GPI MEDICAL MARIJUANA CLINIC & RESOURCES
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Drug Interactions

Medical Marijuana is currently approved to treat cancer, HIV/ AIDS, amyotrophic lateral sclerosis(ALS), Parkinson's disease, multiple sclerosis, damage to the tissue of the spinal cord with objective neurological indication for intractable spasticity, epilepsy, inflammatory bowel disease (IBD), neuropathy, chronic pain, Huntington's disease, and Post-traumatic Stress Disorder (PTSD). Other indications are pending, such as for Alzheimer’s disease, muscular dystrophy, dystonia, and rheumatoid arthritis.

Because of its current Schedule I drug status under the Controlled Substances Act, there is a limited amount of studies that investigate drug interactions in human subjects. Since the majority of studies have been investigated in vitro with non-human subjects, all interactions are rated, according to the Natural Medicines Database, as follows:
  • Interaction Rating: Moderate – Use cautiously or avoid combination; warn patients that a significant interaction or adverse outcome could occur.
  • Likelihood of Occurrence: Possible - Clinical research, pharmacokinetic data in humans or animals, or in vitro research suggest that this might occur in some patients.
  • Severity: Moderate - Moderate impairment or significant discomfort possible.
  • Level of Evidence: D – Theoretically an interaction could exist based on pharmacology.

Based on prior in vitro studies, it has been found that medical marijuana inhibits various cytochrome P450 enzymes.
The cytochrome P450 enzymes affected are: CYP1A1, CYP1A2, CYP1B1, CYP2A6, CYP2B6, CYP2C19, CYP2C9, CYP2D6, CYP3A4, and CYP3A5. Furthermore, medical marijuana has been found to exhibit inhibitory effects on P-glycoprotein.

The purpose of this report is to investigate potential interactions that may occur between medical marijuana and drugs used to treat the approved conditions listed above. Conditions that are pending approval are also included in this report.
Click on the disease or class of medications below to learn more
Section 1. BONE AND JOINT DISORDERS
Rheumatoid Arthritis
  • Disease-Modifying Anti-rheumatic Drugs (DMARD's)
  • Disease - Modifying Biologic Drugs (Biologics)
  • IL-1 Receptor Antagonists
  • Immunosuppressive Agents
Section 2. Gastrointestinal DISOrderS
Inflammatory Bowel Disease (IBD)
  • Corticosteroids
  • Immunosuppressive agents
  • Aminosalicylates
  • Antimetabolites
  • Immunomodulators

Irritable Bowel Syndrome (IBS)
  • Antidiarrheal agents
  • Tricyclic antidepressants (TCA’s)
  • Selective serotonin reuptake inhibitors (SSRI’s)
  • Serotonin receptor antagonists
  • Anticholinergics
  • Osmotic laxatives
  • Bulking agents
  • Chloride channel activators
  • Guanylate cyclase-C agonists
Section 3. Infectious Diseases
Hepatitis C
  • Antihepacevirals
  • Immunomodulators

HIV and AIDS
  • Protease inhibitors (PI’s)
  • Non-nucleoside reverse transcriptase inhibitors (nrti’S)
  • Nucleoside/nucelotide reverse transcriptase inhibitors (NRTI’s)
  • Integrase strand transfer inhibitors (INSTI’s)
SECTION 4. Neurologic DISEASES
Alzheimer's Disease
  • Acetylcholinesterase inhibitors
  • N-methyl-D- aspartate receptor antagonist

Huntington's Disease
  • Vesicular Monoamine Transporter 2 (VMAT2) Inhibitor
  • Dopamine agonists
  • Dopamine precurser + decarboxylase inhibitor
  • First generation(typical) antipsychotics
  • Second generation (atypical) antipsychotics
  • Benzodiazepines
  • Older anticonvulsants
  • Newer anticonvulsants

Migraines
  • Selective serotonin receptor agonists (triptans)
  • Ergot alkaloids
  • Beta-blockers
  • Calcium channel blockers
  • Tricyclic antidepressants (TCA's)
  • Selective serotonin-norepinephrine reuptake inhibitors (SNRI's)

Multiple sclerosis (MS)
  • Disease Modifying Agents
    • Antineoplastic Agent
    • Immunomodulators
    • Interferons
    • Sphingosine 1-Phosphate (S1P) Receptor Modulator
  • Corticosteroids
  • Symptom management for bladder dysfunction​
    • Alpha -1 Blocker
    • Anticholinergics
    • ​Antispasmodic Agents
    • Neuromuscular blocker agent
    • Tricyclic Antidepressant
  • Desmopressin
  • Symptom management for depression/emotional changes/fatigue
    • CNS Stimulants
    • Dopamine - Norepinephrine Reuptake Inhibitor 
    • N-Methyl-D-Aspartate Receptor Antagonist
    • Selective Serotonin - Norepinephrine Reuptake inhibitors
    • Selective Serotonin Receptor Inhibitors (SSRI's)
  • Symptom management for sexual dysfunction
    • Phosphodiesterase - 5 Enzyme Inhibitors
  • Symptom management for spasticity/tremors/gait difficulties
    • Alpha -2 Adrenergic Agonist​
    • ​Anti tubercular agent
    • Benzodiazepines
    • Neuromuscular blocker agent
    • Potassium Channel Blocker
    • Skeletal Muscle Relaxants

Neuropathy
  • Tricyclic antidepressants (TCA’s)
  • Serotonin-norepinephrine reuptake inhibitors (SNRI's)
  • Opioid analgesics
  • Local anesthetic
  • Anticonvulsants

Parkinson’s Disease
  • Anticholinergics
  • Catechol-o-methyl transferase (COMT) inhibitors
  • Dopamine agonists
  • Dopamine precurser + decarboxylase inhibitors
  • Monoamine oxidase - B(MOAB)Inhibitors

Seizures
  • Older anticonvulsants
  • Newer anticonvulsants
section 5. Psychiatric diseases
Anxiety
  • Selective serotonin reuptake Inhibitors (SSRI's)
  • Serotonin-norepinephrine reuptake inhibitors (SNRI's)
  • Benzodiazepines
  • 5HT1A-Partial Agonist

Bipolar Disease
  • Older anticonvulsants
  • Newer anticonvulsants
  • Second generation (atypical) antipsychotics
  • Lithium
  • Benzodiazepines

Depression
  • Selective serotonin reuptake Inhibitors (SSRI's)
  • Serotonin-norepinephrine reuptake inhibitors (SNRI's)
  • Tricyclic antidepressants (TCA’s)
  • Triazolopyridines
  • Alpha -2 antagonist

Post -Traumatic Stress Disorder (PTSD)
  • Selective serotonin reuptake Inhibitors (SSRI's)
  • Serotonin-norepinephrine reuptake inhibitors (SNRI's)
  • Tricyclic antidepressants (TCA’s)
  • Triazolopyridines
  • Alpha -2 antagonist

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Last Updated: May 2018.
  • Home
  • Company
    • About Us
    • Services
  • Support
    • For Patients >
      • Qualifying Conditions
      • Cost of Visit
      • How Marijuana Works
      • Side Effects and Safety
      • Approved Formulations and Dosing
      • Dispensaries
      • Caregivers
      • How to Register ?
      • FAQ
    • For Clinicians >
      • Research
      • Drug Interactions
  • Contact