Cannabis and interaction with other drugs

[DANZIG]

Cannabis and interaction with other drugs

Leo Hollister

Although medical cannabis is not officially approved, cannabis has been tried empirically for treating a variety of medical disorders, such as nausea and vomiting associated with cancer chemotherapy, weight loss associated with AIDS, and spasticity from neurological diseases.

In each instance, other drugs are also present. So far, no adverse interactions from such use have been reported. However, this might not reflect the true frequency. Unless one looks for something, one is not likely to find it. The published literature, at least in regard to studies with humans, has been rather silent. Usually this silence indicates that no meaningful interactions have been observed in the real life use of marijuana as compared with experimental studies

One of the most reasonable therapeutic uses of cannabis and THC has been to ameliorate the nausea and vomiting associated with cancer chemotherapy. Thus, cannabinoids will be used simultaneously with many highly toxic cancer drugs. In none of the reports of use of THC or marihuana in patients simultaneously undergoing cancer chemotherapy has there been any mention of increased toxicity of anticancer drugs.

In one animal study in which THC was given with muscle relaxants, it was found to increase the desired effect of the latter drugs. In this case, the interaction might be advantageous.

(Please note: This text has been taken from a scientific article. Some sentences have been changed to improve understandability.). Interactions of cannabis and D9-THC with other drugs. In: Nahas G, Sutin KM, Harvey DJ, Agurell S, eds. Marihuana and medicine. Totowa, NJ: Humana Press, 1999

Franjo Grotenhermen

Cannabis and dronabinol (THC) have been used in combination with a multitude of medications without significant deleterious drug interactions. Clinical studies in the beginning of the 20th century often demonstrated mutual enhancement of therapeutic effects of cannabis preparations and other drugs. In modern therapeutic concepts a combination of cannabis/THC with other medications could also be of benefit for many indications. Cannabis has been used illegally by individuals suffering from many diseases concomitantly with numerous prescription medicines

No unwanted side effects of clinical relevance have been observed to date. Other medicines may enhance or attenuate certain actions of cannabis/THC or certain actions of these medicines may be enhanced or attenuated by cannabis/THC. Moreover, it is possible that certain effects are enhanced and others reduced, as is the case with phenothiazines applied against side effects of cancer chemotherapy. Of greatest clinical relevance is reinforcement of the sedating effect of other psychotropic substances,

Pharmacology, toxicology, and therapeutic potential. Haworth Press, Binghamton/New York 2001, in press

The Medicinal Uses of Cannabis and Cannabinoids, published by Ph Press

Advises the following

Contraindications

Cannabis and cannabinoids. seem to have a very low physical toxicity. As yet there is limited knowledge on the contraindications to the use of cannabinoids as almost all information is derived from anecdotes and from studies on recreational users. As experience grows these may change. Our current contraindications are as listed below.

Absolute contraindications

• There is evidence that cannabis might precipitate a psychotic illness, particularly in those who are at risk of developing such a disorder in the future. Therefore until there is sufficient evidence, a history of psychosis should remain an absolute contraindication (Hall, 1999).

• There is evidence that there may be an interaction with levodopa and similar anti-parkinsonism drugs. Therefore use of this group of drugs is currently considered to be an absolute contraindication.

• Drugs using cytochrome P450 3A4 enzyme as their exclusive mode of metabolism (theoretically fentanyl could be a problem), until further expedience is gained

Relative contraindications

• The effects on the cardiovascular system are varied and cannot be reliably predicted. While this may be of minor importance to a healthy person there may be a risk in the presence of significant hypertension or ischaemic heart disease.

• Many patients are on a range of drugs that may affect both the CNS and the cardiovascular system. As yet we have little knowledge about the interaction of most drugs or herbal medicines with cannabinoids. The metabolism of anticoagulants such as warfarin may be affected.

• Assessing the effects of CBME on patients presenting with a complex range of symptomatology (physical, psychological and social) can present almost impossible problems. Frail and elderly patients may prove extremely sensitive to the side-effects.

• Patients who are intolerant of a wide range of psychoactive drugs. Currently it is impossible to separate the therapeutic from the psy¬choactive effects. Therefore extreme caution and slow titration is essential for this group.

• We already have concerns on the use of morphine and other psychoactive drugs in patients with actual or suspected substance misuse. Control of the use of such drugs is usually very difficult. Some too will have a history of recreational use of cannabis and may see the prescribing of CBME as a route to a regular source of high-grade material. The physician has the responsibility here in ensuring that the prescribed medicine will be used for its specified purpose. The presence in a patient's household of an individual who is a substance misuser/recreational user should also be taken into account. The presentation of the medication in a package which is tamper evident and not easy to divert for illicit use is therefore crucial.

[daisy]

is it okay for me to nick a copy of these pinned posts about cannabis - to stick on my cannabis blog... of course linking back to this forum???

[DANZIG]

is it okay for me to nick a copy of these pinned posts about cannabis - to stick on my cannabis blog...  of course linking back to this forum???

426057[/snapback]

Of course it is

Put a link to 420 as well

[daisy]

added links to BB, UK420 and THC4MS without even thinking!!

[nerchakelp]

Cannabis and interaction with other drugs

Leo Hollister

Although medical cannabis is not officially approved, cannabis has been tried empirically for treating a variety of medical disorders, such as nausea and vomiting associated with cancer chemotherapy, weight loss associated with AIDS, and spasticity from neurological diseases.

In each instance, other drugs are also present. So far, no adverse interactions from such use have been reported. However, this might not reflect the true frequency. Unless one looks for something, one is not likely to find it. The published literature, at least in regard to studies with humans, has been rather silent. Usually this silence indicates that no meaningful interactions have been observed in the real life use of marijuana as compared with experimental studies

One of the most reasonable therapeutic uses of cannabis and THC has been to ameliorate the nausea and vomiting associated with cancer chemotherapy. Thus, cannabinoids will be used simultaneously with many highly toxic cancer drugs. In none of the reports of use of THC or marihuana in patients simultaneously undergoing cancer chemotherapy has there been any mention of increased toxicity of anticancer drugs.

In one animal study in which THC was given with muscle relaxants, it was found to increase the desired effect of the latter drugs. In this case, the interaction might be advantageous.

(Please note: This text has been taken from a scientific article. Some sentences have been changed to improve understandability.). Interactions of cannabis and D9-THC with other drugs. In: Nahas G, Sutin KM, Harvey DJ, Agurell S, eds. Marihuana and medicine. Totowa, NJ: Humana Press, 1999

Franjo Grotenhermen

Cannabis and dronabinol (THC) have been used in combination with a multitude of medications without significant deleterious drug interactions. Clinical studies in the beginning of the 20th century often demonstrated mutual enhancement of therapeutic effects of cannabis preparations and other drugs. In modern therapeutic concepts a combination of cannabis/THC with other medications could also be of benefit for many indications. Cannabis has been used illegally by individuals suffering from many diseases concomitantly with numerous prescription medicines

No unwanted side effects of clinical relevance have been observed to date. Other medicines may enhance or attenuate certain actions of cannabis/THC or certain actions of these medicines may be enhanced or attenuated by cannabis/THC. Moreover, it is possible that certain effects are enhanced and others reduced, as is the case with phenothiazines applied against side effects of cancer chemotherapy. Of greatest clinical relevance is reinforcement of the sedating effect of other psychotropic substances,

Pharmacology, toxicology, and therapeutic potential. Haworth Press, Binghamton/New York 2001, in press

The Medicinal Uses of Cannabis and Cannabinoids, published by Ph Press

Advises the following

Contraindications

Cannabis and cannabinoids. seem to have a very low physical toxicity. As yet there is limited knowledge on the contraindications to the use of cannabinoids as almost all information is derived from anecdotes and from studies on recreational users. As experience grows these may change. Our current contraindications are as listed below.

Absolute contraindications

• There is evidence that cannabis might precipitate a psychotic illness, particularly in those who are at risk of developing such a disorder in the future. Therefore until there is sufficient evidence, a history of psychosis should remain an absolute contraindication (Hall, 1999).

• There is evidence that there may be an interaction with levodopa and similar anti-parkinsonism drugs. Therefore use of this group of drugs is currently considered to be an absolute contraindication.

• Drugs using cytochrome P450 3A4 enzyme as their exclusive mode of metabolism (theoretically fentanyl could be a problem), until further expedience is gained

Relative contraindications

• The effects on the cardiovascular system are varied and cannot be reliably predicted. While this may be of minor importance to a healthy person there may be a risk in the presence of significant hypertension or ischaemic heart disease.

• Many patients are on a range of drugs that may affect both the CNS and the cardiovascular system. As yet we have little knowledge about the interaction of most drugs or herbal medicines with cannabinoids. The metabolism of anticoagulants such as warfarin may be affected.

• Assessing the effects of CBME on patients presenting with a complex range of symptomatology (physical, psychological and social) can present almost impossible problems. Frail and elderly patients may prove extremely sensitive to the side-effects.

• Patients who are intolerant of a wide range of psychoactive drugs. Currently it is impossible to separate the therapeutic from the psy¬choactive effects. Therefore extreme caution and slow titration is essential for this group.

• We already have concerns on the use of morphine and other psychoactive drugs in patients with actual or suspected substance misuse. Control of the use of such drugs is usually very difficult. Some too will have a history of recreational use of cannabis and may see the prescribing of CBME as a route to a regular source of high-grade material. The physician has the responsibility here in ensuring that the prescribed medicine will be used for its specified purpose. The presence in a patient's household of an individual who is a substance misuser/recreational user should also be taken into account. The presentation of the medication in a package which is tamper evident and not easy to divert for illicit use is therefore crucial.

I smoke solid and have done since my stroke in 1999. Blood pressure down, Heart rate down, Epilepsy controlled. When i tell doctor;s i toke i dont get any adverse comment;s and i tell them all doctor;s.

[Jessiedog]

I like those pieces.

There's no reason to suspect that cannabis doesn't interact with other substances.

Who hasn't had a (good) few drinks and then toked on a fat spliff and thrown a whitey?

Woof

[Pacaman]

I've found that after a big night on a heady satvia smoke, a camomile tea brings out the body stone and helps me to sleep. It's a great way to wind down before bed.

Edit: I Don't know if you'd call this a positive interaction or not??

Edited July 15, 2006 by Pacaman

[nerchakelp]

I've found that after a big night on a heady satvia smoke, a camomile tea brings out the body stone and helps me to sleep. It's a great way to wind down before bed.

Edit: I Don't know if you'd call this a positive interaction or not??

after a few spliffs i dont anything to make me sleep, sometimes not even a bed. Water thats all i drink with my weed nothing interferes with the high { body stone } im totaly stoned mind and body.

[Pacaman]

I smoke solid and have done since my stroke in 1999. Blood pressure down, Heart rate down, Epilepsy controlled. When i tell doctor;s i toke i dont get any adverse comment;s and i tell them all doctor;s.

Vote one on the Blood pressure. Have a family history of high blood pressure and a regular toke keeps this under control.

Only wish I could convince my mum of this (I'd love to see her have a smoke )

Edited July 16, 2006 by Pacaman

[Pacaman]

after a few spliffs i dont anything to make me sleep, sometimes not even a bed. Water thats all i drink with my weed nothing interferes with the high { body stone } im totaly stoned mind and body.

I find with a heady rushy type smoke, my head get's all creative, ideas popping in, new inventions (most of which are like those dodgy Japanese thingys) etc..... and doesn't want to sleep. The Camomile slows this down a wee bit.

[nerchakelp]

Vote one on the Blood pressure. Have a family history of high blood pressure and a regular toke keeps this under control.

Only wish I could convince my mum of this (I'd love to see her have a smoke )

Yes i would have liked to have seen my dear departed mother toke, It would done her some good. And been well funny.

[Om]

For those of you who are suffering from the Hepatitis C virus and taking the treatment with ribavirin and interferon please read on

My apologies as this has already been posted but I just thought I would add a link to this THREAD here. I felt the information was a little buried where it was and it was too important to be missed.

I found cannabis to be one of the key factors for getting me through the treatment. I didn't think I was affected by the treatment too badly but some people out there really struggle with it and if there is anything that can help get them through it then maybe this thread will help. Generally the NHS only put people through the treatment if there is really no alternative so it is important the treatment works. For me I was one of the lucky ones but then I smoked all through the treatment .

Om

[GB4]

For those of you who are suffering from the Hepatitis C virus and taking the treatment with ribavirin and interferon please read on

My apologies as this has already been posted but I just thought I would add a link to this THREAD here. I felt the information was a little buried where it was and it was too important to be missed.

I found cannabis to be one of the key factors for getting me through the treatment. I didn't think I was affected by the treatment too badly but some people out there really struggle with it and if there is anything that can help get them through it then maybe this thread will help. Generally the NHS only put people through the treatment if there is really no alternative so it is important the treatment works. For me I was one of the lucky ones but then I smoked all through the treatment .

Om

Hi Om,

I've just started treatment this week. I won't be giving up smoking unless it really feels like I should - only your own body knows.

I think smoking has probably saved me a lot of liver damage over the possible 25 years I've had HCV, as it means I didn't drink so much at the least, and may have helped in many ways we don't even know yet. The story linked below and others like it came out just before I was due to start treatment so it must be some sort of Karma telling me not to pack up!!!

Even my nurse won't actually say "don't do it", all she says is that she can't tell me TO do it. If my results start going funny I may try to pack up for a bit.

Glad to hear you beat it - well done!!!!!!

http://today.reuters.com/news/articlenews....S-MARIJUANA.xml

[Digit]

i use cannabis to treat (and prevent) numerous conditions, and i did so when i was still taking the pharmaceutical drugs too. but no more. cannabis alone* i found is sufficient. inline with that which is suggested here, i too found no adverse interaction.

i, and others have noted fewer recalled dreams, suggesting that there is perhaps some interaction with DMT or it's uptake/release.

all Drs i have informed of my use of cannabis have either been neutral (seemed like they were wary of straying from a party line) or quite positive, and once with the only condition, that i still consider myself deriving medical benefit from it, mentioned.

*correct diet & other lifestyle choices too though.

[GB4]

I didn't clear my Hep C. I'm a non-responder - the only treatment we have in the UK for this hasn't worked for me. A real bastard when for my type, there is an 85% success rate.......

I would have been sectioned if I hadn't had a smoke to cool off and get to sleep while I was on interferon / ribavirin - that or I would have had to take 6 months off work, which would not have been possible.

All I can add is that even having had this for over 20 years, I don't have very much liver damage. Perhaps smoking helps to keep my liver inflamation down, slowing the virus progress.