Cannabis and Drug Interactions
How does cannabis interact with other drugs? When taking cannabis orally, its active ingredients interact with enzymes as part of the body’s process in metabolizing cannabis. This particular interaction can increase or decrease the effect of cannabis and other medications as well. Caution is crucial when taking oral cannabis while also taking the medications we have listed below. While the interaction of smoked or vaporized cannabis in combination with these other medications is still unknown, caution is still advised.
Blood Plasma Protein
Blood plasma proteins are primarily combined in the liver. A smaller percent of blood plasma proteins due to immunoglobulins are produced by lymphocytes and plasma cells. Total protein in made of albumin, globulins, and fibrinogen (in plasma only). The role of proteins is to control oncotic pressure, transport substances such as hemoglobin, lipids, calcium, and promote inflammation.
Understanding Blood Protein Binding
Blood plasma proteins are not specific with their binding habits, which means that they are not picky as to what they bind to. So, this means that different drugs have to compete for the same binding site. Displacement may be a problem when the protein chooses one molecule over another, therefore throwing off one chemical in favor of another.
Drugs That Can Increase the Effects of Oral Cannabis
- Amiodarone (Cordarone): This medication treats cardiac arrhythmias
- Clarithromycin (Biaxon): Antibiotic
- Diltiazem (Tiazac, Cardizem, Dilacor): This medication treats high blood pressure (also known as hypertension), and angina.
- Erythromycin (Robimycin, Ilosone, Acnasol): Antibiotic
- Fluconazole (Diflucan, Trican): Antifungal medication
- Isoniazid (Nydrazid, Rifamate): medication that treats tuberculosis.
- Ketoconzole (Monistat): Over-the-counter antifungal medication.
- Ritonavir (Norvir): HIV protease inhibitor
- Verapamil (Calan, Veralan, Isoptin): This medication treats cardiac arrhythmias.
Drugs That Can Decrease the Effects of Oral Cannabis
- Carbamazepine (Tegretol, Equetro, Carbetrol): Anticonvulsant medication
- Phenobarbital: Sedative and anticonvulsant medication
- Phenytoin (Dilantin): anticonvulsant medication
- Primodone (Mylosine): anticonvulsant medication
- Rifabutin (Mycobutin): Mycobacterium avium complex (MAC) disease
- Rifampicin (Rifampin, Rifadin, Rifater, Rimactane): Antibiotic
- St. John’s Wort: Herbal antidepressant
In addition to the medications listed above, cannabis (whether it’s smoked, taken orally, sublingually, or vaporized-also increase the effects of alcohol, benzodiazepines (Ativan, Halcion, Librium, Valium, Xanax, etc.) and opiates (codeine, fentanyl, morphine, etc.)