Marijuana (Herb/Suppl)

Brand and Other Names:Cannabis, Ganja, more...Hash, Hashish, Hemp, Mary Jane, Pot, Reefer, Weed
  • Print

Suggested Dosing

Analgesia, Antiemetic, Appetite Stimulant, Glaucoma

Dosing of marijuana preparations is highly dependent on a variety of factors (eg, growing and harvesting conditions, plant parts isolated)

No standard guidelines exist for dosage ranges

Oral

  • Tincture: 5-15 drops or 1-3 drops of fluid extract

Inhalation

  • 1-3 grains (65-195mg) cannabis for smoking
  • Potency highly variable
  • Drug deteriorates rapidly

Wasting Syndrome (Orphan)

Treatment of HIV-associated wasting syndrome

Orphan indication sponsor

  • Multidisciplinary Association for Psychedelic Studies, Inc; 3 Francis St; Belmont, MA 02478

Hepatocellular Carcinoma (Orphan)

Delta-9-tetrahydrocannibinol: Orphan designation for treatment of hepatocellular carcinoma

Sponsor

  • Tetra Bio-Pharma Inc; 3005 Blvd Matte, Suite 300A; Brossard, Quebec; Canada
Next:

Suggested Uses

Decrease intraocular pressure, analgesia, antiemetic effects, appetite stimulant

Availability

The United States (US) Drug Enforcement Administration (DEA) classifies marijuana as a Schedule 1 substance under the Controlled Substances Act (CSA). Schedule I drugs are recognized as having a high potential for abuse with insufficient evidence for safety and efficacy with no currently accepted medical use for treatment in the US

Marijuana is not approved by the US Food and Drug Administration (FDA) for medical use in the US and remains classified as an illicit drug by the DEA. However, 33 states and the Distric of Columbia have adopted individual State Medical Marijuana Laws

In October of 2009 the US Justice Department announced that it will no longer enforce federal drug laws on persons who use marijuana for medicinal purposes or their sanctioned suppliers, as long as state laws are followed

Previous
Next:

Interactions

Interaction Checker

and Marijuana

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            All Interactions Sort By:
             activity indicator 

            Contraindicated (1)

            • pimozide

              marijuana increases levels of pimozide by decreasing metabolism. Contraindicated. Risk of QT interval prolongation.

            Serious - Use Alternative (23)

            • abametapir

              abametapir will increase the level or effect of marijuana by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. For 2 weeks after abametapir application, avoid taking drugs that are CYP3A4 substrates. If not feasible, avoid use of abametapir.

            • apalutamide

              apalutamide will decrease the level or effect of marijuana by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Coadministration of apalutamide, a strong CYP3A4 inducer, with drugs that are CYP3A4 substrates can result in lower exposure to these medications. Avoid or substitute another drug for these medications when possible. Evaluate for loss of therapeutic effect if medication must be coadministered. Adjust dose according to prescribing information if needed.

            • calcium/magnesium/potassium/sodium oxybates

              marijuana, calcium/magnesium/potassium/sodium oxybates. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

            • dihydroergotamine

              marijuana will increase the level or effect of dihydroergotamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

            • dihydroergotamine intranasal

              marijuana will increase the level or effect of dihydroergotamine intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

            • dronedarone

              marijuana will increase the level or effect of dronedarone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

            • enzalutamide

              enzalutamide will decrease the level or effect of marijuana by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

            • ergotamine

              marijuana will increase the level or effect of ergotamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

            • erythromycin base

              marijuana will increase the level or effect of erythromycin base by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

            • erythromycin ethylsuccinate

              marijuana will increase the level or effect of erythromycin ethylsuccinate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

            • erythromycin lactobionate

              marijuana will increase the level or effect of erythromycin lactobionate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

            • erythromycin stearate

              marijuana will increase the level or effect of erythromycin stearate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

            • everolimus

              marijuana will increase the level or effect of everolimus by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

            • ivosidenib

              ivosidenib will decrease the level or effect of marijuana by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP3A4 substrates with ivosidenib or replace with alternative therapies. If coadministration is unavoidable, monitor patients for loss of therapeutic effect of these drugs.

            • lovastatin

              marijuana will increase the level or effect of lovastatin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

            • ranolazine

              marijuana will increase the level or effect of ranolazine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

            • silodosin

              marijuana will increase the level or effect of silodosin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

            • simvastatin

              marijuana will increase the level or effect of simvastatin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

            • sirolimus

              marijuana will increase the level or effect of sirolimus by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

            • sodium oxybate

              marijuana, sodium oxybate. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.

            • thioridazine

              marijuana will increase the level or effect of thioridazine by affecting hepatic enzyme CYP2D6 metabolism. Contraindicated.

            • tolvaptan

              marijuana will increase the level or effect of tolvaptan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated.

            • tucatinib

              tucatinib will increase the level or effect of marijuana by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid concomitant use of tucatinib with CYP3A substrates, where minimal concentration changes may lead to serious or life-threatening toxicities. If unavoidable, reduce CYP3A substrate dose according to product labeling.

            Monitor Closely (285)

            • acarbose

              marijuana decreases effects of acarbose by pharmacodynamic antagonism. Use Caution/Monitor.

            • albuterol

              marijuana increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • alfentanil

              alfentanil and marijuana both increase sedation. Use Caution/Monitor.

            • alitretinoin

              marijuana will increase the level or effect of alitretinoin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • almotriptan

              marijuana will increase the level or effect of almotriptan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • alprazolam

              marijuana will increase the level or effect of alprazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              alprazolam and marijuana both increase sedation. Use Caution/Monitor.

            • amiodarone

              marijuana will increase the level or effect of amiodarone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • amitriptyline

              amitriptyline and marijuana both increase sedation. Use Caution/Monitor.

            • amobarbital

              amobarbital and marijuana both increase sedation. Use Caution/Monitor.

            • amoxapine

              amoxapine and marijuana both increase sedation. Use Caution/Monitor.

            • apomorphine

              apomorphine and marijuana both increase sedation. Use Caution/Monitor.

            • aprepitant

              marijuana will increase the level or effect of aprepitant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • arformoterol

              marijuana increases and arformoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • aripiprazole

              marijuana will increase the level or effect of aripiprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              aripiprazole and marijuana both increase sedation. Use Caution/Monitor.

            • armodafinil

              marijuana increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • artemether/lumefantrine

              marijuana will increase the level or effect of artemether/lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • atorvastatin

              marijuana will increase the level or effect of atorvastatin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • azelastine

              azelastine and marijuana both increase sedation. Use Caution/Monitor.

            • baclofen

              baclofen and marijuana both increase sedation. Use Caution/Monitor.

            • bazedoxifene/conjugated estrogens

              marijuana will increase the level or effect of bazedoxifene/conjugated estrogens by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • belladonna and opium

              belladonna and opium and marijuana both increase sedation. Use Caution/Monitor.

            • benperidol

              benperidol and marijuana both increase sedation. Use Caution/Monitor.

            • benzhydrocodone/acetaminophen

              marijuana will increase the level or effect of benzhydrocodone/acetaminophen by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Hydromorphone (<3% of the circulating parent hydrocodone [benzhydrocodone is prodrug of hydrocodone]) is mainly formed by CYP2D6 mediated O-demethylation of hydrocodone. Hydromorphone may contribute to the total analgesic effect of hydrocodone.

            • benzphetamine

              marijuana increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • bosentan

              bosentan will decrease the level or effect of marijuana by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • brompheniramine

              brompheniramine and marijuana both increase sedation. Use Caution/Monitor.

            • budesonide

              marijuana will increase the level or effect of budesonide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • buprenorphine

              buprenorphine and marijuana both increase sedation. Use Caution/Monitor.

            • buprenorphine buccal

              buprenorphine buccal and marijuana both increase sedation. Use Caution/Monitor.

            • buspirone

              marijuana will increase the level or effect of buspirone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • butabarbital

              butabarbital and marijuana both increase sedation. Use Caution/Monitor.

            • butalbital

              butalbital and marijuana both increase sedation. Use Caution/Monitor.

            • butorphanol

              butorphanol and marijuana both increase sedation. Use Caution/Monitor.

            • caffeine

              marijuana increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • carbamazepine

              marijuana will increase the level or effect of carbamazepine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              carbamazepine will decrease the level or effect of marijuana by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • carbinoxamine

              carbinoxamine and marijuana both increase sedation. Use Caution/Monitor.

            • carisoprodol

              carisoprodol and marijuana both increase sedation. Use Caution/Monitor.

            • carvedilol

              marijuana will increase the level or effect of carvedilol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • cenobamate

              cenobamate will decrease the level or effect of marijuana by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Increase dose of CYP3A4 substrate, as needed, when coadministered with cenobamate.

            • chloral hydrate

              chloral hydrate and marijuana both increase sedation. Use Caution/Monitor.

            • chlordiazepoxide

              chlordiazepoxide and marijuana both increase sedation. Use Caution/Monitor.

            • chlorpheniramine

              chlorpheniramine and marijuana both increase sedation. Use Caution/Monitor.

            • chlorpromazine

              chlorpromazine and marijuana both increase sedation. Use Caution/Monitor.

            • chlorpropamide

              marijuana decreases effects of chlorpropamide by pharmacodynamic antagonism. Use Caution/Monitor.

            • chlorzoxazone

              chlorzoxazone and marijuana both increase sedation. Use Caution/Monitor.

            • cilostazol

              marijuana will increase the level or effect of cilostazol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • cinacalcet

              marijuana will increase the level or effect of cinacalcet by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • cinnarizine

              cinnarizine and marijuana both increase sedation. Use Caution/Monitor.

            • clarithromycin

              clarithromycin will increase the level or effect of marijuana by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • clemastine

              clemastine and marijuana both increase sedation. Use Caution/Monitor.

            • clobetasone

              marijuana will increase the level or effect of clobetasone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • clomipramine

              marijuana will increase the level or effect of clomipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

              clomipramine and marijuana both increase sedation. Use Caution/Monitor.

            • clonazepam

              clonazepam and marijuana both increase sedation. Use Caution/Monitor.

            • clopidogrel

              marijuana will decrease the level or effect of clopidogrel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Inhibition of CYP3A4 will reduce clopidogrel bioactivation

            • clorazepate

              clorazepate and marijuana both increase sedation. Use Caution/Monitor.

            • clozapine

              marijuana will increase the level or effect of clozapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              clozapine and marijuana both increase sedation. Use Caution/Monitor.

            • codeine

              codeine and marijuana both increase sedation. Use Caution/Monitor.

            • conivaptan

              marijuana will increase the level or effect of conivaptan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              conivaptan will increase the level or effect of marijuana by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • conjugated estrogens

              marijuana will increase the level or effect of conjugated estrogens by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • conjugated estrogens, vaginal

              marijuana will increase the level or effect of conjugated estrogens, vaginal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • cortisone

              marijuana will increase the level or effect of cortisone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • cyclizine

              cyclizine and marijuana both increase sedation. Use Caution/Monitor.

            • cyclobenzaprine

              cyclobenzaprine and marijuana both increase sedation. Use Caution/Monitor.

            • cyproheptadine

              cyproheptadine and marijuana both increase sedation. Use Caution/Monitor.

            • dantrolene

              dantrolene and marijuana both increase sedation. Use Caution/Monitor.

            • darifenacin

              marijuana will increase the level or effect of darifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • darunavir

              marijuana will increase the level or effect of darunavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              darunavir will increase the level or effect of marijuana by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • dasatinib

              marijuana will increase the level or effect of dasatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • desipramine

              marijuana will increase the level or effect of desipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

              desipramine and marijuana both increase sedation. Use Caution/Monitor.

            • dexamethasone

              marijuana will increase the level or effect of dexamethasone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • dexchlorpheniramine

              dexchlorpheniramine and marijuana both increase sedation. Use Caution/Monitor.

            • dexfenfluramine

              marijuana increases and dexfenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dexmedetomidine

              dexmedetomidine and marijuana both increase sedation. Use Caution/Monitor.

            • dexmethylphenidate

              marijuana increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dextroamphetamine

              marijuana increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dextromoramide

              dextromoramide and marijuana both increase sedation. Use Caution/Monitor.

            • diamorphine

              diamorphine and marijuana both increase sedation. Use Caution/Monitor.

            • diazepam

              marijuana will increase the level or effect of diazepam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              diazepam and marijuana both increase sedation. Use Caution/Monitor.

            • diethylpropion

              marijuana increases and diethylpropion decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • difenoxin hcl

              difenoxin hcl and marijuana both increase sedation. Use Caution/Monitor.

            • diltiazem

              diltiazem will increase the level or effect of marijuana by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • dimenhydrinate

              dimenhydrinate and marijuana both increase sedation. Use Caution/Monitor.

            • diphenhydramine

              diphenhydramine and marijuana both increase sedation. Use Caution/Monitor.

            • diphenoxylate hcl

              diphenoxylate hcl and marijuana both increase sedation. Use Caution/Monitor.

            • dipipanone

              dipipanone and marijuana both increase sedation. Use Caution/Monitor.

            • dobutamine

              marijuana increases and dobutamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dopamine

              marijuana increases and dopamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • dopexamine

              marijuana increases and dopexamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • doxepin

              doxepin and marijuana both increase sedation. Use Caution/Monitor.

            • doxylamine

              doxylamine and marijuana both increase sedation. Use Caution/Monitor.

            • droperidol

              droperidol and marijuana both increase sedation. Use Caution/Monitor.

            • duloxetine

              marijuana will increase the level or effect of duloxetine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • efavirenz

              efavirenz will decrease the level or effect of marijuana by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • eletriptan

              marijuana will increase the level or effect of eletriptan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • encorafenib

              encorafenib, marijuana. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Encorafenib both inhibits and induces CYP3A4 at clinically relevant plasma concentrations. Coadministration of encorafenib with sensitive CYP3A4 substrates may result in increased toxicity or decreased efficacy of these agents.

            • ephedrine

              marijuana increases and ephedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • epinephrine

              marijuana increases and epinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • epinephrine racemic

              marijuana increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • erlotinib

              marijuana will increase the level or effect of erlotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • estazolam

              estazolam and marijuana both increase sedation. Use Caution/Monitor.

            • estradiol

              marijuana will increase the level or effect of estradiol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • estrogens conjugated synthetic

              marijuana will increase the level or effect of estrogens conjugated synthetic by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • estropipate

              marijuana will increase the level or effect of estropipate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • ethanol

              ethanol and marijuana both increase sedation. Use Caution/Monitor.

            • etonogestrel

              marijuana will increase the level or effect of etonogestrel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • etravirine

              marijuana will increase the level or effect of etravirine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • fedratinib

              fedratinib will increase the level or effect of marijuana by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Adjust dose of drugs that are CYP3A4 substrates as necessary.

            • felodipine

              marijuana will increase the level or effect of felodipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • fenfluramine

              marijuana increases and fenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • fesoterodine

              marijuana will increase the level or effect of fesoterodine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • flecainide

              marijuana will increase the level or effect of flecainide by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • fludrocortisone

              marijuana will increase the level or effect of fludrocortisone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • fluphenazine

              fluphenazine and marijuana both increase sedation. Use Caution/Monitor.

            • flurazepam

              flurazepam and marijuana both increase sedation. Use Caution/Monitor.

            • formoterol

              marijuana increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • fosamprenavir

              marijuana will increase the level or effect of fosamprenavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • fosphenytoin

              fosphenytoin will decrease the level or effect of marijuana by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • glimepiride

              marijuana decreases effects of glimepiride by pharmacodynamic antagonism. Use Caution/Monitor.

            • glipizide

              marijuana decreases effects of glipizide by pharmacodynamic antagonism. Use Caution/Monitor.

            • glyburide

              marijuana decreases effects of glyburide by pharmacodynamic antagonism. Use Caution/Monitor.

            • haloperidol

              marijuana will increase the level or effect of haloperidol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

              haloperidol and marijuana both increase sedation. Use Caution/Monitor.

            • hydrocodone

              marijuana will increase the level or effect of hydrocodone by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor. Hydromorphone (<3% of the circulating parent hydrocodone) is mainly formed by CYP2D6 mediated O-demethylation of hydrocodone. Hydromorphone may contribute to the total analgesic effect of hydrocodone.

            • hydrocortisone

              marijuana will increase the level or effect of hydrocortisone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • hydromorphone

              marijuana will increase the level or effect of hydromorphone by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

              hydromorphone and marijuana both increase sedation. Use Caution/Monitor.

            • hydroxyprogesterone caproate

              marijuana will increase the level or effect of hydroxyprogesterone caproate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • hydroxyzine

              hydroxyzine and marijuana both increase sedation. Use Caution/Monitor.

            • idelalisib

              idelalisib will increase the level or effect of marijuana by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • iloperidone

              marijuana will increase the level or effect of iloperidone by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

              marijuana will increase the level or effect of iloperidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              iloperidone and marijuana both increase sedation. Use Caution/Monitor.

            • imipramine

              marijuana will increase the level or effect of imipramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

              imipramine and marijuana both increase sedation. Use Caution/Monitor.

            • indinavir

              marijuana will increase the level or effect of indinavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              indinavir will increase the level or effect of marijuana by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • insulin aspart

              marijuana decreases effects of insulin aspart by pharmacodynamic antagonism. Use Caution/Monitor.

            • insulin detemir

              marijuana decreases effects of insulin detemir by pharmacodynamic antagonism. Use Caution/Monitor.

            • insulin glargine

              marijuana decreases effects of insulin glargine by pharmacodynamic antagonism. Use Caution/Monitor.

            • insulin glulisine

              marijuana decreases effects of insulin glulisine by pharmacodynamic antagonism. Use Caution/Monitor.

            • insulin lispro

              marijuana decreases effects of insulin lispro by pharmacodynamic antagonism. Use Caution/Monitor.

            • insulin NPH

              marijuana decreases effects of insulin NPH by pharmacodynamic antagonism. Use Caution/Monitor.

            • insulin regular human

              marijuana decreases effects of insulin regular human by pharmacodynamic antagonism. Use Caution/Monitor.

            • isoproterenol

              marijuana increases and isoproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • istradefylline

              istradefylline will increase the level or effect of marijuana by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Istradefylline 40 mg/day increased peak levels and AUC of CYP3A4 substrates in clinical trials. This effect was not observed with istradefylline 20 mg/day. Consider dose reduction of sensitive CYP3A4 substrates.

            • itraconazole

              itraconazole will increase the level or effect of marijuana by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • ixabepilone

              marijuana will increase the level or effect of ixabepilone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • ketoconazole

              ketoconazole will increase the level or effect of marijuana by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • ketotifen, ophthalmic

              ketotifen, ophthalmic and marijuana both increase sedation. Use Caution/Monitor.

            • lapatinib

              marijuana will increase the level or effect of lapatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • levalbuterol

              marijuana increases and levalbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • levorphanol

              levorphanol and marijuana both increase sedation. Use Caution/Monitor.

            • lisdexamfetamine

              marijuana increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • lofepramine

              marijuana will increase the level or effect of lofepramine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

              lofepramine and marijuana both increase sedation. Use Caution/Monitor.

            • lofexidine

              lofexidine and marijuana both increase sedation. Use Caution/Monitor.

            • lopinavir

              marijuana will increase the level or effect of lopinavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              lopinavir will increase the level or effect of marijuana by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • loprazolam

              loprazolam and marijuana both increase sedation. Use Caution/Monitor.

            • loratadine

              marijuana will increase the level or effect of loratadine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • lorazepam

              lorazepam and marijuana both increase sedation. Use Caution/Monitor.

            • lorlatinib

              lorlatinib will decrease the level or effect of marijuana by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • lormetazepam

              lormetazepam and marijuana both increase sedation. Use Caution/Monitor.

            • loxapine

              loxapine and marijuana both increase sedation. Use Caution/Monitor.

            • loxapine inhaled

              loxapine inhaled and marijuana both increase sedation. Use Caution/Monitor.

            • lumefantrine

              marijuana will increase the level or effect of lumefantrine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • maprotiline

              maprotiline and marijuana both increase sedation. Use Caution/Monitor.

            • maraviroc

              marijuana will increase the level or effect of maraviroc by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • melatonin

              marijuana and melatonin both increase sedation. Use Caution/Monitor.

            • meperidine

              meperidine and marijuana both increase sedation. Use Caution/Monitor.

            • meprobamate

              marijuana and meprobamate both increase sedation. Use Caution/Monitor.

            • mestranol

              marijuana will increase the level or effect of mestranol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • metaproterenol

              marijuana increases and metaproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • metaxalone

              metaxalone and marijuana both increase sedation. Use Caution/Monitor.

            • metformin

              marijuana decreases effects of metformin by pharmacodynamic antagonism. Use Caution/Monitor.

            • methadone

              marijuana will increase the level or effect of methadone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              methadone and marijuana both increase sedation. Use Caution/Monitor.

            • methamphetamine

              marijuana will increase the level or effect of methamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

              marijuana increases and methamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • methocarbamol

              methocarbamol and marijuana both increase sedation. Use Caution/Monitor.

            • methylenedioxymethamphetamine

              marijuana increases and methylenedioxymethamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • methylprednisolone

              marijuana will increase the level or effect of methylprednisolone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • metoprolol

              marijuana will increase the level or effect of metoprolol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • mexiletine

              marijuana will increase the level or effect of mexiletine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • midazolam

              marijuana will increase the level or effect of midazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              midazolam and marijuana both increase sedation. Use Caution/Monitor.

            • midodrine

              marijuana increases and midodrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • miglitol

              marijuana decreases effects of miglitol by pharmacodynamic antagonism. Use Caution/Monitor.

            • mirtazapine

              marijuana and mirtazapine both increase sedation. Use Caution/Monitor.

            • mitotane

              mitotane will decrease the level or effect of marijuana by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • modafinil

              marijuana increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • morphine

              marijuana will increase the level or effect of morphine by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

              morphine and marijuana both increase sedation. Use Caution/Monitor.

            • motherwort

              marijuana and motherwort both increase sedation. Use Caution/Monitor.

            • moxonidine

              marijuana and moxonidine both increase sedation. Use Caution/Monitor.

            • nabilone

              marijuana and nabilone both increase sedation. Use Caution/Monitor.

            • nafcillin

              nafcillin will decrease the level or effect of marijuana by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • nalbuphine

              nalbuphine and marijuana both increase sedation. Use Caution/Monitor.

            • nateglinide

              marijuana decreases effects of nateglinide by pharmacodynamic antagonism. Use Caution/Monitor.

            • nebivolol

              marijuana will increase the level or effect of nebivolol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • nefazodone

              nefazodone will increase the level or effect of marijuana by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • nelfinavir

              marijuana will increase the level or effect of nelfinavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              nelfinavir will increase the level or effect of marijuana by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • nicardipine

              marijuana will increase the level or effect of nicardipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • nilotinib

              marijuana will increase the level or effect of nilotinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • nisoldipine

              marijuana will increase the level or effect of nisoldipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • norepinephrine

              marijuana increases and norepinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • nortriptyline

              marijuana will increase the level or effect of nortriptyline by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

              nortriptyline and marijuana both increase sedation. Use Caution/Monitor.

            • olanzapine

              olanzapine and marijuana both increase sedation. Use Caution/Monitor.

            • opium tincture

              opium tincture and marijuana both increase sedation. Use Caution/Monitor.

            • orphenadrine

              orphenadrine and marijuana both increase sedation. Use Caution/Monitor.

            • ospemifene

              marijuana, ospemifene. Either increases levels of the other by plasma protein binding competition. Modify Therapy/Monitor Closely.

            • oxazepam

              oxazepam and marijuana both increase sedation. Use Caution/Monitor.

            • oxycodone

              marijuana will increase the level or effect of oxycodone by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

              oxycodone and marijuana both increase sedation. Use Caution/Monitor.

            • oxymorphone

              marijuana will increase the level or effect of oxymorphone by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

              oxymorphone and marijuana both increase sedation. Use Caution/Monitor.

            • paliperidone

              paliperidone and marijuana both increase sedation. Use Caution/Monitor.

            • papaveretum

              papaveretum and marijuana both increase sedation. Use Caution/Monitor.

            • papaverine

              marijuana and papaverine both increase sedation. Use Caution/Monitor.

            • pazopanib

              marijuana will increase the level or effect of pazopanib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Avoid coadministration of pazopanib with strong CYP3A4 inhibitors if possible; if must coadminister, decrease pazopanib dose to 400 mg/day

            • pentazocine

              pentazocine and marijuana both increase sedation. Use Caution/Monitor.

            • pentobarbital

              pentobarbital and marijuana both increase sedation. Use Caution/Monitor.

            • perphenazine

              perphenazine and marijuana both increase sedation. Use Caution/Monitor.

            • phendimetrazine

              marijuana increases and phendimetrazine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • phenobarbital

              phenobarbital and marijuana both increase sedation. Use Caution/Monitor.

              phenobarbital will decrease the level or effect of marijuana by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • phentermine

              marijuana increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • phenylephrine

              marijuana increases and phenylephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • phenylephrine PO

              marijuana increases and phenylephrine PO decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .

            • phenytoin

              phenytoin will decrease the level or effect of marijuana by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • pholcodine

              marijuana and pholcodine both increase sedation. Use Caution/Monitor.

            • pimozide

              pimozide and marijuana both increase sedation. Use Caution/Monitor.

            • pioglitazone

              marijuana decreases effects of pioglitazone by pharmacodynamic antagonism. Use Caution/Monitor.

            • pirbuterol

              marijuana increases and pirbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • posaconazole

              posaconazole will increase the level or effect of marijuana by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • prednisolone

              marijuana will increase the level or effect of prednisolone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • prednisone

              marijuana will increase the level or effect of prednisone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • primidone

              primidone and marijuana both increase sedation. Use Caution/Monitor.

              primidone will decrease the level or effect of marijuana by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • prochlorperazine

              prochlorperazine and marijuana both increase sedation. Use Caution/Monitor.

            • promethazine

              promethazine and marijuana both increase sedation. Use Caution/Monitor.

            • propafenone

              marijuana will increase the level or effect of propafenone by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • propranolol

              marijuana will increase the level or effect of propranolol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • propylhexedrine

              marijuana increases and propylhexedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • protriptyline

              protriptyline and marijuana both increase sedation. Use Caution/Monitor.

            • quazepam

              quazepam and marijuana both increase sedation. Use Caution/Monitor.

            • quetiapine

              marijuana will increase the level or effect of quetiapine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              quetiapine and marijuana both increase sedation. Use Caution/Monitor.

            • quinidine

              marijuana will increase the level or effect of quinidine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • ramelteon

              marijuana and ramelteon both increase sedation. Use Caution/Monitor.

            • repaglinide

              marijuana will increase the level or effect of repaglinide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              marijuana decreases effects of repaglinide by pharmacodynamic antagonism. Use Caution/Monitor.

            • ribociclib

              ribociclib will increase the level or effect of marijuana by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • rifampin

              rifampin will decrease the level or effect of marijuana by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • rifapentine

              rifapentine will decrease the level or effect of marijuana by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • risperidone

              risperidone and marijuana both increase sedation. Use Caution/Monitor.

            • ritonavir

              marijuana will increase the level or effect of ritonavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              ritonavir will increase the level or effect of marijuana by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • rosiglitazone

              marijuana decreases effects of rosiglitazone by pharmacodynamic antagonism. Use Caution/Monitor.

            • rucaparib

              rucaparib will increase the level or effect of marijuana by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP3A4 substrates, if clinically indicated.

            • salmeterol

              marijuana increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • saquinavir

              marijuana will increase the level or effect of saquinavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              saquinavir will increase the level or effect of marijuana by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • saxagliptin

              marijuana decreases effects of saxagliptin by pharmacodynamic antagonism. Use Caution/Monitor.

            • scullcap

              marijuana and scullcap both increase sedation. Use Caution/Monitor.

            • secobarbital

              secobarbital and marijuana both increase sedation. Use Caution/Monitor.

            • shepherd's purse

              marijuana and shepherd's purse both increase sedation. Use Caution/Monitor.

            • sitagliptin

              marijuana decreases effects of sitagliptin by pharmacodynamic antagonism. Use Caution/Monitor.

            • solifenacin

              marijuana will increase the level or effect of solifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • stiripentol

              stiripentol, marijuana. affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Stiripentol is a CYP3A4 inhibitor and inducer. Monitor CYP3A4 substrates coadministered with stiripentol for increased or decreased effects. CYP3A4 substrates may require dosage adjustment.

              stiripentol, marijuana. Either increases effects of the other by sedation. Use Caution/Monitor. Concomitant use stiripentol with other CNS depressants, including alcohol, may increase the risk of sedation and somnolence.

            • sufentanil

              sufentanil and marijuana both increase sedation. Use Caution/Monitor.

            • sunitinib

              marijuana will increase the level or effect of sunitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • tacrolimus

              marijuana will increase the level or effect of tacrolimus by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • tadalafil

              marijuana will increase the level or effect of tadalafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • tapentadol

              tapentadol and marijuana both increase sedation. Use Caution/Monitor.

            • tazemetostat

              tazemetostat will decrease the level or effect of marijuana by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • temazepam

              temazepam and marijuana both increase sedation. Use Caution/Monitor.

            • temsirolimus

              marijuana will increase the level or effect of temsirolimus by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • terbutaline

              marijuana increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • theophylline

              marijuana will increase the level or effect of theophylline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • thioridazine

              thioridazine and marijuana both increase sedation. Use Caution/Monitor.

            • thiothixene

              thiothixene and marijuana both increase sedation. Use Caution/Monitor.

            • timolol

              marijuana will increase the level or effect of timolol by affecting hepatic enzyme CYP2D6 metabolism. Use Caution/Monitor.

            • tipranavir

              marijuana will increase the level or effect of tipranavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • tolazamide

              marijuana decreases effects of tolazamide by pharmacodynamic antagonism. Use Caution/Monitor.

            • tolbutamide

              marijuana decreases effects of tolbutamide by pharmacodynamic antagonism. Use Caution/Monitor.

            • tolterodine

              marijuana will increase the level or effect of tolterodine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • topiramate

              marijuana and topiramate both increase sedation. Modify Therapy/Monitor Closely.

            • tramadol

              tramadol and marijuana both increase sedation. Use Caution/Monitor.

            • trazodone

              marijuana will increase the level or effect of trazodone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              trazodone and marijuana both increase sedation. Use Caution/Monitor.

            • triamcinolone acetonide injectable suspension

              marijuana will increase the level or effect of triamcinolone acetonide injectable suspension by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • triazolam

              marijuana will increase the level or effect of triazolam by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              triazolam and marijuana both increase sedation. Use Caution/Monitor.

            • triclofos

              triclofos and marijuana both increase sedation. Use Caution/Monitor.

            • trifluoperazine

              trifluoperazine and marijuana both increase sedation. Use Caution/Monitor.

            • trimipramine

              trimipramine and marijuana both increase sedation. Use Caution/Monitor.

            • triprolidine

              triprolidine and marijuana both increase sedation. Use Caution/Monitor.

            • vardenafil

              marijuana will increase the level or effect of vardenafil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • verapamil

              marijuana will increase the level or effect of verapamil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • vildagliptin

              marijuana decreases effects of vildagliptin by pharmacodynamic antagonism. Use Caution/Monitor.

            • voriconazole

              voriconazole will increase the level or effect of marijuana by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • warfarin

              marijuana will increase the level or effect of warfarin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • xylometazoline

              marijuana increases and xylometazoline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • yohimbine

              marijuana increases and yohimbine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.

            • ziconotide

              marijuana and ziconotide both increase sedation. Use Caution/Monitor.

            • ziprasidone

              ziprasidone and marijuana both increase sedation. Use Caution/Monitor.

            Minor (75)

            • alfentanil

              marijuana will increase the level or effect of alfentanil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • alfuzosin

              marijuana will increase the level or effect of alfuzosin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • alosetron

              marijuana will increase the level or effect of alosetron by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • amitriptyline

              marijuana will increase the level or effect of amitriptyline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • aripiprazole

              marijuana will increase the level or effect of aripiprazole by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • armodafinil

              marijuana will increase the level or effect of armodafinil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • atazanavir

              marijuana will increase the level or effect of atazanavir by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • bosentan

              marijuana will increase the level or effect of bosentan by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • cevimeline

              marijuana will increase the level or effect of cevimeline by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • chlorpromazine

              marijuana will increase the level or effect of chlorpromazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • clarithromycin

              marijuana will increase the level or effect of clarithromycin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • clomipramine

              marijuana will increase the level or effect of clomipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • codeine

              marijuana will increase the level or effect of codeine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • dapsone

              marijuana will increase the level or effect of dapsone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • desipramine

              marijuana will increase the level or effect of desipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • dexfenfluramine

              marijuana will increase the level or effect of dexfenfluramine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • dextroamphetamine

              marijuana will increase the level or effect of dextroamphetamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • dextromethorphan

              marijuana will increase the level or effect of dextromethorphan by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • disopyramide

              marijuana will increase the level or effect of disopyramide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • docetaxel

              marijuana will increase the level or effect of docetaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • donepezil

              marijuana will increase the level or effect of donepezil by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

              marijuana will increase the level or effect of donepezil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • doxepin

              marijuana will increase the level or effect of doxepin by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • dutasteride

              marijuana will increase the level or effect of dutasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • efavirenz

              marijuana will increase the level or effect of efavirenz by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • encainide

              marijuana will increase the level or effect of encainide by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • eplerenone

              marijuana will increase the level or effect of eplerenone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • eucalyptus

              marijuana will increase the level or effect of eucalyptus by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              eucalyptus and marijuana both increase sedation. Minor/Significance Unknown.

            • fesoterodine

              marijuana will increase the level or effect of fesoterodine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • finasteride

              marijuana will increase the level or effect of finasteride by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • fluoxetine

              marijuana will increase the level or effect of fluoxetine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • fluphenazine

              marijuana will increase the level or effect of fluphenazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • galantamine

              marijuana will increase the level or effect of galantamine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

              marijuana will increase the level or effect of galantamine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • imatinib

              marijuana will increase the level or effect of imatinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • imipramine

              marijuana will increase the level or effect of imipramine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • isradipine

              marijuana will increase the level or effect of isradipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • itraconazole

              marijuana will increase the level or effect of itraconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • ketoconazole

              marijuana will increase the level or effect of ketoconazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • loratadine

              marijuana will increase the level or effect of loratadine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • montelukast

              marijuana will increase the level or effect of montelukast by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • nifedipine

              marijuana will increase the level or effect of nifedipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • nimodipine

              marijuana will increase the level or effect of nimodipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • nitrendipine

              marijuana will increase the level or effect of nitrendipine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • oxybutynin

              marijuana will increase the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • paclitaxel

              marijuana will increase the level or effect of paclitaxel by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • paclitaxel protein bound

              marijuana will increase the level or effect of paclitaxel protein bound by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • parecoxib

              marijuana will increase the level or effect of parecoxib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • paroxetine

              marijuana will increase the level or effect of paroxetine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • perhexiline

              marijuana will increase the level or effect of perhexiline by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • perphenazine

              marijuana will increase the level or effect of perphenazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • pimozide

              marijuana will increase the level or effect of pimozide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • pioglitazone

              marijuana will increase the level or effect of pioglitazone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • prochlorperazine

              marijuana will increase the level or effect of prochlorperazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • promazine

              marijuana will increase the level or effect of promazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • promethazine

              marijuana will increase the level or effect of promethazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • propafenone

              marijuana will increase the level or effect of propafenone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • quinine

              marijuana will increase the level or effect of quinine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • rabeprazole

              marijuana will increase the level or effect of rabeprazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • ramelteon

              marijuana will increase the level or effect of ramelteon by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • risperidone

              marijuana will increase the level or effect of risperidone by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • sage

              marijuana and sage both increase sedation. Minor/Significance Unknown.

            • saxagliptin

              marijuana will increase the level or effect of saxagliptin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • sufentanil

              marijuana will increase the level or effect of sufentanil by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • tamoxifen

              marijuana will increase the level or effect of tamoxifen by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • tolterodine

              marijuana will increase the level or effect of tolterodine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • tramadol

              marijuana will increase the level or effect of tramadol by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • trifluoperazine

              marijuana will increase the level or effect of trifluoperazine by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • tropisetron

              marijuana will increase the level or effect of tropisetron by affecting hepatic enzyme CYP2D6 metabolism. Minor/Significance Unknown.

            • vinblastine

              marijuana will increase the level or effect of vinblastine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • vincristine

              marijuana will increase the level or effect of vincristine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • vincristine liposomal

              marijuana will increase the level or effect of vincristine liposomal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • vinorelbine

              marijuana will increase the level or effect of vinorelbine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • zaleplon

              marijuana will increase the level or effect of zaleplon by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • ziprasidone

              marijuana will increase the level or effect of ziprasidone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • zolpidem

              marijuana will increase the level or effect of zolpidem by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • zonisamide

              marijuana will increase the level or effect of zonisamide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            Previous
            Next:

            Adverse Effects

            Frequency Not Defined

            Tolerance

            Psychological or physical dependence

            Withdrawal symptoms

            Altered sensorium

            Dizziness

            Somnolence

            Fatigue

            Reduced coordination

            Cognitive impairment

            Impaired balance

            Euphoria

            Paranoia

            Hallucinations

            Mood alterations

            Panic

            Anxiety

            Hypotension

            Hypertension

            Tachycardia

            Flushing

            Syncope

            Xerostomia

            Nausea

            Vomiting

            Dysgeusia

            Tooth discoloration

            Anorexia

            Increased appetite

            Oral candidiasis

            Diarrhea

            Constipation

            Urinary retention

            Skin rash

            Dry eyes

            Blurred vision

            Allergy

            Cough

            Pharyngitis

            Previous
            Next:

            Warnings

            Contraindications

            Hypersensitivity

            Coadministration with dronabinol (Cannabis derivative)

            Cautions

            History of substance abuse or mental illness

            Hepatic disease

            Cardiovascular disease

            Seizure disorders

            Nonpharmaceutical preparations contaminated with the fungus which may be hazardous to patients with compromised immune systems

            Geriatric patients

            Operating machinery or driving

            Drug interactions

            • May potenitate CNS depression w/ concomitant use with CNS depressants (eg, barbiturates, ethanol, anxiolytics, sedatives, and hypnotics, sedating H1-blockers, SSRIs, TCAs)
            • Use of marijuana with sedating anticholinergics may result in additive tachycardia and drowsiness
            • Other: cocaine, disulfiram, ethanol, protease inhibitors, sildenafil, theophylline, cyclophosphamide, doxorubicin
            • Cannabidiol, an inactive constituent of cannabis, may weakly inhibit cytochrome P450 enzymes (CYP1A2, 2C19, 2D6, & 3A4)
            • Cannabis is also a minor substrate for CYP2C9, 2C19, 2D6, 3A4
            Previous
            Next:

            Pregnancy & Lactation

            Pregnancy

            FDA pregnancy category not available; insufficient data regarding safety to fetus, avoid use

            Case-control study reported maternal use and childhood acute nonlymphoblastic leukemia (ANLL); Children’s Cancer Study Group report 10-fold increase of ANLL w/ maternal use (Robison et al, 1989; Briggs, 1998)

            Some sources found increased risk for low birth weight w/ maternal use

            Lactation

            THC found in Marijuana is reported to be concentrated and secreted into breast milk

            Pregnancy Categories

            A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA: Information not available.

            Previous
            Next:

            Pharmacology

            Mechanism of Action

            Tetrahydrocannabinol (THC), a component of marijuana, acts both centrally and peripherally on endogenous cannabinoid receptors; activation of cannabinoid receptors affects serotonin release, increases catecholamines, inhibits parasympathetic activity, and inhibits prostaglandin biosynthesis

            Pharmacokinetics

            Absorption: 10-20% (inhaled); 1-10% (PO)

            Onset of action: 6-12 min (inhaled); 30-120 min (PO)

            Peak effect: 20-30 min (inhaled); 2-3 hrs (PO)

            Toxic dose (THC): 15 mg/kg; Lethal dose: 30 mg/kg

            Duration of effect: 2-6 hrs

            Vd: 10 L/kg (increases with chronic use)

            Protein Bound: 97-99%

            Metabolism: Hepatic hydroxylation to active and inactive metabolites, then further metabolized by alcohol dehydrogenase or alternatively, metabolites can be further oxidized to more polar compounds and glucuronide conjugates

            Excretion: Feces 30-50%; 10-16% excreted in the urine as metabolites

            Half-life: 28 hr (56 hr chronic use)

            Previous
            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.