This article was first published in herb.co.
Medical cannabis is becoming increasingly more popular around the world. But, while the herb is proving to be a useful medical tool, researchers still know fairly little about how cannabis may interact with various pharmaceutical medications. In the upcoming years, this will certainly be a major area of study. In the meantime, here are nine prescription medications that you generally avoid mixing with weed (or at least talk to a professional about).
A note about drug interactions
The best advice? If you’re trying a new medication and decide to consume cannabis, listen to your body and talk to a doctor.
Drug interactions are quite complicated. Not only might two substances interact with each other, but they may also interact with whatever anomalies you may have going on with your personal biochemistry.
For example, while one person may feel overly sedated after mixing cannabis with Ativan, another person may find that cannabis helps them lower their dose of the benzodiazepine or deal with difficult to manage side effects.
If you’ve been consuming cannabis regularly, suddenly stopping once you start a new medication may result in some withdrawal symptoms. This could affect how you respond to a new medication.
To avoid a bad time, it may be best to talk to a medical professional about gradually increasing your dose of a new medication and staying small with cannabis to see how the new drug cocktail makes you feel.
The more drugs you add in, the more challenging things become. It’s important to note that the information presented in this article is far from complete and intended for educational purposes only. Always work with a medical professional when testing out new drug interactions.
Having a terrible reaction? Call for emergency assistance.
3.Drugs containing propoxyphene
Back in 2010, the opioid painkiller propoxyphene was withdrawn from the U.S. market. The compound is known to be toxic to the heart, even in doses formerly considered therapeutic.
However, if you happen to have any leftover propoxyphene medications, it is best to not use them. It’s also unwise to mix them with cannabis.
Drugs that contain propoxyphene include:
- Balacet
- Darvon (Compound 32, Compound 65, N)
- Darvoset (N 100, A500, N 50)
- PC-Cap
- PP-Cap
- Propacet 100
- Propoxyphene Compound 65
- Trycet
- Wygesic
Symptoms to watch for:
- Over sedation
- Dizziness
- Confusion
- Difficulty concentrating
- Impaired judgement
- Impaired motor skills
- Impaired thinking
These symptoms may be worse in the elderly.
2.Drugs that contain buprenorphine
Ironically, buprenorphine is an opioid pain medication that is also used to treat opioid addiction. As an opioid, this drug is also thought to have a high potential for addiction.
In high doses, this drug can also cause respiratory distress, coma, and death. When combined with cannabis, the risk of these things increases, since both substances depress the central nervous system.
Both buprenorphine and cannabis are sedatives which mean the chance of being overly sedated with this combination is high.
Common drugs that contain buprenorphine include:
- Butrans
- Belbuca
- Bunavail
- Buprenex
- Probuphine
- Suboxone
- Subutex
- ZubslovSome symptoms to watch for include:
- Excessive sedation
- Respiratory problems
- Inability to stay awake
- Difficulty controlling motor function
- Slowed speech
- Inability to perform cognitive tasks
- Slowed or irregular heartbeat
- If you have mixed buprenorphine and cannabis and are experiencing these symptoms, call for emergency help.
- 3.Drugs that contain levomethadyl acetate
Levomethadyl acetate is synthetic opioid painkiller similar to methadone. This drug is sold under the brand name Orlaam. Like other painkillers, this drug can cause some sedation.
Mixing Orlaam with cannabis can be so sedative that it is uncomfortable and may even be physically dangerous.
Symptoms to watch for include:
- Drowsiness or over sedation
- Dizziness or lightheadedness
- Confusion
- Depression
- Slow, shallow breathing
- Poor motor coordination
- Impaired thinking
- Impaired judgement
4.Beta blockers
It’s generally thought that those with heart conditions should be extremely cautious with cannabis. Cannabis lowers blood pressure but increases heart rate, meaning that it might make you more sensitive to heart attack.
Those taking beta-blockers should be particularly cautious, as both substances have opposite effects on heart rate. Beta-blockers also reduce blood pressure but tend to slow the heart down.
Common beta blockers include:
- Sectral
- Tenormin
- Zebeta
- Lopressor
- Toprol-XL
- Corgard
- Bystolic
- Inderal LA
- InnoPran XL
Some symptoms to watch for include:
- Feeling faint, fainting
- Dizziness
- Nausea
- Irregular heart beat
- Shallow breathing
- Fatigue
- Confusion
5.Benzodiazepines
Benzodiazepines are powerful sedatives in their own right. While there are certainly a lot of people out there who mix benzos with cannabis, this can make for a powerful and uncomfortable experience. Common benzodiazepines include:
- Ativan
- Klonopin
- Xanax
Both cannabis and benzodiazepine medications share some similar effects. Both can trigger the release of GABA, a calming neurotransmitter that dampens excitability in the brain.
In general, mixing cannabis and benzodiazepines should be closely monitored. Symptoms to watch for include:
- Oversedation
- Slowed or slurred speech
- Slowed motor skills
- Driving impairment
- Cognitive impairment
- Constipation
6.SSRIs
Thus far, only minor interactions are noted for mixing cannabis with some of the most common SSRIs. Some evidence suggests that cannabis may increase the effect of some SSRIs, like Prozac.
However, those with manic depression (bipolar disorder) or at risk for manic depression should be mindful of potential mood alterations when mixing these two types of medications.
Both cannabis and SSRIs also increase serotonin. The risk of developing sudden serotonin syndrome when combining these two drugs is thought to increase. Some common SSRIs include,
- Lexapro
- Prozac
- Zoloft
- Paxil
Symptoms to watch for:
- Difficulty sleeping
- Symptoms of mania
- Agitation
- Anxiety
- Excessive paranoia
- Rapid heart rate
- Headache
- Gastrointestinal distress
- Mood variability and mood swings
7.SNRIs
Those taking another class of antidepressant drugs, SNRIs, may need to be mindful of cannabis consumption. Both SNRIs and cannabis can cause serotonin spikes, which may make you more likely to develop sudden serotonin syndrome.
Though, there is little research on this topic. SNRI’s are also used to treat nerve pain. Some common SNRIs include:
- Effexor
- Cymbalta
- Pristiq
Symptoms to watch for include:
- Memory impairment
- Confusion
- Agitation
- Paranoia
- Rapid heart rate
- Changes in blood pressure
- Headache
- Muscle twitching
- Gastrointestinal distress
8. Antipsychotic medications
Antipsychotic medications are tranquilizers. High-THC cannabis can also be sedating, meaning that there are some possible interactions between these two substances. When consumed together, symptoms should be closely monitored.
There is some evidence to suggest that cannabis may heighten the effect of certain antipsychotic drugs, like Seroquel and Abilify. Though, the significance of this is unknown. Some common antipsychotic medications include:
- Seroquel
- Abilify
- Clozaril
- Geodon
- Zyprexa
Symptoms to watch for:
- Excessive sedation
- Slow motor skills
- Decreased cognitive function
- Confusion
- Impaired driving
9.Sodium oxybate
Sodium oxybate is an anti-sleep medication that is often used to treat narcolepsy. When combined with cannabis, patients may risk depressing the central nervous system a little too much.
In the most severe cases, this may contribute to coma. Some symptoms to watch for include:
- Dizziness or lightheadedness
- Depression
- Low blood pressure
- Shallow breathing
- Difficulty thinking
- Impaired judgment
- Impaired motor function