As more people decide to venture into the world of cannabis, the more important it becomes for an increased awareness of potential interactions between the cannabinoids in marijuana and other medicines. Not just medicine, but various compounds regularly consumed by people like you and me.
Reminder: The majority of these interactions are a result of the major cannabinoids in marijuana, CBD and Delta-9 THC, altering the performance of the metabolic enzymes in our liver resulting in altered elimination or activation of a drug. This is a very simplistic way of looking at it, but it gets the major points across.
With that being said here are some of the most common interactions to be aware of. This is also not even close to a complete list. I made a small table with the ones I felt were the most clinically significant with general marijuana use.
| Medication Class | Name |
|---|---|
| Benzodiazepines | Lorazepam (Ativan), Clonazepam (Klonopin), Diazepam (Valium) |
| Antiepileptics | Lamotrigine (Lamictal) |
| Pain Medications | Morphine, Gabapentin (Neurontin), Pregabalin (Lyrica), Acetaminophen (Tylenol) |
| Antidepressants | Sertraline (Zoloft), Escitalopram (Lexapro), Fluoxetine (Prozac) |
| Anticoagulants | Warfarin (Coumadin) |
| Miscellaneous | Alcohol |
The three bolded are the most important in my opinion, but that’s based solely on how often Tylenol and alcohol are used, and how quickly an alteration in a patient’s warfarin concentration can lead to severe consequences.
If anyone is particularly interested in how an exact interaction happens and how the medication as well as the marijuana being ingested is affected, I’d be happy to do a deeper dive myself and have a discussion.
References:
Balachandran P, Elsohly M, Hill KP. Cannabidiol Interactions with Medications, Illicit Substances, and Alcohol: a Comprehensive Review. J Gen Intern Med. 2021 Jul;36(7):2074-2084. doi: 10.1007/s11606-020-06504-8. Epub 2021 Jan 29. PMID: 33515191; PMCID: PMC8298645.