Drug Interactions with Cannabis
Cannabis is commonly used to treat nausea, vomiting, chronic pain, epilepsy, eating disorders, muscle spasms, glaucoma, post-traumatic stress disorder, sleep disorders and multiple sclerosis. Oftentimes, these conditions are also treated with prescription medications. It is important to be aware that cannabis may interact with these drugs, as well as drugs used to treat other conditions. Always inform your physician, pharmacist and dispensing agent of any prescriptions medications you use.
Cannabis may increase the risk of bleeding when used in combination with aspirin, anticoagulants (warfarin), anticoagulants (clopidogrel), and nonsteroidal anti-inflammatory drugs (ibuprofen, naproxen). Some herbal supplements such as ginko biloba, garlic and saw palmetto also increase the risk of bleeding. Exercise caution when using cannabis with herbal supplements.
Cannabis may affect blood sugar levels; anyone being treated for diabetes should be closely monitored as medication adjustments may be necessary.
Cannabis may lower blood pressure, adjustments in blood pressure medication may be necessary for some patients.
Cannabis is metabolized, or broken down, in the body by liver enzymes that also metabolize prescription drugs. With oral cannabis use, this can result in increased concentrations of these medications causing potentially serious complications. Ask your doctor or pharmacist if you are taking any medications metabolized by the cytochrome P450 system, an enzyme system used to break down many drugs.
Cannabis may increase the drowsiness and dizziness caused by benzodiazepines (lorazepam, diazepam, alprazolam, clonazepam), narcotics (codeine, hydrocodone, oxycodone, morphine), antidepressants and alcohol. Use caution when using these medications in combination. Many patients using cannabis with prescription pain medications are able to accomplish adequate pain relief with lower doses of narcotics.
Cannabis interactions have not been extensively studied with most drugs. Other drugs that may be affected by cannabis include anabolic steroids, antibiotics, antidepressants, antifungals, barbiturates, corticosteroids, central nervous system depressants, heart medications, hormone supplements, nicotine.
Effective communication is the key to avoiding, identifying and managing interactions between cannabis and prescription medications.
-cannabis, like any medication, can produce unwanted effects. These adverse effects can be frightening to some users who may not be accustomed to its psychoactive effects. Dosage should always be approached with caution in order to minimize discomfort.
-most side effects are associated with THC content, by using cannabis strains that also contain CBD some of the THC related side effects can be reduced or eliminated
-when dealing with most psychoactive side effects, the best approach is usually to remain calm, breathe slowly and relax.
-endocannabinoids are involved in several aspects of fetal and childhood development; cannabis should not be used during pregnancy unless under strict and direct care of an experienced physician.
-cannabinoids are passed through breastmilk; until more information is known about the effects on the nursing infant, breastfeeding is not recommended unless under the strict and direct care of an experienced physician.
-cannabis use temporarily impairs cognition and can cause body sway, lack of steadiness, slowed reflexes, increased reaction time, decreased concentration and short term memory loss. Patients should not drive a vehicle, a vessel or an aircraft or operate heavy or dangerous machinery while under the influence of cannabis.
-due to psychoactive effects of cannabis, care must be taken to ensure responsible use in the presence of children. If directly and solely responsible for children, cannabis se should be discouraged.
-cannabis users may experience orthostatic hypotension, a sudden drop in blood pressure when standing from a seated or reclining position resulting in in sudden lightheadedness and dizziness or loss or consciousness. This is more common in new users, the elderly and cases of overmedication. Urge caution when rising and avoid standing quickly.
-cannabis hyperemesis is characterized by vomiting and abdominal pain following cannabis use. Most commonly, symptoms are experienced in the morning and are relieved by taking a hot bath or shower. This syndrome resolves completely upon cessation of cannabis use.
-short term psychological adverse effects: confusion, anxiety, panic. These are all dose dependent and can be minimized or avoided with proper monitoring of dose until a comfortable baseline is established. Using cannabis rich in CBD, limonene and pinene may reduce some of these effects as well.
-long term adverse effects: heavy, long term smokers of cannabis may develop severe chronic bronchitis. Cognitive deficits have also been noted in long term users, evidence suggests most of these deficits are reversible with cessation of use.
-brain scans of heavy users show that the density of cannabinoid receptors declines, known as receptor down-regulation. This down regulation is responsible for tolerance that develops over time, requiring more cannabis for the same effect. Receptor density appears to be completely restored after 28 days of non-use.
-cannabis use may affect blood sugar levels, caution is advised in patients with diabetes or blood sugar problems and in those using medication, herbs or supplements that affect blood sugar.
-cannabis may cause hives and itching
-if allergic to plants of the Cannabaceae family, cannabis may cause asthma, hives, runny or stuffy nose, itching and red, itchy eyes.
-users may also experience:
•rapid heartbeat (tachycardia)-usually subsides within 20 minutes, slow, long, deep breaths offer some relief
• Hunger and Thirst: enjoy some healthy snacks and plenty of water
•Redness of the eyes: instill rewetting drops. Avoid overuse of Visine® as rebound redness may occur.
•Dry Mouth: suck on some sugarless candy, lemon drops, drink lemonade to stimulate saliva production. For severe cases, dry mouth mouthwashes may provide some comfort.
•Drowsiness: move to a comfortable area and relax
•Dizziness: Use caution when standing, do not stand rapidly.
•Short Term Memory Loss
•Rapid Heartbeat: take long deep breaths
•Coughing: have a non-alcoholic beverage close by. Vaporizers can reduce the amount of inhaled smoke and often result in less coughing.