:

  • Pain relief
  • Anti-anxiety
  • Acne cure
  • Weight management
  • Brain health
  • Cardiovascular health

However, CBD is not for everyone. Some side effects have been reported in rare cases, which may include:

  • Dry mouth
  • Fatigue
  • Sedation
  • Appetite changes
  • Diarrhea

Additionally, using CBD alongside certain medications raises some questions.

How Does CBD Oil Affect Your Blood?

It has been shown that CBD itself has mild anticoagulating effects, meaning that it can act somewhat like a blood thinner. Nevertheless, more studies must be done to better understand how CBD affects your blood.

In clinical trials, case studies, and scientific research, CBD is shown to work well with the endocannabinoid system in the body.

Following the passage of the Farm Bill, scientists now have greater access to CBD and can finally study its potential as a healing agent. As a result, researchers are conducting more and more studies and clinical trials on CBD every day.

Does CBD Interact With Medications?

Various pharmaceuticals, herbal products, and health supplements can interact with CBD. As a result, the use of other drugs might need to be reduced or modified if CBD is introduced.

The main thing is to understand that some medications should not be taken together.

There are many other factors that can influence drug interactions, such as one’s health condition, the dose of a medication, and the dose of CBD. So if you’re starting a new medication, consult your doctor first before taking CBD oil.

Does CBD Interact With Warfarin?

Short answer: Yes.

Taking any kind of medication or substance requires your body to metabolize it. In the metabolic process, drugs are broken down so the body can absorb their effects.

The chemical structure of a drug determines how it’s broken down by the liver, thereby determining how quickly it leaves your system. The enzyme family called cytochrome P450 (CYP450) is responsible for converting foreign substances and making them easily excreted by the body.

The CYP450 enzyme may be slowed or accelerated by some medication or substance, including CBD.

Drug interactions occur because your body’s metabolism rate is altered during this time. This is referred to as the “grapefruit effect” due to the grapefruit’s ability to slow down the absorption of the drug by the body.

CYP450, CBD Oil, and Warfarin

CYP450 is predominantly responsible for the metabolism of warfarin. CBD inhibits this enzyme class. CBD competes with warfarin on the same metabolic pathway, according to a US National Library of Medicine study published in 2017.

CBD can cause warfarin to stay in the body for too long without being broken down when taken together. This can result in unwanted side effects such as excessive bleeding or overdose.

What Can Increase the Risk of Bleeding?

Warfarin treatment can increase your chances of bleeding during the first three months. The risk is even greater for older adults. You may also be at risk if you use other blood-thinning medications.

Genetic factors may also cause some people who take warfarin to be more prone to bleeding. Your doctor may recommend a genetic test to determine the best dose for you.

Other medical conditions that increase your risk of bleeding are:

  • Alcoholism
  • Cancer
  • History of stroke
  • Kidney problems
  • Liver disease
  • Ulcers, gastritis, and peptic disease
  • Uncontrolled blood pressure

Can You Take CBD Oil With Warfarin?

CBD oil and warfarin should not be taken together. Taking any form of CBD during your warfarin treatment should be avoided as well.

Warfarin is an anticoagulant (blood thinner) medication that prevents the formation of dangerous blood clots that could lead to heart attacks or strokes. Warfarin is available under several brand names, including Coumadin and Jantoven.

Severe bleeding, headaches, swelling, or sudden pain in the extremities are some of the risks associated with warfarin.

A 2017 study published in Epilepsy & Behavior Case Reports showed that CBD increased the effects of blood-thinning drugs like warfarin by slowing down how the body metabolizes the substance. CBD may potentially increase some of the risks of warfarin by extending its duration in the body.

If you’re currently taking warfarin and want to use CBD for another condition, be sure to speak with your healthcare provider first.

Can You Take Other Blood Thinners With CBD Oil?

Drug interactions can be influenced by a number of factors, including your health, weight, and general tolerance. When CBD oil is combined with blood thinners, several considerations must be made.

Two of the remaining three oral anticoagulants approved by the FDA to treat irregular rapid heart rates are also metabolized by the CYP450 system. As a result, they will also be affected by CBD’s grapefruit effect.

Rivaroxaban and apixaban are the oral anticoagulants described.

Further, a study published in 2011 described how dabigatran (Pradaxa), another oral anticoagulant, doesn’t undergo CYP450 metabolism. A review of dabigatran suggests that the drug may have a few drug-food and drug-drug interactions. The use of dabigatran as an alternative to warfarin treatment is also being considered.

Once again, it’s advisable to consult your doctor before taking any anticoagulant together with CBD to determine safety and tolerance.

The FDA has authorized warfarin use for the following purposes:

  • Treatment of venous thrombosis, associated pulmonary embolisms, and pulmonary thrombosis.
  • Treatment of thromboembolic complications caused by cardiac valve replacement or irregular or rapid heartbeats (atrial fibrillation).
  • Identify and prevent deaths, recurrent heart attacks or myocardial infarctions (MI), and other thromboembolic events like strokes and systemic embolisms that may follow a cardiac arrest.
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Can CBD Replace Warfarin?

The overall research on CBD is relatively young compared to traditional drugs. Currently, CBD has not been explicitly evaluated as a safe replacement for warfarin or any form of the anticoagulant.

Phytomedicine published a study written in 2007 that used an obese rat model to show that cannabis extracts may have anticoagulant effects. In this study, cannabinoids like cannabinol (CBN) and tetrahydrocannabinol (THC) exhibited anticoagulant properties.

According to the researchers, the cannabinoids THC and CBN from Cannabis sativa were possible treatments for thrombosis and diabetes, a condition that could lead to an irregular rise in blood clotting.

There have been limited studies to determine if CBD can act as an anticoagulant, and at this time, there is no evidence that CBD can act as an anticoagulant medication.

You should still consult a medical expert before taking CBD as a substitute for warfarin or any prescription medication. There are still many unknowns regarding CBD’s effects on the body.

What To Look For When Shopping for CBD Oil

The market for CBD oil has expanded a lot in recent years. It is available online and in stores across the country. However, not all CBD oils are created equal and there are certain things you should know before purchasing your first bottle.

CBD Concentration

Some people are not sure what CBD concentration means when buying CBD oil.

There are many different types, and some can be much stronger than others. The concentration will depend on what you’re looking to use the CBD oil for and how often you plan on using it. The higher the concentration, the stronger the effects are likely to be.

There is also a limit to the amount of THC that can be present in a product. The percentage of THC in CBD oil should be clear on its label.

CBD Dosage

The next thing you should look at is how much CBD is in each dosage (the number of milligrams). Taking a certain amount of CBD will vary depending on the concentration as well as other factors like age or medical needs.

CBD Vendor’s Certificate of Analysis (COA)

Before buying CBD oil, it’s important to check its COA. This will not only ensure that the product is of good quality but also tell you if the vendor has been trustworthy in providing accurate information about the product.

This certificate ensures that the product is safe, and you shouldn’t have any worries about what you’re putting into your body. It lets you know that this product has been tested and meets all safety standards mandated by law.

CBD Source

When shopping for CBD oil, check the CBD’s source. If you’re in the United States, it’s best to buy CBD that uses American-grown organic hemp.

Hemp is a bioaccumulator, which means it absorbs the nutrients and elements from the soil it’s planted. These nutrients are dissolved within the plant’s cell walls and then released throughout its life cycle.

Bioaccumulators are effective at absorbing either good or harmful elements. So you can also compromise the quality of the CBD plant if polluted soil is used.

Ideally, hemp should be grown in fertile soil with no harsh chemicals.

Additional Ingredients

CBD products may be formulated with beneficial ingredients like MCT oils or melatonin.

Unfortunately, CBD products can sometimes contain potentially hazardous ingredients, such as vegetable glycerin and propylene. So be aware of these substances and steer clear of CBD products containing them.

Other Products That May Interact With Warfarin

In addition to individual factors, there are several drug interactions that can change how your body reacts.

Warfarin interacts with vitamins, nutritional supplements, drugs, and food. These items may reduce the efficacy of warfarin or increase bleeding risks.

Here’s a list of common foods and drinks to avoid while taking warfarin:

  • Grapefruit or grapefruit juice
  • Cranberries or cranberry juice
  • Pomegranate or pomegranate juice
  • Garlic
  • Black licorice
  • Alcohol

Here’s a list of common drugs to avoid while taking warfarin:

  • Abnormal heart rhythm medications, such as amiodarone (Pacerone, Nexterone)
  • Antibiotics
  • Aspirin or products containing aspirin
  • Antacids or laxatives
  • Antifungal medications, including fluconazole (Diflucan)
  • Colds and allergy medications
  • Ibuprofen (Advil, Motrin IB, etc.)
  • Naproxen sodium (Aleve, Naprelan, etc.)
  • Product containing acetaminophen (Tylenol, etc.)

Here’s a list of common herbal or nutritional supplements to avoid while taking warfarin:

  • Vitamin E
  • Ginseng
  • Green tea
  • Dong quai (Angelica sinensis)
  • St. John’s wort
  • Coenzyme Q10 (ubiquinone)

Key Takeaways on Interactions Between CBD and Warfarin

The body absorbs CBD through the CPY450 system, which also helps your body process warfarin. Therefore, combining CBD with warfarin is not advisable.

If you insist on taking CBD together with it, warfarin may stay in your body for longer than necessary. This can lead to severe side effects such as excessive bleeding and even death from overdose.

If you’re on warfarin or about to use this medicine, be mindful of the other foods, drugs, and supplements that you should avoid as well.

CBD oil is a legal and safe drug in the United States. However, there are laws different for every state and you should make sure we check the law first before you buy CBD oil.

There are many benefits of using CBD. However, there are many fake products out there that don’t meet quality standards. To maximize its benefits and prevent any harm to your body, be sure to buy from a trusted source. You should also make sure that the product has been third-party tested.

Most importantly, it’s highly recommended to seek medical advice before using CBD products as a replacement for a prescribed drug or a nutritional supplement.

Have you tried taking CBD and warfarin together? Share your experience in the comments below to help other readers!

References:

  1. Grinspoon, P. (2019, Aug 27). Cannabidiol (CBD) — what we know and what we don’t. Retrieved from https://www.health.harvard.edu/blog/cannabidiol-cbd-what-we-know-and-what-we-dont-2018082414476. (1)
  2. Yamaori S., Koeda K., Kushihara M., Hada Y., Yamamoto I., Watanabe K. Comparison in the in vitro inhibitory effects of major phytocannabinoids and polycyclic aromatic hydrocarbons contained in marijuana smoke on cytochrome P450 2C9 activity. Drug Metab Pharmacokinet. 2012;27(3):294–300. (2)
  3. Deaton, J. G., & Nappe, T. M. (n.d.). Warfarin Toxicity. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK431112/
  4. Doliner B, Jaller JA, Lopez AJ, Lev-Tov H. Treatments to prevent primary venous ulceration after deep venous thrombosis. J Vasc Surg Venous Lymphat Disord. 2019 Mar;7(2):260-271.e1.
  5. W., M., D., K., & M., B. (2013). Co-administration of rivaroxaban with drugs that share its elimination pathways: pharmacokinetic effects in healthy subjects. doi: 10.1111/bcp.12075.
  6. Ganetsky, M., Babu, K. M., Salhanick, S. D., Brown, R. S., & Boyer, E. W. (2011). Dabigatran: Review of Pharmacology and Management of Bleeding Complications of This Novel Oral Anticoagulant, 7(4). doi: 10.1007/s13181-011-0178-y
  7. Sharp CR, deLaforcade AM, Koenigshof AM, Lynch AM, Thomason JM. Consensus on the Rational Use of Antithrombotics in Veterinary Critical Care (CURATIVE): Domain 4-Refining and monitoring antithrombotic therapies. J Vet Emerg Crit Care (San Antonio). 2019 Jan;29(1):75-87.
  8. Badjatiya A, Rao SV. Advances in Antiplatelet and Anticoagulant Therapies for NSTE-ACS. Curr Cardiol Rep. 2019 Jan 12;21(1):3.
  9. Unger, E. F. (2015, October 16). Atrial fibrillation and new oral anticoagulant drugs. Retrieved from https://www.fda.gov/drugs/news-events-human-drugs/atrial-fibrillation-and-new-oral-anticoagulant-drugs
  10. Coetzee, C., Levendal, R. A., van de Venter, M., & Frost, C. L. (2007). Anticoagulant effects of a Cannabis extract in an obese rat model. Phytomedicine, 14(5). doi: 10.1016/j.phymed.2006.02.004
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Nina Julia

Nina created CFAH.org following the birth of her second child. She was a science and math teacher for 6 years prior to becoming a parent — teaching in schools in White Plains, New York and later in Paterson, New Jersey.

Blood Thinners and CBD Oil Interaction

CBD oil has been making headlines for potentially being able to treat hypertension and heart disease, so naturally, if you suffer from a hemostasis disorder, you may be wondering if CBD could be of any help in treating your condition.

Although CBD oil has been shown to be relatively safe, it should be used cautiously with some blood thinning medications, including some commonly prescribed anticoagulants.

If you are considering combining CBD oil and blood thinners, or simply want to explore if it’s a safe option, here is everything you need to know.

Effects of CBD on Blood Clotting

The effects of CBD oil on blood clotting are not well understood, but it is thought that a few factors may be involved. First is CBD oil’s impact on blood flow.

CBD oil can aid the circulatory system by dilating blood vessels. This allows the blood to flow quicker, and in turn, can make the occurrence of blood clots less likely. A 2017 study found that just a single dose of CBD significantly reduced the blood pressure of subjects both at rest and in stressful situations.

Broad spectrum CBD, or full spectrum CBD oil in particular, may be a useful tool in preventing thrombosis, or the formation of blood clots. A study on the anticoagulant effects of cannabis found the cannabinoids tetrahydrocannabinol (THC) and cannabinol (CBN) to be effective anti-thrombotics, doubling the amount of time it took for blood clots to form in obese and lean rat test subjects compared to the control group.

Both CBN and THC are present in full spectrum CBD oil, along with all the other cannabinoids and terpenes present in cannabis. CBD oil derived from the industrial or agricultural hemp variety of the cannabis plant contains less than 0.3% THC, which is in line with federal regulations.

If you’d rather not have any THC in your CBD product, but still want the anticoagulant effects of CBN and CBD, a broad spectrum CBD oil would be ideal. Broad-spectrum CBD products contain all the cannabinoids and terpenes of the hemp plant except THC. If you aren’t sure whether you’d like a full- or broad-spectrum product, a good place to start is researching your state’s laws on cannabis, THC, and CBD, as well as seeking advice from a medical professional.

Interactions Between CBD and Blood Thinners

Although CBD oil has been found to be generally well-tolerated and without any significant side effects in studies , it can interact negatively with some medications. Often referred to as the ‘grapefruit effect,’ CBD oil is one of a number of natural substances that can slow down systems the body uses to metabolize and break down toxins.

One of the main metabolic systems in the body is the cytochrome P-450 enzyme system , which is made up of liver enzymes that break down certain drugs in the body, with removal of potentially harmful byproducts. If the P-450 enzyme system is inhibited by a compound like CBD, medications typically broken down by the liver enzymes remain in the system for longer than desirable, making it more likely you will experience side effects from the medication.

As you’ll see in the table below, not all pharmaceuticals are processed by the cytochrome P-450 enzyme system. So while you may need to take care when taking CBD oil with a blood thinner like warfarin, for example, people taking heparin face fewer risks.

Ultimately, it’s important to consult with a doctor before using CBD oil if you take any blood thinning medication. Your doctor will make adjustments to your medication, taking into account any effects that CBD oil may have in any potential interactions with it.

As a starting point, here is a list of some of the most commonly prescribed blood thinners and what we currently know about their interaction with CBD oil.

Anticoagulant Type Brand Name Common Drug Side Effects Possible Side Effects of Combining Medication + CBD Oil
Rivaroxaban Xarelto Prolonged bleeding; bruising easily; nosebleeds; bleeding gums Rivaroxaban may remain in the system longer and increase the likelihood you’ll experience its side effects
Dabigatran Pradaxa Prolonged bleeding; bruising easily; nosebleeds; bleeding gums No known interaction
Apixaban Eliquis Prolonged bleeding; bruising easily; nosebleeds; bleeding gums Combine with caution; apixaban may remain in the system longer and make side effects more likely
Edoxaban Lixiana Prolonged bleeding; bruising easily; skin rash; reduced liver function; anemia No known interaction
Warfarin Coumadin; Jantoven Unusual bruising; bleeding gums; nosebleeds; prolonged bleeding Combine with caution; Warfarin may remain in the system longer and side effects could become more likely
Heparin Various Prolonged bleeding; bruising easily; nosebleeds; bleeding gums; skin irritation; allergic reaction No known interaction

How to Safely Take CBD and Blood Thinners Together

When combining CBD oil and blood thinners, there are a variety of factors that come into play. Your health, weight, and general tolerance can all influence how likely you are to experience possible drug-drug interactions. Because there are so many variables to consider, you should first speak to your doctor about the possibility of adding CBD oil to your medication regimen. Together, you can create a plan to ensure there is minimal disruption to your system.

In order to further minimize the risks of an adverse reaction between CBD oil and your anticoagulant, it’s suggested that you start with a lower dose than what is recommended for your chosen CBD product, and slowly increase the dosage over time if needed. This not only allows you to build a tolerance to CBD oil, but also provides your doctor with the time and flexibility to monitor changes and decrease the dosage of your blood thinners if necessary.

Safest CBD Oils to Take with Blood Thinners

With so many varieties of CBD oil available to you, how do you know where to start? If you’re looking for a safe CBD oil to combine with blood thinners, or are turning to CBD oil as a preventative measure against blood clots, there are a few things to consider to ensure you’re making the smartest and safest choice possible.

First, choose your CBD delivery method. You can buy CBD oil in a wide variety of forms including capsules, vapes , edibles , and drops . While vaping CBD will deliver the fastest results, drops are more discreet with longer-lasting effects, and capsules offer a user-friendly, familiar option for people who are new to CBD. When deciding on a method, it is worth noting that any format that’s processed through the digestive system will take longer to show effects and as such, may lose some of its potency.

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After you have chosen your preferred method for CBD administration, look for a high quality CBD product that has been organically grown, sustainably sourced, and third-party lab tested. Reading the lab reports (called Certificates of Analysis) will ensure the product you purchase is in fact the safest CBD oil to take with blood thinners. A Certificate of Analysis should tell you if the CBD product you have contains herbicides, pesticides, heavy metals, or chemical additives.

When you have your CBD oil product, figuring out your ideal dosage is the final step to making sure you’re using CBD safely. The safest way to take CBD oil with blood thinners is to start with a small dose and gradually increase it over a period of time if needed. For additional guidance on CBD dosage, consider speaking with a naturopathic doctor who specializes in using CBD oil to treat medical conditions.

If you’ve spoken to your physician and are ready to choose a CBD oil, check out the Best CBD Oil Products to Buy .

CBD and Xarelto

CBD and Xarelto explained. The anticoagulant Xarelto can treat clotting disorders, which are diseases of the blood. If you take Xarelto and are interested in CBD for health benefits, speak with your doctor first.

CBD is sometimes taken to treat pain or inflammation and may sound like a safer option than prescription medications. But is it safe to combine the two?

Is it Safe to Mix CBD and Xarelto?

It is not safe to combine CBD and Xarelto because CBD changes the way your body metabolizes certain drugs. Some research has shown that CBD affects metabolic enzymes that break down Xarelto. Discuss your plan with your healthcare team before making any medication changes.

What is Xarelto?

Xarelto (Rivaroxaban) is a prescription anticoagulant. It can treat or prevent the formation of blood clots. If clots form in the cardiovascular system, they can become lodged in critical organs. A clot lodged in the veins of the lungs is called a pulmonary embolism, and one stuck in the veins of the legs or arms is called a deep vein thrombosis.

Xarelto can also prevent blood clots after surgery or in those have atrial fibrillation, an irregular heart rhythm.

Why Could it Be Unsafe to Mix CBD and Xarelto?

CBD changes how your body breaks down drugs, which can lead to higher levels of Xarelto in the bloodstream. When your body breaks down drugs more slowly than usual, it is similar to taking more Xarelto than prescribed.

Cytochrome P450 Enzymes

Enzymes are unique proteins that carry out roles in the cells. They can speed up chemical reactions, or they can help to break down waste products, drugs, or medications.

CBD affects a family of metabolic enzymes called cytochrome P450 (CYP450). There are over 50,000 different kinds of CYP450 enzymes, which all break down different things.

Metabolic enzymes are found in tissues all over your body, but this article will focus on the ones found in your gut and liver. CYP450 enzymes break down about 60% of prescription drugs.

Drug Metabolism Basics

When you take a medication by mouth, it travels to the stomach and then the small intestine. CYP450 enzymes in the small intestine may start breaking down the drug before it enters the bloodstream. Most drugs are mostly intact by the time they enter circulation.

One in the bloodstream, Xarelto is first transported to the liver through the hepatic portal vein. The liver has a high concentration of CYP450 enzymes, which break down a larger portion of Xarelto than those in the small intestine.

After passing through the liver, the remaining medication circulates to the rest of the body. After reaching various parts of your body, Xarelto flows through the blood and into the liver again. This process repeats until the drug is eliminated.

The First Pass Effect and Bioavailability

When you swallow a medication, only a percentage reaches your bloodstream. Some drug is broken down by the liver, and this is called the first-pass effect.

The percentage of drug that reaches the bloodstream after the first-pass effect is called bioavailability. If a drug has a bioavailability of 90%, that means 10% of the drug is lost, and 90% makes it into your systemic bloodstream. Bioavailability varies from drug to drug.

Xarelto has a bioavailability of roughly 60% to 100%, depending on the dose and if you take it with food.

Grapefruit and the First Pass Effect

You may have noticed a warning on some medications that reads, “Avoid eating grapefruit or drinking grapefruit juice while taking this medication.” Drugs carry this warning because grapefruit can affect CYP450 enzymes.

Certain compounds in grapefruit can bind to and shut down CYP450 enzymes. When these enzymes are shut down, the drug stays in the bloodstream for longer than usual. Therefore, grapefruit can increase the level of certain drugs to dangerously high amounts.

The compounds in grapefruit can interact with drugs for a long time. They can permanently shut down certain CYP450 enzymes, sometimes as long as 72 hours.

CBD and the First Pass Effect

Just like grapefruit, CBD changes how fast your body breaks down drugs. A study found that CBD is a powerful inhibitor of the CYP450 enzymes CYP3A4 and CYP3A5. Both of these enzymes play a role in breaking down Xarelto.

When CBD inhibits CYP3A4 and CYP3A5, Xarelto stays in the body for longer. Higher levels of Xarelto can lead to side effects, including higher rates of minor and major bleeding events.

Speak with your doctor or pharmacist before taking CBD, especially if you are taking Xarelto.

Increased Side Effects

If higher than normal amounts of Xarelto are in the body, you could be at a higher risk for unwanted side effects.

Side effects of too much Xarelto may include:

  • Bleeding in the abdomen
  • Bleeding in the brain
  • Bleeding in the lungs
  • Hemorrhagic stroke
  • Liver damage
  • Pain
  • Reduced clotting capabilities
  • Stomach upset
  • Unexplained bruising

Some of these side effects can be life-threatening or even fatal.

Conclusions

It is probably unsafe to combine CBD and Xarelto. CBD changes how fast the body removes Xarelto and causes higher doses in the bloodstream.

Higher levels of Xarelto can increase the rate of dangerous side effects. Some of the side effects of Xarelto can be serious or even fatal. For this reason, CBD should not be combined with Xarelto without the knowledge, consent, and supervision of your healthcare team.

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