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Review
. 2024;42(3):238-254.
doi: 10.1080/26896583.2024.2366741. Epub 2024 Jun 21.

Metabolism and liver toxicity of cannabidiol

Si Chen  1 , Yuxi Li  1 , Xilin Li  2 , Qiangen Wu  1 , Montserrat Puig  3 , Frederic Moulin  4 , Jeremy Gingrich  5 , Lei Guo  1
Affiliations
Review

Metabolism and liver toxicity of cannabidiol

Si Chen et al. J Environ Sci Health C Toxicol Carcinog. 2024.

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: CBD; Cannabidiol; liver toxicity; metabolism; toxicity.

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Conflict of interest statement

Conflict of interest: The authors declare no conflict of interest.

Figures

Figure 1.
Figure 1.
Structures of CBD and its metabolites
Figure 2.
Figure 2.
Interactions between CBD and cytochrome P450 enzymes
See this image and copyright information in PMC

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