CBD for Older Adults: A Safety-First Guide • Proof

If you are an older adult curious about CBD, the most useful first step is not choosing a product. It is a five-minute conversation with your pharmacist. CBD is processed by the same liver enzymes that handle many common prescriptions, it can cause drowsiness, and it can raise liver enzymes in some people. None of that means CBD is off the table. It means the questions matter more when you already take several medications.

We make CBD products, and we would rather you start carefully than start fast. This guide covers the safety points that matter most later in life: medication interactions, drowsiness, liver monitoring, and a few practical tips, including how to open a child-resistant cap without a struggle.

It does not cover whether CBD helps with any health condition. That is a question for your clinician, and CBD is not a treatment for any disease.

Key takeaways

Many older adults take several prescriptions. CBD can affect how some of them are processed, so bring your full list to a pharmacist before you start.
The FDA warns that combining CBD with alcohol or other drugs that slow brain activity increases the risk of sedation and drowsiness, which can lead to injuries.
An FDA-run trial found liver enzyme elevations in 5.6% of healthy adults taking CBD for four weeks. That trial did not include anyone over 55.
If you start, start low, follow the label, change one thing at a time, and keep a simple log.
Child-resistant caps are there for a reason, but there is an easy way to open ours.

Why medication lists matter more later in life

Taking several medications at once, sometimes called polypharmacy, becomes common with age. A CDC National Center for Health Statistics analysis of 2015 to 2016 survey data found that 34.5% of U.S. adults aged 60 to 79 had used five or more prescription drugs in the past 30 days. Add over-the-counter products and supplements, and the list gets longer.

Every item on that list is a chance for an interaction. CBD is metabolized mainly in the liver by two enzymes in the cytochrome P450 family, CYP3A4 and CYP2C19. The prescribing information for Epidiolex, the only FDA-approved CBD medication, is the clearest public record of what that means in practice. It advises clinicians to consider dose changes for drugs processed by several enzymes (including CYP1A2, CYP2B6, CYP2C8 and CYP2C19) when taken alongside it, and it notes that strong inducers of CYP3A4 and CYP2C19 lower CBD levels in the blood.

Epidiolex is prescribed at far higher amounts than a typical consumer serving, so those findings do not transfer one-to-one to a wellness tincture. They do show the mechanism is real. Our guide to CBD and prescription medication explains the enzyme overlap in more detail and lists the medication categories worth asking about.

Drowsiness, sedation and staying steady on your feet

Drowsiness is one of the more commonly reported effects of CBD. The Epidiolex label says it can cause somnolence and sedation, advises patients not to drive or operate machinery until they know how it affects them, and warns that taking it with other central nervous system depressants, including alcohol, may increase the risk of sedation and sleepiness.

The FDA's consumer guidance puts the same point plainly: using CBD with alcohol or other drugs that slow brain activity, such as those used for anxiety, panic, stress or sleep disorders, increases the risk of sedation and drowsiness, which can lead to injuries.

For older adults, the injury that comes to mind first is a fall. The CDC reports that about 1 in 4 older adults report falling each year, that falls are the leading cause of injury for adults 65 and older, and that medicines that may increase fall risk are one of the risk factors worth reviewing. We are not aware of good research on CBD and falls specifically, so we will not put a number on it. The practical takeaway is simple: anything that can make you drowsy deserves extra caution if you already take a sleep aid, an anxiety medication, or a pain medication, or if you have been unsteady lately.

A few habits help:

Take your first servings at home, on a day with nothing planned, and not before driving.
Do not combine a new CBD product with alcohol while you are learning how it affects you.
If you notice you feel foggy, dizzy or unsteady, stop and talk to your clinician.

Liver enzymes: what the FDA's own trial found

The FDA ran its own study on this question. In a randomized, placebo-controlled trial published in JAMA Internal Medicine in 2025, researchers at the FDA's Center for Drug Evaluation and Research gave 201 healthy adults either CBD (2.5 mg per kilogram of body weight twice a day) or a placebo for 28 days. Eight people in the CBD group (5.6%) had liver enzyme levels more than three times the upper limit of normal, compared with none in the placebo group. Seven met the study's criteria for withdrawal for potential drug-induced liver injury, detected at day 21 or day 28.

Two details matter for older readers. The researchers chose an amount within the range consumers report taking with unregulated CBD products, not the much higher prescription doses studied before. And the trial only enrolled people aged 18 to 55 who, with few exceptions, were not taking other medications, according to its ClinicalTrials.gov record. So it tells us nothing directly about people in their 60s, 70s and 80s, or about people on several prescriptions. The authors themselves called for more research on long-term use, different populations, and lower doses.

The Epidiolex label lists the signs of liver problems that warrant a prompt call to a healthcare provider, including loss of appetite, nausea, vomiting, unusual tiredness, yellowing of the skin or the whites of the eyes, unusual darkening of the urine, and pain in the upper right side of the stomach. If you already have liver concerns or get regular blood work, ask your clinician whether it makes sense to check your liver enzymes after you start.

How to talk to your pharmacist

Pharmacists are well placed to answer interaction questions, and you usually do not need an appointment. To get a useful answer:

Bring the complete list. Prescriptions, over-the-counter medicines, vitamins and supplements.
Bring the product or a photo of the label. They need the milligrams of CBD per serving, not just "some CBD oil." For Proof CBD Comfort Drops, that is 33 mg of CBD per 0.5 ml serving.
Ask directly. "Do any of my medications go through CYP3A4 or CYP2C19? Do any of them make me drowsy? Is there anything I should watch for or have tested?"
Write down the answer and mention CBD to your prescribing doctor at your next visit.

If your pharmacist says to wait, wait. For a wider overview of side effects to watch for, see CBD side effects and our CBD safety page.

If you do start: go slow and keep notes

With your clinician's okay, the safest approach is also the simplest. Start low and follow the product label. Our Comfort Drops label direction is 0.5 ml once or twice daily. Change one thing at a time, so you are not starting CBD in the same week a prescription changes. Keep a short daily note of the time, the amount, and anything you notice. That log is the most useful thing you can bring to a follow-up visit.

Before any surgery or procedure, tell your care team you use CBD, the same way you would mention any supplement.

Opening child-resistant caps

Our drops come in child-resistant packaging, and it matters in homes where grandchildren visit. It can also be frustrating if your hands are stiff or your grip is weaker than it used to be. There is an easy trick: slide a butter knife or another flat, dull edge between the upper and lower parts of the cap, gently pry upward, and work your way around until the top pops loose. After that, the bottle opens normally. Our step-by-step guide and video shows exactly how.

Wherever you keep CBD, store it up high and out of sight of children and pets, in a cool, dark place.

FAQ

Is CBD safe for seniors?

It depends on the person, especially their medications and liver health. Research in older adults is limited, and the FDA's recent liver trial did not include anyone over 55. Talk to a pharmacist or clinician before you start.

Can CBD interact with blood thinners?

It can interact with some medications that are processed by the same liver enzymes, and blood thinners are one of the categories pharmacists often want to review. Only a pharmacist or clinician looking at your specific list can tell you whether it matters for you.

Can CBD make me dizzy or drowsy?

Drowsiness is one of the more commonly reported effects. The FDA warns that combining CBD with alcohol or other sedating drugs increases the risk of drowsiness, which can lead to injuries. Try it at home first and avoid driving until you know how it affects you.

Does CBD affect the liver?

It can raise liver enzymes in some people. In an FDA-run trial, 5.6% of healthy adults taking CBD for four weeks had significant elevations, compared with none on placebo. Ask your clinician whether liver tests make sense for you.

How do I open a child-resistant CBD bottle?

For Proof drops, insert a butter knife between the two layers of the cap and gently pry upward around the edge until the top comes off. Our how-to post has a short video.

CBD for Older Adults: What to Check Before You Start