Cannabis Interaction with Other Drugs


1. Drugs containing propoxyphene


Back in 2010, the opioid painkiller propoxyphene was withdrawn from the U.S. market. The compound is known to be toxic to the heart, even in doses formerly considered therapeutic.However, if you happen to have any leftover propoxyphene medications, it is best to not use them. It’s also unwise to mix them with cannabis.
Drugs that contain propoxyphene include:

Balacet
Darvon (Compound 32, Compound 65, N)
Darvoset (N 100, A500, N 50)
PC-Cap
PP-Cap
Propacet 100
Propoxyphene Compound 65
Trycet
Wygesic

Symptoms to watch for:

Oversedation
Dizziness
Confusion
Difficulty concentrating
Impaired judgement
Impaired motor skills
Impaired thinking

These symptoms may be worse in the elderly.

2. Drugs that contain buprenorphine

Ironically, buprenorphine is an opioid pain medication that is also used to treat opioid addiction. As an opioid, this drug is also thought to have a high potential for addiction.In high doses, this drug can also cause respiratory distress, coma, and death. When combined with cannabis, the risk of these things increases, since both substances depress the central nervous system. Both buprenorphine and cannabis are sedatives which means the chance of being overly sedated with this combination is high.
Common drugs that contain buprenorphine include:

Butrans
Belbuca
Bunavail
Buprenex
Probuphine
Suboxone
Subutex
Zubslov

Some symptoms to watch for include:

Excessive sedation
Respiratory problems
Inability to stay awake
Difficulty controlling motor function
Slowed speech
Inability to perform cognitive tasks
Slowed or irregular heartbeat

If you have mixed buprenorphine and cannabis and are experiencing these symptoms, call for emergency help.

3. Drugs that contain levomethadyl acetate

Levomethadyl acetate is synthetic opioid painkiller similar to methadone. This drug is sold under the brand name Orlaam. Like other painkillers, this drug can cause some sedation. Mixing Orlaam with cannabis can be so sedative that it is uncomfortable and may even be physically dangerous.

Symptoms to watch for include:

Drowsiness or oversedation
Dizziness or lightheadedness
Confusion
Depression
Slow, shallow breathing
Poor motor coordination
Impaired thinking
Impaired judgement



4. Beta blockers

It’s generally thought that those with heart conditions should be extremely cautious with cannabis. Cannabis can cause blood pressure levels to fluctuate and heart rate, meaning that it might make some more sensitive to a heart attack. This is especially true for novice consumers. In regulars, cannabis may slow heart rate.Those taking beta blockers or other blood pressure medications should be particularly cautious, as both substances can have opposite effects on heart rate. Beta blockers reduce blood pressure but slow heart rate. In regular consumers, there’s a chance that cannabis may amplify the effects of beta blockers by having an additive effect on slowing heartbeat. Either way, it’s a tricky mix.
Common beta blockers include:

Sectral
Tenormin
Zebeta
Lopressor
Toprol-XL
Corgard
Bystolic
Inderal LA
InnoPran XL

Some symptoms to watch for include:

Feeling faint, fainting
Dizziness
Nausea
Irregular heartbeat
Shallow breathing
Fatigue
Confusion

5. Benzodiazepines

Benzodiazepines are powerful sedatives in their own right. While there are certainly a lot of people out there who mix benzos with cannabis, this can make for a powerful and uncomfortable experience. Common benzodiazepines include:

Ativan
Klonopin
Xanax

Both cannabis and benzodiazepine medications can have strong sedative effects on the brain, putting patients at risk of oversedation. Both compounds can have an effect on GABA, a calming neurotransmitter that dampens excitability in the brain. In general, mixing cannabis and benzodiazepines should be closely monitored. Similarly, patients may want to avoid mixing cannabis with other sedative medications like sleeping pills.
Symptoms to watch for include:

Oversedation
Slowed or slurred speech
Slowed motor skills
Driving impairment
Cognitive impairment
Constipation



6. SSRIs


Thus far, only minor interactions are noted for mixing cannabis with some of the most common SSRIs. Some evidence suggests that cannabis compounds may increase the effect of some SSRIs, like Prozac. Those with manic depression (bipolar disorder) or at risk for manic depression have reason to be more mindful of potential mood alterations when mixing these two types of medications.Both cannabis and SSRIs also increase serotonin. There is a potential risk developing sudden serotonin syndrome when combining these two drugs, but firm research on the subject is needed. Some common SSRIs include,

Lexapro
Prozac
Zoloft
Paxil

Symptoms to watch for:

Difficulty sleeping
Symptoms of mania
Agitation
Anxiety
Excessive paranoia
Rapid heart rate
Headache
Gastrointestinal distress
Mood variability and mood swings



7. SNRIs

Those taking another class of antidepressant drugs, SNRIs, may need to be mindful of cannabis consumption. Both SNRIs and cannabis can cause serotonin fluctuations, which may make you more likely to develop sudden serotonin syndrome or have other unwanted mood side effects. Further, some cannabis compounds may increase blood concentrations of antidepressant drugs. Though, there is little research on this topic. SNRI’s are also used to treat nerve pain.Some common SNRIs include:

Effexor
Cymbalta
Pristiq

Symptoms to watch for include:

Memory impairment
Confusion
Agitation
Paranoia
Rapid heart rate
Changes in blood pressure
Headache
Muscle twitching
Gastrointestinal distress



8. Antipsychotic medications

There is some evidence to suggest that cannabis may heighten the effect of certain antipsychotic drugs, like Seroquel and Abilify. Though, the significance of this is unknown. Some common antipsychotic medications include:

Seroquel
Abilify
Clozaril
Geodon
Zyprexa

Symptoms to watch for:

Excessive sedation
Slow motor skills
Decreased cognitive function
Confusion
Impaired driving


9. Sodium oxybate

Sodium oxybate is an anti-sleep medication that is often used to treat narcolepsy. When combined with cannabis, patients may risk depressing the central nervous system a little too much.
In the most severe cases, this may contribute to coma. Some symptoms to watch for include:

Dizziness or lightheadedness
Depression
Low blood pressure
Shallow breathing
Difficulty thinking
Impaired judgement
Impaired motor function