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Agency notes data gaps about CBD toxicity and concerns about potential harm.
November 26, 2019
By: Sean Moloughney
Editor
The U.S. Food and Drug Administration (FDA) issued warning letters to 15 companies for selling products containing cannabidiol (CBD) in ways the agency said violate the Federal Food, Drug, and Cosmetic Act (FD&C Act). At the same time, FDA published a revised Consumer Update detailing safety concerns about CBD products more broadly. Based on the lack of scientific information supporting the safety of CBD in food, the FDA also indicating that it cannot conclude that CBD is generally recognized as safe (GRAS) among qualified experts for its use in human or animal food. The actions come as FDA continues to explore potential pathways for various types of CBD products to be lawfully marketed. This includes ongoing work to obtain and evaluate information to address outstanding questions related to the safety of CBD products, while maintaining the agency’s public health standards. FDA said it plans to provide an update on its progress regarding the agency’s approach to these products in the coming weeks. “As we work quickly to further clarify our regulatory approach for products containing cannabis and cannabis-derived compounds like CBD, we’ll continue to monitor the marketplace and take action as needed against companies that violate the law in ways that raise a variety of public health concerns,” said FDA Principal Deputy Commissioner Amy Abernethy, MD, PhD. “In line with our mission to protect the public, foster innovation, and promote consumer confidence, this overarching approach regarding CBD is the same as the FDA would take for any other substance that we regulate,” she continued. “We remain concerned that some people wrongly think that the myriad of CBD products on the market, many of which are illegal, have been evaluated by the FDA and determined to be safe, or that trying CBD ‘can’t hurt.’ Aside from one prescription drug approved to treat two pediatric epilepsy disorders, these products have not been approved by the FDA and we want to be clear that a number of questions remain regarding CBD’s safety—including reports of products containing contaminants, such as pesticides and heavy metals—and there are real risks that need to be considered. We recognize the significant public interest in CBD and we must work together with stakeholders and industry to fill in the knowledge gaps about the science, safety and quality of many of these products.” Many unanswered questions and data gaps about CBD toxicity exist, FDA noted, and some of the available data raise concerns about potential harm from CBD. The revised Consumer Update outlines specific safety concerns related to CBD products, including potential liver injury, interactions with other drugs, drowsiness, diarrhea, and changes in mood. In addition, studies in animals have shown that CBD can interfere with the development and function of testes and sperm, decrease testosterone levels, and impair sexual behavior in males. Questions also remain about cumulative use of CBD and about CBD’s impacts on vulnerable populations such as children and pregnant or breastfeeding women. CBD is marketed in a variety of product types, such as oil drops, capsules, syrups, food products such as chocolate bars and teas, and topical lotions and creams. As outlined in the warning letters, these particular companies are using product webpages, online stores and social media to market CBD products in interstate commerce in ways that violate the FD&C Act, including marketing CBD products to treat diseases or for other therapeutic uses for humans and/or animals. Other violations include marketing CBD products as dietary supplements and adding CBD to human and animal foods. The companies receiving warning letters are: Koi CBD LLC, of Norwalk, California Pink Collections Inc., of Beverly Hills, California Noli Oil, of Southlake, Texas Natural Native LLC, of Norman, Oklahoma Whole Leaf Organics LLC, of Sherman Oaks, California Infinite Product Company LLLP, doing business as Infinite CBD, of Lakewood, Colorado Apex Hemp Oil LLC, of Redmond, Oregon Bella Rose Labs, of Brooklyn, New York Sunflora Inc., of Tampa, Florida/Your CBD Store, of Bradenton, Florida Healthy Hemp Strategies LLC, doing business as Curapure, of Concord, California Private I Salon LLC, of Charlotte, North Carolina Organix Industries Inc., doing business as Plant Organix, of San Bernardino, California Red Pill Medical Inc., of Phoenix, Arizona Sabai Ventures Ltd., of Los Angeles, California Daddy Burt LLC, doing business as Daddy Burt Hemp Co., of Lexington, Kentucky The FDA has previously sent warning letters to other companies illegally selling CBD products in interstate commerce that claimed to prevent, diagnose, mitigate, treat or cure serious diseases, such as cancer, or otherwise violated the FD&C Act. Some of these products were in further violation because CBD was added to food, and some of the products were also marketed as dietary supplements despite products which contain CBD not meeting the definition of a dietary supplement. Under the FD&C Act, any product intended to treat a disease or otherwise have a therapeutic or medical use, and any product (other than a food) that is intended to affect the structure or function of the body of humans or animals, is a drug. The FDA has not approved any CBD products other than one prescription human drug product to treat rare, severe forms of epilepsy. There is very limited information for other marketed CBD products, which likely differ in composition from the FDA-approved product and have not been evaluated for potential adverse effects on the body. Unlike drugs approved by the FDA, there has been no FDA evaluation of whether these unapproved products are effective for their intended use, what the proper dosage might be, how they could interact with FDA-approved drugs, or whether they have dangerous side effects or other safety concerns. In addition, the manufacturing process of unapproved CBD drug products has not been subject to FDA review as part of the human or animal drug approval processes. Some of the products outlined in the warning letters today raised other legal and public health concerns, according to FDA. For example, some of the products are marketed for infants and children—a vulnerable population that may be at greater risk for adverse reactions due to differences in the ability to absorb, metabolize, distribute, or excrete a substance such as CBD. Some of the products are foods to which CBD has been added. Under the FD&C Act, it is illegal to introduce into interstate commerce any human or animal food to which certain drug ingredients, such as CBD, have been added. In addition, the FDA is not aware of any basis to conclude that CBD is GRAS among qualified experts for its use in human or animal food. There also is no food additive regulation which authorizes the use of CBD as an ingredient in human food or animal food, and the agency is not aware of any other exemption from the food additive definition that would apply to CBD. CBD is therefore an unapproved food additive, and its use in human or animal food violates the FD&C Act for reasons that are independent of its status as a drug ingredient. Some of the products are marketed as dietary supplements. However, CBD products cannot be dietary supplements because they do not meet the definition of a dietary supplement under the FD&C Act. One product outlined in a warning letter to Apex Hemp Oil LLC is intended for food-producing animals. The agency remains concerned about the safety of human food products (e.g., meat, milk, and eggs) from animals that consume CBD, as there is a lack of data establishing safe CBD residue levels. The FDA has requested responses from the companies within 15 working days stating how the companies will correct the violations. Failure to correct the violations promptly may result in legal action, including product seizure and/or injunction. The FDA encourages human and animal healthcare professionals and consumers to report adverse reactions associated with these or similar products to the agency’s MedWatch program.
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