CBD has barely been tested in older adults, so its safety in this group is uncertain. 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 effects on the liver.
How much evidence is there in older adults?
Very little for CBD on its own.
- The epilepsy trials behind Epidyolex did not include enough people over 55 to tell whether they respond differently from younger people.2
- How the body handles CBD has not been studied in people over 55.1
- A 2021 systematic review gathered every double-blind trial of cannabinoid medicines in which the average participant was 50 or older. It found 46 trials with 6,216 participants. Only 4 of those trials tested CBD without THC, with about 43 people taking CBD and 44 taking placebo.3
That review also cautions that tolerability may be different in people over 65 or 75.3
What did the over-50s review find?
The review separated products by what they contained, which matters because most “medicinal cannabis” research involves THC.3
| Product type | Side effects compared with placebo or control |
|---|---|
| THC alone | All side effects increased (rate ratio 1.42). More dizziness or light-headedness, dry mouth and drowsiness. |
| THC and CBD combined | All side effects increased (rate ratio 1.58). More people dropped out because of side effects (risk ratio 1.40). |
| CBD alone | No increase in side effects overall (rate ratio 1.02), from 4 small trials. Evidence rated generally low quality. |
A rate ratio of 1.42 means side effects were reported 42% more often than in the comparison group.
The authors concluded that cannabinoid medicines “in general are safe and acceptable in older adults”, but that THC and CBD combinations may be less acceptable at the doses used.3
The CBD finding rests on fewer than 100 people, so it cannot rule out uncommon problems.
Why are prescribers cautious with older people?
The prescribing information says dose selection for an older person “should be cautious”, usually starting at the low end of the range. The reasons given are that reduced liver, kidney or heart function, other illnesses and other medicines are all more common with age.12
The TGA’s general guidance on medicinal cannabis says low starting doses are important for the elderly and asks doctors to “carefully assess elderly and particularly sensitive patients”. It names people with memory and thinking difficulties, liver and kidney disease, and frailty from severe chronic illness as needing low starting doses.4 That guidance covers THC products as well as CBD.
A prescriber sets the dose. This page describes the cautions regulators have published, not what any individual should take.
Which medicines are the main concern?
CBD slows several of the liver enzymes that clear other medicines.2 Several medicines affected are ones older adults often take.
| Medicine | What may happen | Evidence |
|---|---|---|
| Warfarin (blood thinner) | INR, the clotting test, can rise | Case reports with prescription CBD5 |
| Clopidogrel (anti-platelet) | May be activated less, so could work less well | Predicted from how it is processed2 |
| Digoxin (heart) | Levels may rise | Predicted2 |
| Benzodiazepines, opioids, sleeping tablets | Added sleepiness | Label warning for sedating medicines2 |
| Morphine, lorazepam | Levels may rise | Predicted from laboratory data1 |
| Omeprazole (reflux) | Levels may rise | Predicted from laboratory data1 |
| Tacrolimus, sirolimus, everolimus (transplant) | Levels can rise substantially | Study and case reports25 |
Our research did not find verified studies of CBD with blood pressure tablets, statins or diabetes medicines. That means the question is open, not that the combination is known to be safe.
The full table, with what prescribers usually do, is on CBD drug interactions.
Does CBD cause falls or confusion?
Falls. We found no study that measured falls in older people taking CBD alone. What is known is indirect:
- Sleepiness is one of the most common CBD side effects. In the epilepsy trials, at doses of roughly 700 to 1,400 mg a day for a 70 kg adult, it affected 32% of people on CBD and 11% on placebo.2
- The prescribing information warns that alcohol and other sedating medicines can add to it.2
- The over-50s review found dizziness and drowsiness were increased by THC-containing products. The authors noted this could raise falls risk in older people. The review did not measure falls.3
Thinking and memory. In a small Australian trial in adults with insomnia, 150 mg of CBD each night for two weeks did not impair thinking the next day.6 That trial was not in older adults specifically. THC is different: the TGA lists confusion and distorted thinking among the effects of THC-rich products.4
Blood pressure. In small studies of healthy men, a single 600 mg dose lowered blood pressure, mainly during stress tests, and raised heart rate. The effect on resting blood pressure faded within 7 days of daily dosing.7 These studies were not in older people or in people taking blood pressure medicines. See CBD and blood pressure.
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.8 Older adults were not included in that trial.
The Australian product information mentions one relevant observation: in an uncontrolled study for a condition other than epilepsy, two elderly patients had liver enzyme rises that resolved after CBD was stopped.1
People with moderate or severe liver impairment reach CBD blood levels 2.5 to 5.2 times higher than people with healthy livers after the same dose.2 See CBD and the liver.
What happened in trials that enrolled older patients?
Two sets of trials give some real-world tolerability data, though neither was designed as a safety study in the elderly.
- Advanced cancer. An Australian trial gave CBD oil or placebo for 28 days to adults receiving palliative care. CBD added no benefit over specialist palliative care alone.9
- Parkinson’s disease. A trial of 21 people compared 75 mg a day, 300 mg a day and placebo. Movement scores did not differ.10 A later 12-week trial of 26 mg a day reported no safety concerns and no difference on its main measure of thinking.11
The pattern so far is tolerable but not clearly helpful. See CBD for dementia and CBD for Parkinson’s disease.
THC matters more with age
Much of the caution about cannabis medicines in older people is really about THC. The TGA says THC-rich products have been linked to confusion, hallucinations and other effects, and that medicinal cannabis is not appropriate for people with unstable cardiovascular disease.4
A product described as “CBD” may contain some THC if it is a full-spectrum extract, or if it is mislabelled. Ask your prescriber or pharmacist exactly what is in a product. See Full spectrum vs broad spectrum vs isolate.
If you or a relative are considering it
- Take a complete medicine list to the appointment, including over-the-counter products and supplements.
- Ask the prescriber which of those medicines could interact, and whether any blood tests are needed.
- Ask what the trial evidence is for the condition in question, and how it compares with other treatment options. See How we grade the evidence.
- Tell the prescriber about any previous falls, liver or kidney problems, or memory difficulties.
- Report new drowsiness, dizziness, unsteadiness, bruising or bleeding to the prescriber or pharmacist.
For a suspected overdose or a medicine mix-up, call the Poisons Information Centre on 13 11 26.12 Call 000 in an emergency.
Footnotes
-
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 ↩3 ↩4 ↩5 ↩6
-
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 ↩7 ↩8 ↩9 ↩10
-
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 ↩4 ↩5
-
Therapeutic Goods Administration. Guidance for the use of medicinal cannabis in Australia: patient information, version 1, December 2017. https://www.tga.gov.au/sites/default/files/guidance-use-medicinal-cannabis-australia-patient-information.pdf ↩ ↩2 ↩3
-
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/ ↩ ↩2
-
Next-day cognition results from the Australian trial of 150 mg nightly CBD in insomnia, 2024. https://pmc.ncbi.nlm.nih.gov/articles/PMC11063694/ ↩
-
Systematic review of randomised trials of oral cannabidiol and blood pressure in adults. https://pmc.ncbi.nlm.nih.gov/articles/PMC13531894/ ↩
-
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 ↩
-
Hardy J and others. MedCan1-CBD: randomised placebo-controlled trial of cannabidiol oil in advanced cancer. Journal of Clinical Oncology, 2023. https://pubmed.ncbi.nlm.nih.gov/36409969/ ↩
-
Chagas and others. Double-blind trial of cannabidiol 75 mg and 300 mg a day in Parkinson’s disease, 2014. https://pubmed.ncbi.nlm.nih.gov/25237116/ ↩
-
Randomised controlled trial of sublingual cannabidiol in Parkinson’s disease, 2025. https://pubmed.ncbi.nlm.nih.gov/40267585/ ↩
-
healthdirect. Poisoning (Poisons Information Line 13 11 26). https://www.healthdirect.gov.au/poisoning ↩
Common questions
Is CBD safe for older people?
It has not been studied enough to say. Epilepsy trials included too few people over 55 to tell whether they respond differently, and the Australian product information says safety in people 65 and over has not been established. Prescribers are advised to be cautious because liver, kidney and heart problems and other medicines are more common with age.
Does CBD increase the risk of falls?
Nobody has measured this directly for CBD on its own. CBD can cause sleepiness, which is a plausible route to falls, especially with other sedating medicines. A review of trials in over-50s found dizziness was increased by THC-containing products and noted this could raise falls risk, but it did not measure falls.
Is CBD safe with lots of other medications?
The more medicines you take, the more chances there are for an interaction. CBD can raise levels of some medicines and add to sedation from others. A prescriber and pharmacist need your full medicine list, including non-prescription products, to check this properly.
Does CBD help dementia or Parkinson's symptoms?
The evidence is insufficient for both. Small trials in Parkinson's disease found no benefit for movement symptoms, and dementia trials have mostly used products that also contain THC, with mixed results. See the dementia and Parkinson's disease pages for the details.
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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