Metabolism and liver toxicity of cannabidiol

Abstract

Increasing public interest has resulted in the widespread use of non-pharmaceutical cannabidiol (CBD) products. The sales of CBD products continue to rise, accompanied by concerns regarding unsubstantiated benefits, lack of product quality control, and potential health risks. Both animal and human studies have revealed a spectrum of toxicological effects linked to the use of CBD. Adverse effects related to exposure of humans to CBD include changes in appetite, gastrointestinal discomfort, fatigue, and elevated liver aminotransferase enzymes. Animal studies reported changes in organ weight, reproduction, liver function, and the immune system. This review centers on human-derived data, including clinical studies and in vitro investigations. Animal studies are also included when human data is not available. The objective is to offer an overview of CBD-related hepatotoxicity, metabolism, and potential CBD-drug interactions, thereby providing insights into the current understanding of CBD’s impact on human health. It’s important to note that this review does not serve as a risk assessment but seeks to summarize available information to contribute to the broader understanding of potential toxicological effects of CBD on the liver.

Keywords:

• Cannabidiol
• CBD
• toxicity
• liver toxicity
• metabolism

Acknowledgments

The authors express their gratitude to Dr. Laura Ewing for conducting the literature search and to Drs. Luisa Camacho and Xiaoqing Guo for their valuable critical review.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Disclaimer

This article reflects the views of the authors and does not necessarily reflect those of the U.S. Food and Drug Administration. Any mention of commercial products is for clarification only and is not intended as approval, endorsement, or recommendation.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.