Cannabis and drug interactions
Thinking of giving up pills for plants? Are you a new MMJ patient who doesn’t know much about cannabis other than it gets you high? Or maybe you’re concerned about how medical marijuana will interact with your other meds. We get it. You need confidence in order to take the leap with something that will affect your health. Well, get ready to get woke about cannabis medicine! Elevate Holistics’ Russell Colby recently chatted live on Facebook with an actual cannabis pharmacist (yes, they do exist!), and she shared some valuable need-to-know info for patients who use cannabis as medicine. In this post, our expert fills us in on cannabis and drug interactions.
About Kelsey Schwander
Kelsey Schwander is a Doctor of Pharmacy originally from Denver, Colorado, who has been practicing in St. Louis, Missouri for the last three years. Through her company,
BHealth Consulting, she meets one-to-one with patients in a doctor’s office. In her work, she helps patients and doctors understand the overall picture of their medications and supplements and how they work and interact with cannabis. Additionally, she is also a professor at a pharmacy school—helping to fill the gap of medical cannabis experts in the healthcare field!
Can Cannabis Interact with Other Medications?
To close the interview, Russell asked Dr. Schwander if there are interactions between cannabis and medications. And also, can cannabis interact or is it harmful or should it be avoided with specific diseases?
Dr. Kelsey Schwander (BHealth Consulting): So let’s start with the medication. Yes, cannabis can interact with supplements with prescription medications. I have a lot of patients who say, “Oh well, cannabis is completely natural. It can’t interact with my prescription medication.” I’m like, “No, no it can.” So we have to be careful.
Dr. Schwander’s 4 Main Interactions
Dr. Kelsey Schwander (BHealth Consulting): There are four main interactions I like to talk to people about. So I’ll briefly go over those, and hopefully, that will give people an idea. I won’t go over all the medications because there’s a lot on how they work and it depends what other medications you’re on, but I’ll go over generally how these interactions work.
Because I think it’s really important for you to understand. Because a lot of healthcare providers will be like, “Oh, it interacts. You can’t use it,” and that’s not necessarily true.
You really just need to talk to someone who’s aware of the interaction.
Dr. Kelsey Schwander (BHealth Consulting): When you have a prescription medication and cannabis, what happens is when you consume both of them, they have to be metabolized. And a lot of times they’re metabolized in the liver by the same enzyme. When they’re both in there they’re fighting to be metabolized—and one wins out. Whichever loses, so let’s say we have a prescription medication and then we have THC. We’ve metabolized them and the prescription medication wins and holds on to the enzyme. And so THC increases in your body. So there are some prescription medications that will actually increase the amount of THC or cannabis or CBD in your body. So you want to be aware of that because you may need to consume less than another person would.
Dr. Kelsey Schwander (BHealth Consulting): Another example, which as a pharmacist, is scarier for me is when it’s the opposite. This is when we have a prescription medication and THC, and the prescription medication levels change. The prescription medication goes really high or really low. So for example, let’s say it’s a blood thinner and there’s an interaction and it increases. You’re at an increased risk of bleeding, which can be really dangerous. So we need to be aware of that.
Dr. Kelsey Schwander (BHealth Consulting): Some other interactions that happen are additive effects. THC, alcohol, benzodiazepines, like Xanax—things like that. They have additive effects like sedation for example. We know that THC can have sedating side effects, but you add alcohol and you add some medications that can increase that, it can be dangerous as well.
Dr. Kelsey Schwander (BHealth Consulting): The last one is, some prescription medication we call them prodrugs, so this is really nerdy but I think it’s important to know. One example is a breast cancer drug, called Tamoxifen. I don’t know if anyone’s heard of it, but it’s a prodrug. So what that means is when I consume it, it’s not in its active form. It has to be metabolized to get into its active form. And what happens is, if there’s an interaction, so let’s say I take that medication and I take cannabis and there’s an interaction, that drug can’t be converted into its active form and therefore it’s not working. And in this case, it’s a cancer drug. So that can have really bad side effects. Sometimes we can monitor it.
So it’s really important to let people know what you’re on, let a physician know or someone like myself know, so we can help monitor that. Not to go too far, into the medications, but the big ones I like to let people know are the blood thinners, you want to be careful, talk to someone about it. Any HIV or transplant, if you have a transplant medication, we have to be careful and then any antipsychotics. So if someone has some mental health issues and they’re stable on their antipsychotics, we want to be careful because if they interact, we can disrupt that balance. So those are the four, generally speaking, we really should be careful of.
Good Interactions (Opioids)
Dr. Kelsey Schwander (BHealth Consulting): I left one thing out. So someone mentioned opioids, so there is a drug interaction there, but it’s actually a good drug interaction. So that actually a patient who use both of them together, we find that patients can use less opioids. So that’s something that you have to be careful because of the state of effects, but some drug interactions can have good responses. So keep that in mind too. So sorry. So you, your question was, are there dangerous side effects?
Always Tell Your Doctor If You Take Cannabis
I always tell patients if you’re on opioids or chronic pain, you always, always, always, no matter what you’re on, you should always tell your healthcare provider that you’re starting to use cannabis because they’re going to have to monitor you. They’re changing the dose with opioids—we know that it can increase sedation with cannabis. So, that’s a bad side effect we need to be careful of. Always talk to your provider before you start cannabis, if you’re on opioids. But again, the downside to the side effects of cannabis are minimal compared to some of the prescription medications out there.
Elevate Holistics for Access to Cannabis Knowledge
Knowledge and understanding are the great connectors that keep us from being divided from that which could greatly benefit us. This is why Elevate Holistics believes in being a part of the cannabis community. Feel free to join our Facebook group where you will find regular interviews with industry experts, visits to dispensaries, and cannabis advocates of all sorts who believe in patient access to medical marijuana.
And check out our website for additional services like pharmacist consultations. Some of these are free add-ons when you book an appointment for your medical marijuana card or renewal. As always, if you have any questions—reach out! We’re here to make your cannabis experience safe, easy, and as beneficial as possible. Cheers!