How Does Marijuana Interact With Common Medications?

About 66% of adults in the United States take one or more prescription drugs. According to the Centers for Disease Control and Prevention (CDC), the percentage of Americans using at least one prescription drug has increased by 48.6%. The number of patients using three or more prescription drugs regularly has also increased by 24%.

The Food and Drug Administration (FDA) has approved over 20,000 prescription medications. About 66% of adults in the United States take one or more prescription drugs. Some drugs conflict with other substances and foods, such as grapefruit, vitamin K, herbal supplements like St. John’s Wort, and alcohol. Cannabis is a controlled substance that may also conflict with several other drugs.

When you are coping with health conditions and symptoms, it can be like putting together a puzzle so you can live your best life with the least amount of discomfort or impairment. However, learning about how marijuana may conflict with other drugs is important. In some cases, it may save your life.

Understanding Marijuana and Medication Interaction

Inside the cannabis plant are chemicals called cannabinoids. What is really fascinating is that every human has built-in cannabinoid receptors. The CB1 and CB2 receptors are located throughout the body, and they are like little switches in your brain and nervous system that act like signal receivers.

The CB1 receptors control things like appetite, pain sensations, motor coordination (how you move your muscles), mood, and sleep. They can make you feel happy, excited, talkative, hungry (munchies!) or sleepy. In contrast, the CB2 receptors are an army that supports your health by helping the immune system. The CB2 receptors try to regulate inflammation and reduce swelling and irritation in the body.

Endocannabinoids are messengers in your body. When something is not working correctly, the endocannabinoids attach to CB1 or CB2 receptors and send “marching orders” to fix the problem(s). However, since both cannabinoids and prescription drugs affect the endocannabinoid system, it can cause changes to the way important prescription medications work.

Cannabis can conflict with medications in the following ways:

1. Can Slow Down the Metabolism of Medications by Liver Enzymes

Many prescription medications are metabolized (or broken down for absorption) by the liver. Cannabis can inhibit the enzymes that metabolize medications. When a prescription drug is not broken down correctly, it can cause much higher levels of the medication to remain in the body. Which can increase negative side effects and possible drug interactions.

2. May Reduce Absorption Through Digestive System

Other types of prescription medications are designed to be absorbed through the digestive system, in the intestines, and in the stomach. Some cannabis strains may increase the acidity of the stomach or how quickly the digestive system processes nutrients and medications. This can cause unpredictable and sometimes adverse effects, disrupting the way drugs metabolized by digestion are absorbed.

A drug interaction between cannabis and a prescription medication can reduce absorption. That also means that your body is not getting enough of the prescription drug to help with the condition you are treating.

In some cases, cannabis can increase the risk of bleeding and chemotherapy-induced nausea and cause problems with blood clotting (if you are taking Warfarin). Synthetic forms of THC, such as Delta-8, Delta-10, or HHC, can also disrupt the absorption of prescription drugs.

3. Can Elevate Hypertension and Heart Rate

Cannabis can increase blood pressure and heart rate within a few minutes after it is consumed. The arrhythmias can peak within thirty (30) minutes, but for some people, it can last as long as ninety (90) minutes.

That is because cannabis can impact both the sympathetic (flight or flight) and parasympathetic (rest and digest) nervous systems. Low doses of cannabis with balanced CBD and THC levels can lower blood pressure. Higher doses of cannabis products that have high potency levels (over 20% THC) can increase heart rate, anxiety, and cortisol levels (the stress hormone).

4. May Dangerously Amplify Drowsiness and Sedation

Many classes of medications used for mental health conditions (psychotropic) or pain relief cause sedative effects. The interaction between cannabis and barbituates, benzodiazepines, Ambien, and even diphenhydramine (Benadryl) can dangerously amplify the sedative effects of prescription medications.

Some strains of cannabis can be depressants, and when combined with medications to treat mental health conditions like severe anxiety, ADHD, bipolar disorder, or paranoia, it can increase depression symptoms. This may also increase the risk of suicidal ideation and self-harm.

If you are taking medications for a mental health condition, the use of marijuana may cause unwanted side effects, according to recent research studies. It may amplify the effects of central nervous system depressants.

Patients who combine prescription drugs with marijuana use with sedative drugs can become excessively impaired, leading to a medical problem or increased risk of falling and other injuries. If you are planning a surgery or procedure requiring oral or IV sedation, you must let your physician know about your medical marijuana use.

Potential Interactions: Exploring Risks and Benefits

Clinical studies have shown that cannabis will conflict with a variety of different medications. Patients who are considering whether to get a medical card or not should be aware of the potential drug interactions and risks.

The following drug types are contraindicated (or in conflict) with cannabis:

• Warfarin and other blood thinners such as Coumadin, Plavix, and Heparin.
• Lunesta (prescribed for insomnia).
• Antidepressant SSRIs (Zoloft, Prozac, and Lexapro).
• Benzodiazepines (and other anxiety medications).
• Beta Blockers (and blood pressure drugs).
• Valproate (and other anti-seizure medications, including Tegretol, Topamax, and Depakene).
• Pain medications (including codeine, Percocet, and Vicodin).

Whether you are smoking marijuana or consuming medical cannabis products like tinctures, capsules, edibles, or vape, the result is the same. Taking these medications may increase the risk of serious side effects that can cause a drug interaction and medical emergency.

Get Professional Advice Before Medical Marijuana Use

Patients know that our team at DocMJ are the most trusted marijuana doctors in Florida. We have been providing cannabis healthcare services since 2016. When you attend your medical cannabis health check, your physician will discuss possible interactions and help you decide whether medical marijuana is a safe choice to help with symptom management.

At DocMJ, patient safety comes first. If you have a health condition or you are taking prescription medications that may cause drug interactions with cannabis, our physician will not certify you for a medical card.

Mixing marijuana with some prescription medications may not be safe. However, the marijuana doctor will provide advice on other options, including clinical-grade cannabidiol (CBD), to improve pain or problems with mood management.

Dr. Marissa Magsino

With over 25 years of specialty training in Internal Medicine, as well as fellowship training in Functional and Sexual medicine, Dr. Maginso added Plant Medicine (Medical Marijuana) to her niche practice as of 2017. She is licensed in the State of Florida and attended the University of the East (UERM) in Quezon City, Philippines as well as the University of Medicine and Dentistry in Newark, NJ.

She joined DocMJ in 2019 to align with a known group of compassionate physicians that empower their patients to be better versions of themselves. Her favorite hashtag is #powerpassionperformance, using the combination of optimized bioidentical hormones, medical marijuana, plasma therapies, and sexual wellness.

She is an author, speaker and community advocate for Medical Marijuana, Sexual Health, and the empowerment of mature women.