CBD for older people: precautions and gaps in the studies

With age, three things add up: more medicines, organs that sometimes clear them more slowly, and greater sensitivity to side effects. France's Haute Autorité de santé has run a programme on safer prescribing for older people. It points out that most medicine-related harm can be avoided with appropriate care.

The only CBD-based medicine follows the same logic. The summary of product characteristics for Epidyolex, published by the European Medicines Agency, asks for cautious dose selection in older patients, starting at the lowest dose. It cites the higher frequency of liver, kidney or heart impairment, other illnesses and concomitant treatments.

The broadest synthesis is a 2021 meta-analysis in PLOS Medicine. It pools 46 controlled trials of natural or synthetic cannabinoids, in 6,216 adults with an average age of 58.6. For CBD alone, tested in four of these trials, the authors saw no more adverse events than with placebo, and no serious adverse event related to treatment.

The limit lies in the participants' age. Only four trials recruited people aged 65 and over, 68 participants with an average age of 72.4; just one covered people aged 75 and over. The authors themselves stress that tolerability may differ after 65 or 75.

The Epidyolex file points the same way. Its trials did not include enough patients over 55 to compare their response with that of younger patients, and how the body handles CBD has not been studied beyond age 74.

CBD slows several enzymes that clear medicines. In healthy volunteers taking CBD at Epidyolex doses, the level of a metabolite of clobazam, an antiepileptic, rose 3 to 4 fold, and that of everolimus, an immunosuppressant, 2.5 fold. A published case describes a sharp rise in INR, the clotting marker, in a patient on warfarin. Our article on the grapefruit effect of CBD details these measurements.

These figures concern high doses, around 1,000 mg a day. At the doses of products sold to the public, nobody has measured them. That is why EFSA, which set a provisional level of 2 mg a day for a 70 kg adult on 9 February 2026, states that safety is not established for people on medication. The UK Food Standards Agency advises them against CBD. Our article on how much CBD per day compares these benchmarks.

In the controlled trials of Epidyolex, 29% of patients on CBD had drowsiness or sedation, more often at the start of treatment. The rate reached 43% with clobazam. The product summary states that alcohol and other nervous system depressants can strengthen this effect. In an older person, unusual drowsiness also raises the risk of a fall.

The second effect concerns the liver. CBD can raise liver enzymes, the transaminases, in a dose-dependent way. The same document reports that in a study outside epilepsy, two older patients showed a rise in these markers, which resolved after CBD was stopped.

Another point, often overlooked: a CBD product can contain traces of THC. France's drug policy agency, MILDECA, notes that they can pass into saliva and trigger a positive roadside test. Our article on CBD and driving sets out the penalties.

The framework changed in 2026. On 20 May, the Ministry of Agriculture restated that foods containing CBD, supplements included, are not authorised and must be withdrawn from sale. Our overview of CBD regulation in 2026 lists what remains on sale. CBD cosmetics are among them. They cannot claim any effect on a disease: MILDECA states that therapeutic claims are banned under criminal penalties. Our guide to assessing a CBD cream or balm describes what a label must show.

For an illness, the route is medical. France's medical cannabis experiment ended on 31 December 2024, and the ANSM states that a transition phase lets patients already enrolled continue their treatment. Our article on medical cannabis in 2026 follows the texts, and our guide to choosing CBD explains how to read a lab report.

Before talking to the pharmacist, prepare three things: the full list of medicines, including over-the-counter ones; the product you are considering and its CBD content; and any history of liver problems or falls.