CBD’s safety in older adults is uncertain, because it has barely been tested in them. The Australian product information for Epidyolex, the registered CBD medicine, says its safety and efficacy in people aged 65 and over “have not been established”.1 The clearest practical concern is interactions with the medicines older people commonly take, followed by sleepiness and liver effects.
How much evidence is there?
Very little for CBD on its own. A 2021 systematic review found 46 double-blind trials of cannabinoid medicines where the average participant was 50 or older. Only 4 tested CBD without THC, with about 43 people taking CBD.2
| Product type | Side effects compared with control |
|---|---|
| THC alone | Increased (rate ratio 1.42), including dizziness and drowsiness |
| THC and CBD combined | Increased (rate ratio 1.58) |
| CBD alone | No increase overall (rate ratio 1.02), from 4 small, generally low-quality trials |
Source: Velayudhan and colleagues, 2021.2 The CBD finding rests on fewer than 100 people, so it cannot rule out uncommon problems.
Which medicines are the main concern?
CBD slows several of the liver enzymes that clear other medicines.3
| Medicine | What may happen |
|---|---|
| Warfarin | INR, the clotting test, can rise (case reports)4 |
| Clopidogrel | May work less well (predicted)3 |
| Digoxin | Levels may rise (predicted)3 |
| Benzodiazepines, opioids, sleeping tablets | Added sleepiness3 |
We found no verified studies of CBD with blood pressure tablets, statins or diabetes medicines. That question is open, not answered. See does CBD interact with blood thinners?
Does CBD cause falls?
No study has measured falls in older people taking CBD alone. Sleepiness is a common side effect: in epilepsy trials at high doses, it affected 32% of people on CBD and 11% on placebo.3 THC-containing products increased dizziness and drowsiness in the over-50s review, which the authors noted could raise falls risk.2
What about the liver?
Liver enzyme rises are dose-related and have been seen in healthy adults aged 18 to 55 at about 350 to 400 mg a day. Older adults were not in that trial.5 See is CBD bad for your liver?
Why are prescribers cautious?
The prescribing information says dose selection for an older person “should be cautious”, usually starting low, because reduced liver, kidney or heart function and other medicines are more common with age.13 The prescriber sets the dose.
What should you bring to the appointment?
A complete medicine list, including supplements, and details of any falls, liver or kidney problems or memory difficulties. Report new drowsiness, unsteadiness, bruising or bleeding.
Read the full guide: CBD for older adults.
Footnotes
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Therapeutic Goods Administration. Epidyolex (cannabidiol) Australian Product Information, version attached to the AusPAR, January 2021 (may be superseded). https://www.tga.gov.au/sites/default/files/auspar-cannabidiol-210115-pi.pdf ↩ ↩2
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Velayudhan L, McGoohan K, Bhattacharyya S. Safety and tolerability of natural and synthetic cannabinoids in adults aged over 50 years: a systematic review and meta-analysis. PLOS Medicine, 2021. https://doi.org/10.1371/journal.pmed.1003524 ↩ ↩2 ↩3
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Jazz Pharmaceuticals. Epidiolex (cannabidiol) oral solution, US prescribing information, DailyMed (accessed November 2026). https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=8bf27097-4870-43fb-94f0-f3d0871d1eec ↩ ↩2 ↩3 ↩4 ↩5 ↩6
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Nachnani R and others. Systematic review of drug-drug interactions of delta-9-tetrahydrocannabinol, cannabidiol, and Cannabis. Frontiers in Pharmacology, 2024. https://pmc.ncbi.nlm.nih.gov/articles/PMC11167383/ ↩
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JAMA Network. News release on Florian J and others, cannabidiol and liver enzyme level elevations in healthy adults, JAMA Internal Medicine, 7 July 2025. https://www.eurekalert.org/news-releases/1089832 ↩
This page is general information, not medical or legal advice. Laws and evidence change; we show the date we last checked the facts at the top of every page. Talk to your doctor or pharmacist before starting, stopping or changing any medicine.
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