Cannabis and prescription medication interactions

Hey all! Earlier this week I posted a quick read about why its so important to talk with your PCP and cannabis nurse when beginning your cannabis journey. Today I wanted to look at this topic a little closer and really delve into the potential interactions cannabis might have with prescription medications.

Prior to going down this rabbit hole of cannabis and prescription medication interactions, I had a basic understanding of the medicines that might have an interaction with cannabis. Medicines that deal with blood pressure, pain and some mood stabilizers might have an interaction with cannabis because of their mechanism of action; some blood pressure and pain medications could have an increased effect since cannabis can help with both issues and mood stabilizers could have a decreased affect on the body if cannabis is already interacting with the same enzyme/receptor sites as the medication is supposed to interact with. So, when doing an internet search to look at the specific medicines, I was expecting quite the list to go through, but was surprised to find a list of medications 393 items long to go through. This list of medications comes from a trusted site that I have used in the past to find quick and easy to understand patient education on different prescription medicines. This website is Drugs.com and was one of the first links on the page when I searched "list of prescription medications that can interact with cannabis." This list of medicines can be daunting and raised some concerns for me. I have about 10 years' experience educating and learning about different medications and even with that experience, the list and information was a bit confusing to get through. It is most likely due to the way my mind orders information to absorb/understand, but it was difficult to absorb the information there. With this though in mind, I began to collect the data into an easier to read through spreadsheet. Once I'm through the list I'll post it here just in case it can help anyone else learn a bit more about the medications they're taking.

This list is by no means the exhaustive list from the drugs com website (as I'm still working my way down the list and as we learn more about cannabis, other or more medications will be added to the list), but these are a couple of the more common meds that I see on a variety of patient's home medication lists that may interact with cannabis. Read over the list below to see if any of your medications may interact with cannabis. The more you know and learn about cannabis as a medicine, the more efficiently cannabis can be used for your particular symptom or issue. Reach out to me through this website or on social media as "The Green Nurse Educator" to book some time with me and we can discuss how/if your medications can be taken safely with cannabis or if alternative methods are needed. I look forward to hearing from you!

Generic name	Brand name	Used to treat	Drug classification	Interaction scale	Notes
Alprazolam	Xanax	Anxiety, panic disorder	Benzodiazepine	Moderate	May increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating.
Amitriptylline	Elavil	Depression, low mood, pain, and migrains	Antidepressant	Moderate	May increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating.
Amlodipine	Norvasc	Hypertension, angina, coronary artery disease	Calcium channel blocker	Moderate	May have additive effects in lowering your blood pressure.
Aripiprazole	Abilify	Bipolar 1, major depressive disorder, schizophrenia, autism, and Tourette's syndrome	Antipsychotic	Moderate	May increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating.
Baclofen	Lioresal	Muscle spasms from MS or spinal injury	Skeletal muscle relaxant	Moderate	May increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating.
Benazepril	Lotensin	Hypertension	ACE inhibitor	Moderate	May have additive effects in lowering your blood pressure.
Bumetanide	Bumex	Fluid retention related to CHF, liver, and kidney disease	Loop diuretic	Moderate	May have additive effects in lowering your blood pressure.
Carvedilol	Coreg	Heart failure, hypertension after a heart attack	Beta blocker	Moderate	May have additive effects in lowering your blood pressure.
Ciprofloxacin	Cipro	UTI's, chest/skin/bone infections	Antibiotic	Moderate	May increase the blood levels of the psychoactive component of cannabis.
Citalopram	Celexa	Depression (works to restore balance of serotonin in the brain)	SSRI (selective serotonin reuptake inhibitor)	Moderate	May increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating.
Cyclobenzaprine	Flexeril	Muscle relaxer	Skeletal muscle relaxant	Moderate	May increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating.
Diazepam	Valium	Anxiety, seizures, muscle spasms and twitches	Benzodiazepine	Moderate	May increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating.
Desvenlafaxine	Pristiq	Mood regulator and depression	SSNRI (selective serotonin and norepinephrine reuptake inhibitor)	Moderate	May increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating.
Diltiazem	Cardizem	Hypertension, angina, Afib, Aflutter, decreases the work of the heart	Calcium channel blocker	Moderate	May have additive effects in lowering your blood pressure.
Duloxetine	Cymbalta	Depression, anxiety, diabetic neuropathy, and chronic muscle or joint pain	SSNRI	Moderate	May increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating.

References

1. Cannabis Drug Interactions Checker (no date) Drugs.com. Available at: https://www.drugs.com/drug-interactions/cannabis-index.html (Accessed: 20 July 2023).