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YES, Cannabis Does Interact With Some Medications
I often hear a list of questions from patients who want to know if they can use cannabis while taking antibiotics. “Is it safe to smoke marijuana when I’m on other medicines,” they ask. “Will cannabis affect my antibiotics? Will my antibiotics work if I use CBD oil?”
It’s good to be concerned, because yes, medication interactions CAN occur with cannabis. For example, cannabis and some antidepressants can interact. (And yes, the risk of drug interactions also applies to hemp-based CBD oil.) There CAN be interactions between cannabis and some antibiotics, specifically macrolide antibiotics like clarithromycin and erythromycin.
How Do I Know If I’m at Risk for an Interaction?
Patients should look up the specific medication they’re consuming to see if it uses the metabolic pathway CYP450. If it does utilize CYP450, then there is a risk of cannabis drug interactions.
Fortunately, most people do not experience a significant interaction when even when combining cannabis with macrolide antibiotics. Additionally, interactions are usually dose dependent, so the higher dose of cannabis you consume, the greater the risk.
Still because interactions are possible, consumers should be aware of what could happen…
New to Medical Marijuana? READ THIS: Cannabis 101.
Interactions Between Marijuana & Antibiotics
As far as we know, cannabis does not reduce the effectiveness of antibiotics. (Incidentally, cannabis actually has antibacterial properties as well.)
However, because cannabis can increase the blood levels of some medicines, it can also increase the risk of side-effects. For most people this increase is not significant, but for some it can be.
It has a genetic component and so effects vary from person-to-person. Maybe your best friend, Sue, didn’t have an issue, but that doesn’t necessarily mean the same will hold true for you.
The thing is, Cytochrome P450 (CYP450) differs genetically, so you and Sue might have different genetic expressions. Which means medications might be processed differently and thus result in different reactions.
Cytochrome CYP450
Cytochrome P450 is the metabolic pathway in the liver that metabolizes cannabinoids. This is the same metabolic pathway many medications (including some some antibiotics).
Taking More Than One Medication Can Cause the Same Issue
It should be noted that medication interactions due to the CYP450 pathway are common. Every day, patients are prescribed numerous medications that all utilize the same pathway without consideration of overtaxing the system. The use of multiple prescription medications can present the same issues as combining marijuana with prescription medication.
Conclusion
Yes, cannabis can interact with some antibiotics, but usually, it’s insignificant. There’s no documented evidence of a dangerous drug interaction. However using cannabis may increase the risk of side effects from some medications (and that can be unpleasant and theoretically dangerous). As far as we know, cannabis does not decrease the effectiveness of antibiotics and research suggests it may act as an antibiotic itself.
Patients who choose to combine marijuana and antibiotics should be aware of the potential side-effects of all medications prescribed. As always, medication use, including medical marijuana, should be discussed with your licensed healthcare provider.
I’m in love with this pretty bong, so I’m selling it in my pipe shop.
Here’s how I answered this question on Quora:
Is it considered dangerous to smoke weed while on antibiotics?
Have you ever heard the warnings not to mix grapefruit juice and when taking some medications?
For example, when a patient is taking some cholesterol medications they are advised NOT to drink grapefruit juice. This is because grapefruit juice increases the level of the medication. For some medications, like blood thinner warfarin, this can be dangerous.
So you’re smart to be concerned. Marijuana is a medication, after all, and one should always use caution when mixing medications.
The truth is, we can’t say for certain. We haven’t been able to research weed since 1937, so a lot of these questions are still waiting to be answered.
Clinically, I haven’t read of any case studies of an antibiotic interaction, however, this is what you need to know.
Marijuana inhibits a specific enzyme in the liver, cytochrome p450. This enzyme is used by many medications – including some antibiotics.
So – using some macrolide antibiotics, (including troleandomycin, erythromycins, josamycin, flurithromycin, roxithromycin, clarithromycin, miocamycin, and midecamycin) could potentially interact with marijuana.
What this means is that the effect of the medications will be increased. That also means you’d be at a higher risk of experiencing side effects and adverse reactions from the antibiotics.
Intestinal issues and cardiac side effects have been noted with some macrolide antibiotics. It should be noted that there’s research suggesting marijuana might impact the heart as well.
Guess what else affects CP450? Grapefruit juice.
Grapefruit juice isn’t bad. It just needs to be used with caution. If someone won’t give up their grapefruit juice, the doctor needs to monitor their blood levels a little more closely. The same should be done with marijuana.
Always use caution when mixing meds.
Sweetest regards,
Jessie Gill, RN
FAQ
- Can I Smoke Weed on Antibiotics?
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