Your Favorite Relaxation Habit Might Be Secretly Screwing With Your Meds
Yep, even OTC cold meds.
Considering that Martha Stewart now co-hosts a stoner-friendly TV show with Snoop Dogg (thank you, Potluck Dinner Party), it’s pretty safe to say that smoking weed is no longer a habit you need to hide from your mom. (Or your doctor, for that matter.)
But as medical marijuana (and, let’s be real, casual marijuana) use continues to rise, have you ever considered the fact that your weed pen might actually be screwing with some of the other medications you take? Yep, kind of scary.
“There are literally hundreds of of chemicals in the cannabis plant, including the psychoactive chemicals that give us a traditional marijuana high and chemicals that just happen to be in the plant,” says Timothy Brennan, M.D., director of the Addiction Institute at Mount Sinai West and Mount Sinai St. Luke’s Hospitals. “All of those, of course, are free to interact with prescription, over-the-counter, or any other medications one might be using.”
In fact, some of the compounds in cannabis can trigger certain enzymes that impact the way your body processes medications, Brennan explains. (This isn’t limited to cannabis; if you’ve ever seen a note to avoid grapefruit on your pill bottles, that’s because grapefruit can have the same effect.)
Related: 5 Women Who Use Pot In Their Everyday Lives Share How They Do It
“The problem is that cannabis is still listed as a Schedule I drug through the Drug Enforcement Agency,” he says, which effectively means that researchers aren’t supposed to study it. “That makes it’s very challenging for physicians and medical scientists to do any research on cannabis.”
So, where does that leave you? If you’re going to use marijuana (prescribed or otherwise) while you’re taking other drugs, “being truthful and open with your physician about your medication use is the most important thing, because you could be setting yourself up for potential marijuana drug interactions,” says Brennan. “It could at least plant the seed in a doctor’s mind that if you are suffering from certain side effects related to your other drugs the doctor can investigate if cannabis might be causing that.”
That said, there are a few types of drugs to watch out for if you’re planning on smoking pot.
Antidepressant Medications, or SSRIs and SNRIs
“The key point here is that cannabis is fundamentally a psychoactive compound,” says Brennan. “People use it because it exerts its action on the brain, on the central nervous system receptors.” But antidepressant medications—the most common of which are selective serotonin reuptake inhibitors (SSRIs), like Zoloft (or sertraline) or Celexa (or ditalopram), and serotonin norepinephrine reuptake inhibitors (SNRIs), like Cymbalta (or duloxetine)—also exert psychoactive effects on some of the same receptors.
“The challenge for people who have mood disorder or depression is that every time they’re using cannabis, they’re taking another psychoactive drug,” says Brennan. “And that can make it very challenging for a patient or physician to figure out what drug is actually having an effect on what.” Plus, he adds, the cannabis could actually negate the positive effects of prescription medication.
This is what it’s like to suffer from depression:
Anti-Anxiety Medications, or Benzodiazepines
Anti-anxiety medications like Ativan (Lorazepam), Klonopin (Clonazepam), or Xanax (Alprazolam) are all part of a class of medications called benzodiazepines, says Brennan. “Again, you have two psychoactive compounds interacting with each other in the brain,” he says. “If somebody’s really struggling with anxiety, I’d like to know what products are going in their brain so I can better understand how I’m medicating them. But if they’re smoking cannabis at the same time as using Ativan or Klonopin, it’s really hard to figure out what’s going on.”
A lot of people will smoke marijuana and say, “This is the only thing that helps my anxiety!” Other people will say they’re never more paranoid than when they smoke pot. That’s true for prescription drugs, too—people have different reactions to different products. “The challenge with cannabis is there’s no scientific data out there to say it tested against Ativan or Klonopin—the data doesn’t exist,” says Brennan.
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You’re already aware that mixing alcohol with sleeping pills is a bad idea. Same goes for pot. “This depends on how much cannabis someone is using and what effect cannabis has on them, but mixing any product that with the opportunity to sedate someone or alter their consciousness is potentially dangerous,” says Brennan. “When you combine cannabis with a sedative hypnotic like Zolpidem or Ambien, I think people could perhaps find themselves in a very usual psychological state.”
If you’ve been prescribed sleeping medication, whether you use it regularly or just to get through those tough red-eye flights, you’re better off sticking to just the prescription medication for the duration of the dose, versus mixing it with cannabis or any other drugs.
Related: 5 Signs Your Exhaustion Is A Symptom Of A Much Bigger Problem
Allergy and Cold Meds
You might think that allergy and cold medicines like Benadryl (diphenhydramine) or Mucinex (guaifenesin) are NBD because you can grab them straight off the drugstore shelves—but if you take them with marijuana, they could have unanticipated effects.
“Benadryl, or allergy and cold meds, are sedative products,” says Brennan. “Some people can take them and go about their day, others take one dose and they’re on the couch for the rest of the day. I think it’s really important for people to remember that cannabis is not a harmless product, and we don’t know how it might interact with even over-the-counter drugs.”
So if you’re sick, stick to just one drug (the cold meds, please) if you want it to work its magic as fast as possible.
Smoking pot can mess with cold medicines, anti-depressants, and more. Experts share potential marijuana drug interactions and how to avoid them.
What other names is Marijuana known by?
Anashca, Banji, Bhang, Blunt, Bud, Cannabis, Cannabis sativa, Charas, Dope, Esrar, Gaga, Ganga, Grass, Haschisch, Hash, Hashish, Herbe, Huo Ma Ren, Joint, Kif, Marie-Jeanne, Mariguana, Marijuana Médicale, Marihuana, Mary Jane, Medical Marijuana, Pot, Sawi, Sinsemilla, Weed.
What is Marijuana?
Marijuana is an herb. It contains chemicals called cannabinoids that affect the central nervous system. Cannabinoids are found in the highest concentration in the leaves and flowers, the parts of the herb that are used to make medicine.
Some people take marijuana extract by mouth or as a spray to be applied under the tongue for pain and symptoms of multiple sclerosis.
Some people inhale marijuana for medicinal purposes. Marijuana is smoked for nausea, glaucoma, appetite stimulation, to reduce swelling of mucous membranes, for leprosy, fever, dandruff, hemorrhoids, obesity, asthma, urinary tract infections, cough, anorexia associated with weight loss in AIDS patients, nerve pain, and multiple sclerosis. It is also inhaled to weaken the immune system after kidney transplant to lessen the chance of transplant rejection. In addition, marijuana is smoked to reduce symptoms amyotrophic lateral sclerosis (ALS, Lou Gehrig’s disease).
Some people use marijuana recreationally to create a sense of well-being or to alter the senses. It is either taken by mouth or smoked (inhaled).
Avoid confusion with hemp, a distinct variety of Cannabis sativa cultivated for its fiber and seeds, which contains less than 1% THC.
In the U.S., marijuana is classified as a Schedule I controlled substance, making possession illegal. Some states, such as California, Washington, Oregon, Arizona, and others, have legalized or decriminalized the use of medical marijuana, despite objections from the federal government. Some countries such as Canada also permit the use of medical marijuana.
Possibly Effective for.
- HIV/AIDS-related weight loss. Smoking marijuana seems to stimulate the appetite of people with AIDS. Marijuana cigarettes can also cause weight gain in people with HIV who are also taking indinavir (Crixivan) or nelfinavir (Viracept).
- Multiple sclerosis (MS). Applying a specific spray containing marijuana extract (Sativex, GW Pharmaceuticals) under the tongue seems to improve some self-reported symptoms of multiple sclerosis, including muscle spasms, need to urinate, and nerve pain. In the UK, this product is approved as a prescription medicine to treat muscle spasms in people with MS. In Canada, this product is approved to treat nerve pain in people with MS. This product is not available as a prescription medicine in the US. Also, some conflicting evidence suggests that this product does not significantly improve muscle spasms, nor does it reduce the need to urinate or tremors in MS patients. There are conflicting results regarding the effects of marijuana extract when taken by mouth. One small study shows that taking a specific marijuana extract (Cannador, Society for Clinical Research) by mouth reduces self-reported muscle stiffness and muscle spasms in people with MS. However, other studies show that taking marijuana extract by mouth does not significantly improve muscle spasms, the ability to walk, or tremors in people with MS. Early research shows that smoking marijuana may reduce muscle spasms, pain in the arms and legs, and tremors in people with MS.
- Nerve pain. Early research shows that smoking marijuana three times a day might reduce nerve pain caused by HIV and other conditions.
Insufficient Evidence to Rate Effectiveness for.
- Amyotrophic lateral sclerosis (ALS, Lou Gehrig’s disease). Early research shows that patients with ALS who use marijuana might have improvements in some symptoms, including depression, appetite, spasms, and drooling.
- Weight loss in people with advanced cancer (cachexia). Early research shows that taking marijuana extract by mouth does not improve appetite in people with cachexia.
- Glaucoma. Smoking marijuana seems to reduce pressure inside the eye in people with glaucoma. However, this effect seems to last for only 3-4 hours. Also, smoking marijuana seems to decrease blood flow to the nerve that transmits visual information from the eye to the brain. This might increase vision loss in people with glaucoma. So far, it is not known if marijuana can improve sight in people with glaucoma.
- Rheumatoid arthritis (RA). Some research suggests that using a specific mouth spray containing marijuana extract (Sativex, GW Pharmaceuticals) can decrease morning pain and improve sleep in people with RA. However, it does not seem to improve joint stiffness in the morning or overall pain severity.
- Preventing organ rejection after kidney transplants.
- Urinary infections.
- Other conditions.
More evidence is needed to rate marijuana for these uses.
How does Marijuana work?
Marijuana contains chemicals that work by binding to specific sites in the brain and on the nerves.
Are there safety concerns?
Marijuana extract is POSSIBLY SAFE when used as a standardized spray (Sativex, GW Pharmaceuticals) that is applied under the tongue.
Marijuana is POSSIBLY UNSAFE when smoked. Smoking marijuana is associated with an increased the risk of developing lung cancer. Also, some reports suggest that smoking marijuana might cause air-filled cavities to form within lung tissue. These air-filled cavities can cause symptoms such as chest pressure, soreness, and difficulty breathing.
Smoking marijuana or using mouth sprays containing marijuana extract can cause headache, dizziness, drowsiness, dry mouth, nausea, and paranoid thinking. Smoking marijuana might also increase appetite, cause coughs, increase heart rate, increase or decrease blood pressure, and impair mental functioning. Some reports suggest that smoking marijuana may also increase the risk of acute coronary syndrome, heart attack, and/or swelling of walls of the arteries (arteritis). However, in many cases, people who experienced these events after smoking marijuana had other risk factors for heart-related events such as smoking cigarettes or being overweight.
Special Precautions & Warnings:
Breast-feeding: Using marijuana, either by mouth or by inhalation is LIKELY UNSAFE during breast-feeding. The dronabinol (THC) in marijuana passes into breast milk and extensive marijuana use during breast-feeding may result in slowed development in the baby.
Bipolar disorder: Using marijuana might worsen manic symptoms in people with bipolar disorder.
Heart disease: Marijuana might cause rapid heartbeat, short-term high blood pressure. It might also increase the risk of a having heart attack.
A weakened immune system: Cannabinoids in marijuana can weaken the immune system, which might make it more difficult for the body to fight infections.
Depression: Marijuana use, especially frequent use, might worsen symptoms of depression.
Multiple sclerosis: Taking marijuana by mouth might worsen some symptoms of multiple sclerosis.
Lung diseases: Long-term use of marijuana can make lung problems worse. Regular, long-term marijuana use has been associated with lung cancer and also with several cases of an unusual type of emphysema, a lung disease.
Schizophrenia: Using marijuana might worsen symptoms of schizophrenia.
Stroke: Using marijuana after having a stroke might increase the risk of having a second stroke.
Surgery: Marijuana affects the central nervous system. It might slow the central nervous system too much when combined with anesthesia and other medications during and after surgery. Stop using marijuana at least 2 weeks before a scheduled surgery.
Are there any interactions with medications?
The body breaks down antipyrine to get rid of it. Some chemicals in marijuana might decrease how quickly the body breaks down antipyrine. This might increase antipyrine levels in the body and increase its effects and side effects.
Disulfiram (Antabuse)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.
Taking marijuana with disulfiram (Antabuse) might cause you to feel irritated, nervous, jittery, and excited. Doctors call this hypomania.
Fluoxetine (Prozac)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.
Taking marijuana with fluoxetine (Prozac) might cause you to feel irritated, nervous, jittery, and excited. Doctors call this hypomania.
Medications changed by the liver (Cytochrome P450 2E1 (CYP2E1) substrates)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.
Some medications are changed and broken down by the liver. Marijuana might increase how quickly the liver breaks down some medications. Using marijuana along with some medications that are broken down by the liver might decrease the effects of some medications. Before using marijuana talk to your healthcare provider if you take any medications that are changed by the liver.
Some medications changed by the liver include acetaminophen, chlorzoxazone (Parafon Forte), ethanol, theophylline, and anesthetics such as enflurane (Ethrane), halothane (Fluothane), isoflurane (Forane), methoxyflurane (Penthrane).
Medications changed by the liver (Cytochrome P450 3A4 (CYP3A4) substrates)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.
Some medications are changed and broken down by the liver. Marijuana might decrease how quickly the liver breaks down some medications. Using marijuana along with some medications that are broken down by the liver might increase the effects and side effects of some medications. Before using marijuana talk to your healthcare provider if you take any medications that are changed by the liver.
Some medications changed by liver include lovastatin (Mevacor), clarithromycin (Biaxin), cyclosporine (Neoral, Sandimmune), diltiazem (Cardizem), estrogens, indinavir (Crixivan), triazolam (Halcion), and others.
Medications moved by pumps in cells (P-glycoprotein Substrates)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.
Some medications are moved by pumps into cells. Marijuana might make these pumps less active and increase how much of some medications get absorbed by the body. This might increase the side effects of some medications.
Some medications that are moved by these pumps include etoposide, paclitaxel, vinblastine, vincristine, vindesine, ketoconazole, itraconazole, amprenavir, indinavir, nelfinavir, saquinavir, cimetidine, ranitidine, diltiazem, verapamil, corticosteroids, erythromycin, cisapride (Propulsid), fexofenadine (Allegra), cyclosporine, loperamide (Imodium), quinidine, and others.
Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.
Marijuana might slow blood clotting. Taking marijuana extracts along with medications that also slow clotting might increase the chances of bruising and bleeding.
Sedative medications (Barbiturates)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.
Marijuana might cause sleepiness and drowsiness. Medications that cause sleepiness are called sedatives. Taking marijuana along with sedative medications might cause too much sleepiness.
Sedative medications (CNS depressants)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.
Marijuana might cause sleepiness and drowsiness. Medications that cause sleepiness are called sedatives. Taking marijuana along with sedative medications might cause too much sleepiness.
TheophyllineInteraction Rating: Moderate Be cautious with this combination.Talk with your health provider.
Taking marijuana might decrease the effects of theophylline. But there isn’t enough information to know if this is a big concern.
Warfarin (Coumadin)Interaction Rating: Minor Be cautious with this combination.Talk with your health provider.
Using marijuana might increase the effects of warfarin (Coumadin). Smoking marijuana while taking warfarin (Coumadin) might increase the chance of bruising and bleeding.
Dosing considerations for Marijuana.
The following doses have been studied in scientific research:
- For multiple sclerosis: One to five capsules containing marijuana extract standardized to contain tetrahydrocannabinol 2.5 mg and cannabinol 0.8 to 1.8 mg (Cannador, Society for Clinical Research, Berlin, Germany) has been taken twice daily for 12 weeks.
AS A MOUTH SPRAY:
- For multiple sclerosis: A specific marijuana extract product (Sativex, GW Pharmaceuticals, Salisbury, UK), standardized to contain 2.7 mg of tetrahydrocannabinol (THC) and 2.5 mg of cannabidiol per spray, has been used daily for up to 2 years.
Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, and Insufficient Evidence to Rate (detailed description of each of the ratings).
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
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Marijuana What other names is Marijuana known by? Anashca, Banji, Bhang, Blunt, Bud, Cannabis, Cannabis sativa, Charas, Dope, Esrar, Gaga, Ganga, Grass, Haschisch, Hash, Hashish, Herbe, Huo Ma