The short answer
CBD may affect hydromorphone metabolism, but an increase in its blood levels has not been established in a human interaction study. Laboratory modeling and measured effects in volunteers answer different questions.
What this answer covers
CBD dose, formulation and route matter; hydromorphone immediate-release oral, extended-release and injected forms differ.
- Supplement or preparation
- Cannabidiol
- Medication ingredient
- hydromorphone
The metabolism finding is a prediction
A laboratory study found inhibition of hydromorphone glucuronidation. Computer simulations predicted a modest increase after oral hydromorphone, with little intravenous change in a healthy simulated population. These were not observed patient blood levels.
The human trial measured drug effects
CBD with oral hydromorphone changed some acute pain-test effects. Higher CBD increased unpleasant/adverse effects, but chronic pain-test benefits were absent and psychomotor impairment was reduced. This does not demonstrate increased absorption.
Dose and route cannot be ignored
The modeling used high repeated CBD exposure, whereas the volunteer trial used single lower doses. Neither establishes a predictable percentage change for an individual, extended-release hydromorphone or every CBD product.
Review co-use with the prescriber
Tell the prescriber about CBD and new drowsiness or other effects. Hydromorphone can impair breathing; do not self-adjust it or assume that a short dosing gap resolves a possible interaction.
Evidence and practical considerations
Absorption & effectiveness
Human increased absorption/blood levels not established; direct in vitro/PBPK evidence supports a hypothesis with route-dependent predictions, while clinical effect trial is not PK proof.
- Exact scope
- CBD dose, formulation and route matter; hydromorphone immediate-release oral, extended-release and injected forms differ. with Hydromorphone RxCUI3423 IN; HCl oral immediate-release, extended-release and injected products distinguished.
- Medication form and route
- oral medication; intravenous medication; intramuscular medication; subcutaneous medication; oral supplement
What remains uncertain
- No unmeasured pair incidence, blanket class transfer or arbitrary spacing interval.
Factors that may matter: Preparation; Dose; Other medicines; Organ function.
Read the supporting source summaries
Source 1: current product label
dailymed.nlm.nih.gov · Source check Sep 10, 2026
Population: People prescribed hydromorphone
Opioid respiratory depression and additive CNS-depressant risk; general serotonergic-drug warning. Constipation can be severe. Hydromorphone is extensively glucuronidated.
How this applies: Exact hydromorphone RxCUI 3423 IN, with stated salt/formulation/route bridge.
No supplement-specific incidence. Oral, injected and extended-release products differ; oral cannabinoid experiments cannot establish every route or formulation.
Source 2: current product label
dailymed.nlm.nih.gov · Source check Sep 10, 2026
Population: People prescribed hydromorphone
Opioid respiratory depression and additive CNS-depressant risk; general serotonergic-drug warning. Constipation can be severe. Hydromorphone is extensively glucuronidated.
How this applies: Exact hydromorphone RxCUI 3423 IN, with stated salt/formulation/route bridge.
No supplement-specific incidence. Oral, injected and extended-release products differ; oral cannabinoid experiments cannot establish every route or formulation.
Source 3: current product label
dailymed.nlm.nih.gov · Source check Sep 10, 2026
Population: People prescribed hydromorphone
Opioid respiratory depression and additive CNS-depressant risk; general serotonergic-drug warning. Constipation can be severe. Hydromorphone is extensively glucuronidated.
How this applies: Exact hydromorphone RxCUI 3423 IN, with stated salt/formulation/route bridge.
No supplement-specific incidence. Oral, injected and extended-release products differ; oral cannabinoid experiments cannot establish every route or formulation.
Source 4: original in vitro and pharmacokinetic modeling study
pubmed.ncbi.nlm.nih.gov · Source check Sep 10, 2026
Population: Human-derived microsomes and virtual healthy/cirrhotic populations.
Metabolic inhibition in vitro; PBPK predicted modest oral hydromorphone exposure increases but little intravenous change in healthy simulation.
How this applies: No measured human combination PK validation. Static and PBPK predictions differ; no universal percentage, clinical dose cut or clinical absorption finding.
No measured human combination PK validation. Static and PBPK predictions differ; no universal percentage, clinical dose cut or clinical absorption finding.
Source 5: original human study
pubmed.ncbi.nlm.nih.gov · Source check Sep 10, 2026
Population: 31 healthy participants.
Some acute laboratory analgesia increased, chronic-pain model outcomes did not; highest CBD dose increased bad/adverse effects, while psychomotor impairment was mitigated.
How this applies: Healthy acute laboratory exposure, not chronic pain care. Abstract reports effect outcomes, not proof of increased hydromorphone blood levels. Full-text XML404 and browser challenge preserved.
Healthy acute laboratory exposure, not chronic pain care. Abstract reports effect outcomes, not proof of increased hydromorphone blood levels. Full-text XML404 and browser challenge preserved.
Research assessment: · Open full citations ↗
Review and change history
- Publication status
- Published research summary
- Clinical review
- Not yet recorded
| Date | Update |
|---|---|
| Article prepared | |
| Prepared exact hydromorphone article with formulation-specific evidence and uncertainty. | |
| Research summary published |
Article revision: b79f187e67fbce4d
This guide brings together the evidence records used by our interaction checker. Each finding retains its own preparation limits, research date, and source summaries.
Full citations require verification. Reading this answer and the source summaries does not.
Taking other supplements or medications?
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Open the interaction checkerInformation, not medical advice. Do not change prescribed treatment based on this guide.