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The following situations call for the most caution: Daily or high-dose oral CBD use alongside any prednisone regimen High-dose prednisone, generally considered 40 mg per day or more Long-term steroid therapy, where cumulative toxicity is already a concern Diabetes or prediabetes, since both prednisone and possible steroid-exposure increases can worsen blood sugar A history of anxiety, panic, mood disorders, or prior steroid psychiatric reactions Active respiratory disease or recurrent infections Osteoporosis or high fracture risk Multiple medications that also rely on CYP3A metabolism A patient taking a short five-day prednisone burst and occasionally using a low-THC product with no meaningful CBD is in a very different risk category than someone on chronic high-dose prednisone using daily oral CBD oil

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