Does Cannabis Have Negative Interactions With Your Pharmaceuticals?

By Delilah Butterfield

Drugs can interact with each other in different ways. Cannabis is no different.

More people have access to medical, nutritional, and adult-use cannabis than ever before. Yet, many consumers feel uncomfortable broaching the subject with medical professionals.

Further, many medical professionals are still woefully undereducated when it comes to appropriately using the herbal supplement along with medications.

This means that many consumers may be unaware that the herb might be negatively interacting with their pharmaceutical medications. Cannabis can have both positive and negative effects on prescription drugs.

How you respond to cannabis is highly individual. Some people may find that the herb helps them better manage side effects related to certain medical treatments. Others may find that cannabis allows them to reduce their dosages of certain pharmaceuticals.

However, it’s also entirely possible to have severe and harmful drug interactions with adding cannabis to your pharmaceutical cocktail. Here’s the scoop on how cannabis may affect some of the most common prescription medications:

Does cannabis have negative interactions with pharmaceuticals?

Your physician needs to know what you’re taking, and what you’re not taking.

Unlike many prescription drugs, cannabis is non-toxic and has a high margin of safety when compared to other commonly consumed substances like alcohol, tobacco, and caffeine. In fact, according to the U.S. Drug Enforcement Administration (DEA) and the Centers for Disease Control (CDC), there have been zero reported deaths from cannabis overdose.

Yet, just because cannabis is safe on its own does not mean that it is good to mix with all medications. Cannabis is a powerful herb that can have profound effects on the body. This includes the ability to either counteract or enhance the effects of certain pharmaceutical medications.

If you are considering adding in cannabis to any sort of treatment routine, it’s wise to ask your doctor about possible drug interactions. While more research is needed, there are a few types of prescription drugs that may have increased side effects when combined with cannabis.

Though this list is far from complete, cannabis may have negative interactions with these pharmaceuticals:

  1. Beta blockers and blood pressure medications

Beta blockers are drugs used to lower blood pressure by blocking the effects of adrenaline, the hormone responsible for the fight or flight response. Taking beta blockers reduces your heart rate and prevents cardiac stress.

Cannabis, however, may have contrasting or amplifying effects on beta blockers. The herb can cause blood pressure to fluctuate while simultaneously causing the heart to beat faster in some people.

In novice consumers, blood pressure may increase slightly. Regular consumers can become tolerant to these effects and may even experience reduced blood pressure and heart rate.

However, the potential increase in heart rate is thought to increase your risk of having a heart attack. Especially in those with a predisposition for heart problems or who have a pre-existing condition.

The complex effects that both of these treatments have on heart rate may make combining cannabis and blood pressure medication might be a bad idea.

Some of the side effects to look out for include dizziness, feeling faint, irregular heartbeat, fatigue, and nausea. If you notice peculiar or prolonged heart complications, contact a medical professional.

  1. Sedatives

Those taking sedative medications such as sleeping medications, anti-anxiety medications (benzodiazepines), mood stabilizers, antipsychotic medications, and anticonvulsant medications will need to be cautious with cannabis. Cannabis can amplify the sedative qualities of tranquilizing drugs, producing an additive effect.

Combining cannabis with tranquilizers like sleeping pills or anxiety medications like Ativan or Xanax may cause some consumers to feel overly sedated to the point that it becomes unpleasant.

Some symptoms to watch for include slow and impaired speech, slowed movement, dizziness, fatigue, and lethargy. When used in combination with a sedative medication, cannabis should be monitored closely.

  1. Antidepressants

Some people taking antidepressant medications may experience negative effects when mixing cannabis with pharmaceuticals. Both cannabis and certain common types of antidepressants (such as Prozac, Zoloft, Cymbalta, etc.) have an effect on the neurotransmitter serotonin.

Animal research suggests that cannabis can cause spikes or drops in serotonin depending on the dose. On their own, antidepressant medications can sometimes cause a condition called serotonin syndrome (SS). This happens when levels of the normally calming neurotransmitter become too high.

In extreme cases, SS can be life threatening. The condition can cause agitation, anxiety, headache, confusion, mania, shivering, nausea, sweating, diarrhea, tremors, and more.

There is little high-quality evidence that cannabis contributes to SS. However since the herb has an effect on serotonin, it is important to be mindful when mixing the substances. Chances are if you’re having a bad experience, something is awry.

Some cannabis compounds may also change how the body breaks down antidepressants, which means that the herb can enhance their effect. This potentially puts patients at a greater risk of negative serotonin side effects.

  1. Opioids

When combining cannabis with opioid pain medications, you may need to lower your dose of the prescription drug. Cannabis can interact with the opioid system in the body, which contributes to the herb’s pain-relieving effects.

While recent medical literature suggests that combining cannabis with opioid treatments may improve pain control and reduce the dosage of opioid painkillers needed for therapeutic effect, combining the two types of medications is something that should be monitored.

Those taking drugs that include buprenorphine, a particular type of opioid pain medication, may need to be especially careful. Both substances can have depressant effects on the central nervous system and may hinder the respiratory system in extreme cases. The interactions with cannabis and other opiates like morphine are currently thought to be less severe.

Some of the negative side effects may include increased sedation, dizziness, confusion, and impaired motor coordination. In extreme and rare cases difficulty breathing and respiratory problems may occur.

  1. Blood thinners

Cannabis may amplify the effects of blood thinning medications like Warfarin. This means that you might bleed a little easier. In some cases, lowering the dose of these medications may be valuable if you want to continue with cannabis consumption. Though, it’s important to always work closely with a medical professional before adjusting dosages.

Does CBD have negative interactions with pharmaceuticals?

CBD in particular can change how your body metabolizes other drugs.

Even cannabidiol (CBD), which is now sold online and available in several different countries, may interact with a large number pharmaceuticals.

CBD is one of at least 113 chemical compounds in the cannabis plant called cannabinoids. Unlike tetrahydrocannabinol (THC), the primary psychoactive in the herb, CBD does not cause a psychotropic “high”.

CBD can have both positive and negative effects when combined with prescription drugs. Research suggests that CBD blocks enzymes in the liver from properly breaking down and clearing out pharmaceuticals.

To be specific, it blocks a family of enzymes called Cytochrome P450. These enzymes are the helpers responsible for detoxing 70 to 80 percent of pharmaceutical drugs from the body. CBD, however, takes over the enzymes and prevents them from undergoing liver metabolism.

This is both a blessing and a curse. The good news is that this potentially allows patients to take lower doses of their prescriptions. The bad news is that this may increase the risk of toxic buildup of pharmaceuticals in the body.

In a 2015 study tested the possible interactions between the anti-anxiety and anticonvulsant drugs, clobazam and norclobazam, in 13 patients. Researchers found that CBD did increase levels of clobazam and norcolobazam in the blood.

The increase of clobazam caused side effects in 10 of the 13 patients. These side effects were reduced after researchers decreased the dose of the drug. Even with the decrease, however, CBD was still effective in preventing seizures.

With CBD, seizures were reduced by over 50 percent in 9 of the 13 participants. This led the study authors to conclude that regardless of the drug interaction, “CBD is a safe and effective treatment of intractable epilepsy in patients receiving [clobazam] treatment.”

Well, at least so long as the prescription dosage is reduced.

Does cannabis have positive interactions with pharmaceuticals?

One of the reasons that cannabis is such a valuable tool in medicine is that the herb may allow patients to reduce their dosages of pharmaceutical drugs with significant side effects.

While more research is needed, scientists have already discovered that cannabis compounds, when administered correctly, seem to enhance the effects of chemotherapy in animal models.

Additional research suggests that CBD may be a useful add-on treatment in psychotic disorders.

More research still suggests that cannabis compounds can improve insulin sensitivity, decrease inflammation, and improve glucose metabolism in patients with diabetes. This is not to mention the wealth of recent research that suggests that CBD effectively reduces seizures in some forms of intractable epilepsy, like the small study mentioned above.

Yet, mixing cannabis with pharmaceutical drugs is tricky business. Every patient will react differently depending on what types of chemical cocktails exist in their bodies at a given period of time.

It’s important to listen closely to your body and communicate clearly with medical professionals about any new side effects or concerns when mixing the herbal medicine with pharmaceuticals.

Always consult a doctor when making changes to your treatment plan or self-treating.

If you want to learn more about all things cannabis, be sure to check out Green Flower’s current line-up of free educational broadcasts with top cannabis experts from all around the world.

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