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Marijuana

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Are there any interactions with medications?



Antipyrine
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

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.

Some medications that slow blood clotting include aspirin, clopidogrel (Plavix), diclofenac (Voltaren, Cataflam, others), ibuprofen (Advil, Motrin, others), naproxen (Anaprox, Naprosyn, others), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, warfarin (Coumadin), and others.



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.

Some sedative medications include clonazepam (Klonopin), lorazepam (Ativan), phenobarbital (Donnatal), zolpidem (Ambien), and others.



Theophylline
Interaction 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:

BY MOUTH:
  • 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.

Therapeutic Research Faculty copyright

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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