cannabis and drug interactions

A Guide to Cannabis Drug Interactions

When talking about cannabis, people are often discussing it’s therapeutic or medicinal benefits. CBD in particular is quoted to have anti-anxiety, anti-nausea, anti-inflammatory, anti-seizure, neuroprotective factors and much more. Though when adding cannabis to an existing health routine it’s necessary to take drug interactions into account. It’s recommended you talk to your primary health care provider about drug interactions before adding cannabis into your regular health routine. 

When we talk about drug interactions we’re not always talking about significant risks associated with multiple medications (although this can be the case). Drug interactions can simply mean a change in the action or side effects of a medication when used in conjunction. As a result, we need to be thoughtful about using drugs together as it can impact things like the safe and most effective dose of each. 

Also note, drug interactions don’t only occur when using two medications together. Drug interactions also with dietary supplements and certain types of foods. 

Drugs.com is a potential resource to use to check drug interactions with cannabis. It provides some information about the potential risks as well as the effects a person may experience. Though this an American resource that classifies cannabis as a schedule one drug. It also does not differentiate between different cannabinoids. 

How Does Cannabis Interact with Other Drugs 

There are many ways cannabis can interact with other medications. Such as; adding to the effects, impacting the length of time a drug is circulating (impacting how quickly it’s broken down), changing the influence of the side effects, etc. Therefore, drug interactions may lead to enhanced drug response or modified or unexpected adverse reactions.

The drug interactions associated with cannabis appear to be a result of CYP450 enzymes that are responsible for metabolizing most cannabinoids. One of the enzymes in the class is also responsible for metabolizing approximately 60 percent of prescription medications. Both cannabis and some prescription medication can inhibit or enhance these enzymes resulting in an increase or decrease in the amount of each circulating in the bloodstream. This means the effects of the medication, or cannabinoids, could be exaggerated and produce unwanted, unexpected, or harmful effects. Or the opposite could occur and the effects could be diminished and not have the intended effects. 

That being said, research focused specifically on drug interactions is minimal at this time. So, as the research continues to develop we will gain a more in-depth understanding of these interactions. In the meantime, it’s best to speak with your primary health care provider about your cannabis use and be cautious when it comes to potential drug interactions. It’s also important to pay attention to any changes that occur as well as any possible side effects.

One recommendation we’ve seen is to be cautious of medications that have a grapefruit warning. A number of medications have the warning to not consume grapefruit as it can increase the amount of medication circulating and lead to adverse effects. It’s not always the case that these medications will also have negative interactions with cannabis but it’s best to be cautious. 

Side Effects

If you’re adding cannabis to your health routine it’s important to pay attention to any changes you experience. Take the time to read or reread the potential side effects of the prescription medication you’re taking to familiarize yourself with what changes may occur. 

Some common side effects you may experience include; drowsiness, fatigue, nausea, diarrhea, changes in appetite, and changes in weight.

It’s also important to pay specific attention to changes in the effects of prescription medication. Does it appear as though the medication is less effective? For example, experiencing breakthrough seizures.

If you do experience changes in medication effectiveness or side effects it’s important to speak to your primary care provider. It doesn’t necessarily mean you’d need to discontinue cannabis use but an adjustment may need to be made.

Cannabis and Anti-Depressants 

One of the most common cannabis drug interactions discussed is with anti-depressants. Cannabis, particularly CBD, is often used to manage mood. Doctors advise individuals to be cautious when it comes to mixing anti-depressants and cannabis. Also, always inform your primary care provider of your cannabis use. It will help them more accurately determine the most appropriate dose and provide the best care (particularly monitoring side effects). 

There are several different types of anti-depressants classifications based on the ways in which they interact with the brain. Three of these classifications are considered high risk when mixed with cannabis. These include monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants, and sedatives. It’s not recommended to consume cannabis while taking these medications if not under doctor supervision. 

Interested in learning more about cannabis and depression? Read our article here.

Final Thoughts

When adding cannabis into your health routine it’s important to pay attention to possible drug interactions.

If you plan to add any cannabinoid into your treatment plan without speaking to your doctor and are currently on medication we advise you to start with a very low dose and increase slowly (ideally overall several days).

Also, it’s important to not do any activities that require mental acuity, such as driving or operating heavy machinery, while first learning the impacts of these medications. 

This article is not a substitute for medical advice. We advise you to speak to your primary care provider before mixing cannabis with any existing medications. 

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