CBD gummies are widely sold as wellness supplements, but they aren’t safe for everyone. Several groups of people face real risks from CBD, ranging from dangerous drug interactions to liver damage and complications during pregnancy. If you take prescription medications, have liver problems, are pregnant or breastfeeding, or are preparing for surgery, CBD gummies may cause serious harm.
People Taking Prescription Medications
CBD interferes with the same liver enzyme system that processes a large number of common medications. When CBD blocks these enzymes, other drugs can build up in your bloodstream to potentially dangerous levels. The list of affected medications is long and covers several major categories.
Blood thinners are a major concern. In one documented case, a patient taking warfarin needed a dose reduction to keep their blood clotting at safe levels after starting CBD. Too much warfarin in the bloodstream raises the risk of serious, even life-threatening bleeding.
Anti-seizure medications like clobazam, carbamazepine, lamotrigine, and phenytoin can all accumulate when taken alongside CBD. The same goes for benzodiazepines (clonazepam, diazepam, lorazepam), tricyclic antidepressants, and SSRIs. CBD can also raise blood levels of opioid painkillers like morphine and tramadol, increasing the risk of sedation and respiratory depression.
Beyond psychiatric and neurological drugs, CBD can increase concentrations of immunosuppressants used by organ transplant recipients. One study found a threefold increase in tacrolimus levels when patients used CBD, a potentially toxic jump. Cyclosporine levels can rise similarly. Certain cholesterol-lowering statins (atorvastatin and simvastatin), antihistamines, some HIV medications, corticosteroids like prednisolone, and common pain relievers including naproxen and celecoxib are also affected. If you take any prescription medication, the safest approach is to check with your pharmacist before trying CBD gummies.
People With Liver Conditions
CBD is processed almost entirely by the liver, and clinical trial data shows it can cause liver toxicity. In trials of prescription-grade CBD, people who already had mildly elevated liver enzymes before starting CBD were at significantly higher risk. Nearly half of all cases of CBD-related liver enzyme elevations, and over 40% of cases that progressed to actual liver injury, occurred in people whose liver enzymes were already above normal at baseline.
CBD also regulates at least 50 genes tied to lipid and drug metabolism, meaning its effects on the liver are broad and complex. If you have hepatitis, fatty liver disease, cirrhosis, or any condition that compromises liver function, CBD gummies add a real risk of further damage. People who drink alcohol regularly should also be cautious, since alcohol and CBD both stress the liver through overlapping pathways.
Pregnant and Breastfeeding Women
The FDA strongly advises against using CBD in any form during pregnancy or while breastfeeding. No comprehensive research exists on CBD’s effects on a developing fetus or nursing infant, but what evidence does exist is concerning. In animal studies, high doses of CBD caused problems with the reproductive system of developing male fetuses.
CBD transfers through breast milk, and many CBD products contain trace amounts of THC, which can remain in breast milk for up to six days after use. THC exposure during infancy has been linked to hyperactivity, poor cognitive function, and other long-term developmental effects. There’s also the contamination problem: CBD products can contain pesticides, heavy metals, bacteria, and undisclosed THC, all of which pose added risks to a baby.
Children and Adolescents
The brain continues developing well into the mid-twenties, and cannabinoids have wide-ranging effects on the central nervous system during this window. Research in both humans and animals shows significant changes in brain structure and function among frequent cannabis users compared to non-users. While most of these studies focus on THC, there is very little understanding of how CBD alone affects a developing brain, particularly a neurodivergent one.
Prescription CBD does exist for specific pediatric seizure disorders, but those treatments are carefully dosed and monitored by neurologists. Over-the-counter CBD gummies are a different story entirely. They lack standardized dosing, may contain undisclosed THC, and haven’t been studied for safety in children. Parents considering CBD for a child’s anxiety or behavioral issues should know that self-treating with store-bought gummies carries risks that outweigh any potential benefit.
People With Glaucoma
This one surprises many people, since cannabis is sometimes associated with eye pressure relief. But CBD and THC are not the same in this regard. The American Academy of Ophthalmology states that CBD is not an effective treatment for glaucoma. One study found that CBD may actually increase eye pressure, which could make glaucoma worse. If you have glaucoma or are at risk for it, CBD gummies could work against your treatment rather than alongside it.
Anyone Preparing for Surgery
The American College of Surgeons recommends stopping all cannabis products, including CBD, at least 72 hours before any surgery requiring general anesthesia. Cannabis compounds affect the airways, making it harder to place a breathing tube. CBD’s interactions with anesthesia drugs and its effects on liver metabolism can also complicate how your body processes sedation during the procedure.
If you’re scheduled for surgery, tell your anesthesiologist about CBD use even if you’ve already stopped. The information helps them adjust your care and avoid complications.
People Subject to Drug Testing
CBD gummies won’t show up on a standard drug test, but THC will, and many CBD products contain more THC than their labels claim. In one laboratory analysis, 24% of products labeled “THC Free” actually contained detectable levels of THC. This contamination has caused positive workplace drug tests, with consequences for employment, military service, sports eligibility, and even child custody cases.
Full-spectrum CBD products intentionally contain small amounts of THC (up to 0.3% by law), which can accumulate with daily use. Even broad-spectrum and isolate products carry contamination risk due to inconsistent manufacturing standards. If a positive drug test would have serious consequences for your life, CBD gummies are a gamble that may not be worth taking.
People With Low Blood Pressure
CBD can cause drops in blood pressure, which for most people is mild and temporary. But if you already have low blood pressure or take medication to lower it, adding CBD gummies could amplify the effect. This can lead to dizziness, lightheadedness, and fainting, particularly when standing up quickly. Beta-blockers are among the medications whose blood levels CBD can increase, compounding the blood pressure effect from both directions.