Are you mixing prescription medication with cannabis? In most cases, you’ll be absolutely fine, but if you happen to be feeling queasy, it’s possible that they don’t interact well with each other. As medical cannabis grows in popularity and more people opt to self-medicate, the potential for medicines clashing is arguably higher than ever. The medicinal properties of cannabis are not in doubt, but the holes in our knowledge mean we don’t have a great understanding of how the body responds when the herb is combined with prescription meds.
In the next decade or so, as medical cannabis becomes even more embedded in our treatment plans, it will be crucial for researchers to assess these interactions extensively. However, we aren’t completely useless, and the thousands upon thousands of anecdotes have given us a clue on what medicines cause problems.
While it’s best to speak with a medical professional (who is ideally a cannabis expert) who can provide personalized advice, here is some general information on what prescription medications you should be careful about mixing with pot.
The interactions that drugs have with the body can be mind-bogglingly complex. It’s not just a case of cannabis reacting badly with a medicine – your unique biochemistry may have oddities which amplify those unwanted effects.
Take the benzodiazepine Ativan. Some users who take the drug with marijuana may find it sedates them too much. In contrast, others will respond well to the mixture, and be able to lower their Ativan dose accordingly – or if not lower it, experience fewer side effects thanks to the presence of cannabis.
Switching from a consistent cannabis treatment plan to an exclusively-prescription medication plan can also have adverse effects. The potential withdrawal symptoms caused by the surprise change may mean your body responds poorly to your new meds.
Consult a medical professional if you’re considering making adjustments to your medication. They may be able to advise on how you will react to the changes. When experimenting with new pharmaceutical meds, it’s best to low-dose on cannabis or cut it out completely for a few days to get acquainted with the drug’s effects.
The more medication in your treatment plan, the harder it is to work out how mixing cannabis with it will influence the body, and if any of the drugs will react abnormally. The following section on types of medicines should not be taken as medical advice, but purely as an informational read that explores the stories that some users have had by combining them with marijuana.
It’s not uncommon for people to mix benzodiazepines with marijuana, although it’s not an advisable mix. Both have potent sedative properties which have a cumulative effect when used together. The heavy sedation can be an overwhelming and uncomfortable experience.
Common benzos include Xanax, Ativan and Klonopin. There is potential for the body to become over-sedated if a user takes, for example, both cannabis and Xanax. Benzos and marijuana influence the GABA neurotransmitter, which has the role of reducing brain excitability. Sleeping pills mixed with cannabis could have a similar effect.
Symptoms of a bad reaction between cannabis and benzos are impaired motor functions, over-sedation, slurred speech, constipation and cognitive impairment.
2) Sodium oxybate
Sodium oxybate is an oft-prescribed medication for narcolepsy and is used to prevent sleep. However, when the drug is taken with marijuana, it can depress the central nervous system to dangerous levels. This can increase the chances of going into a coma.
Symptoms of a bad sodium oxybate reaction with cannabis are depression, shallow breathing, dizziness, impaired motor function and judgment, cognitive impairment and low blood pressure.
If you have concerns about the medication that you are taking – or want to take – with cannabis, then discussing with your doctor is the best step. However, for common prescription drugs, you may be able to find some helpful information on MedScape’s Drug Interaction Checker.
3) Drugs made with propoxyphene
Propoxyphene, an opioid painkiller was taken off the American medication market in 2010, after research revealed that it is toxic for the heart. This applies even when the drug is taken in standard prescription doses. If you have any propoxyphene meds lurking in the cupboard, it’s not a great idea to use them, and you definitely shouldn’t consume them with cannabis.
Propoxyphene is found in Darvoset (N 100, A500, N 50), PC-Cap, PP-Cap, Darvon (Compound 32, Compound 65, N), Propacet 100, Balacet, Wygesic, Trycet and Propoxyphene Compound 65. Side effects of propoxyphene meds include confusion, poor concentration, over-sedation, brain fog, poor judgment, dizziness and impaired motor functions. Elderly people are particularly vulnerable to the side effects of such drugs.
4) Antipsychotic drugs
High-THC cannabis is going to give the user an intense psychoactive experience, and while antipsychotic drugs may be considered a good way to moderate these effects, there’s one major issue. The sedating nature of both could make the user over-sedated and make them physically distressed.
Interestingly, some cannabis is believed to boost the effects of some antipsychotic drugs, although this varies depending on the exact combination. The possible medical benefits of this are not yet fully understood. Seroquel and Abilify are two drugs that have this effect. Zyprexa, Clozaril and Geodon are three examples of other antipsychotic drugs.
Side effects of antipsychotic drug-cannabis mix gone wrong could include over-sedation, reduced motor and cognitive function and confusion.
Antipsychotic drug patients may be interested to know that CBD, a non-psychoactive cannabinoid in marijuana is also anti-psychotic. A natural alternative, maybe?
5) Drugs made with buprenorphine
Buprenorphine is a bizarre opioid painkiller that is sometimes used to wean people off even stronger opioids. Even more troubling, buprenorphine is considered highly addictive.
Large dosages of buprenorphine can lead to respiratory distress, coma and even death. This drug and cannabis products are both anti-depressants (in the central nervous system), therefore, these properties can be dangerous given the known side effects of buprenorphine.
Like marijuana, buprenorphine has sedative traits, which poses a risk of over-sedation when mixing the two.
Buprenorphine can be found in several drugs, including Butrans, Buprenex, Subutex and Zubslov.
Symptoms of the drug include difficulties staying awake, respiratory issues, over-sedation, reduced cognitive functions and an irregular heartbeat.
Contact emergency services immediately if you have a bad reaction with buprenorphine.
Patients who take any SNRI antidepressant drugs should be cautious about adding marijuana into their treatment plan. Both the drugs and the herb influence serotonin production, leading to possible mood swings and even, in rare cases, sudden serotonin syndrome. Some cannabinoids could also cause antidepressant drugs to become more concentrated in the blood, although there is only preliminary research showing this. SNRIs are a medication for nerve pain as well as depression.
Pristiq, Effexor and Cymbalta are perhaps the three most prescribed SNRIs. A bad reaction with SNRIs and cannabis can cause agitation, confusion, paranoia, headaches, muscle spasms (twitching), gastrointestinal distress and rapid heart rate. There are also a few reports of memory loss.
7) Drugs made with levomethadyl acetate
A synthetic opioid painkiller, levomethadyl acetate has a likeness to methadone. The drug is typically sold as ‘Orlaam’, has sedative properties and it could be dangerous to consume it with marijuana. The level of sedation could cause some users to become claustrophobic, it could even be dangerous.
Drowsiness and dizziness are two common symptoms of taking Orlaam. The drug can also cause confusion, depression, impair motor functions and thinking, and slow down breathing rates.
There aren’t thought to be too many problems with using marijuana in conjunction with mainstream SSRIs, but some people are still concerned. Research indicates that marijuana may amplify the effects of certain SSRIs, including Prozac. Furthermore, people with severe mental disorders such as clinical depression and bipolar disorder could experience more violent mood swings if using THC-rich cannabis with SSRIs.
Serotonin production is boosted by both SSRIs and marijuana. Some scientists have made a link between sudden serotonin syndrome and the consumption of both cannabis and SSRIs, also the findings are far from conclusive.
In addition to Prozac, Paxil, Lexapro and Zoloft are popular SSRIs. If mixing them with cannabis, anxiety, paranoia and agitation, headaches and rapid heart rate could be side effects.
9) Beta blockers
It’s a common train of thought that patients with heart conditions should be hesitant about using cannabis in any respect. The herb can cause blood pressure levels and heart rate to become volatile, which may increase the likelihood of suffering a heart attack. New cannabis users are even more vulnerable. Experienced users may just find that marijuana slows their heart rate.
Therefore, patients who take beta blockers or similar medication to moderate their blood pressure should think twice about taking cannabis. Beta blockers cause a slow heart rate and a drop in blood pressure, and cannabis may magnify those effects, which could reduce heart rate to dangerously low levels.
Lopressor, Tenormin, Corgard, Sectral and Bystolic are all well-known beta blockers. These drugs have a reputation for causing nausea, irregular heartbeat, dizziness, confusion, fainting and fatigue.