Now that medical marijuana is legal in most states, more questions about its interactions with other medications are emerging by the day. The answers aren’t that clear— mostly due to insufficient scientific data. If you search on the internet about this topic, chances are you’ll end up even more confused.
There are many baseless assertions. Some people will take the chance to stop using weed altogether, regardless of the many health benefits it could have on your mental and physical health.
To help you navigate through the uncertainty, MDBerry has some good advice: Consult your doctor. Your physician knows more about your prescription and medical history and can furnish you with key interaction data on the spot.
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Drugs Are Metabolized in the Liver
Weed, like other medications, has diverse formulations and administration pathways, including smoking and inhalation, oral prescriptions, sublingual (oral-mucosal), and injections.
Even though generally considered safe, weed is a drug. Like prescription medication, marijuana can cause serious drug-drug interactions, with some being harmful. To understand how muscle relaxers and weed may play out in your body, we must zoom in on the liver.
Drugs get processed by enzymes in the liver. These are mainly the cytochrome P450 (CYP) category of enzymes. Among them, CYP3A4 is the primary drug metabolism enzyme in the liver, breaking down an estimated 50 % of all clinical prescription medicines.
The CYP enzymes have been linked to many clinically significant drug-drug interactions. Some drugs, including muscle relaxers, induce the enzymes’ medication metabolism while others inhibit the process.
The interactions lead to changes in the concentrations of the drugs in the body, plus their pharmacokinetic properties. For instance, if a drug inhibits CYP3A4, it slows the metabolic process, leading to a build-up of drug concentrates and elevating the risk for side effects and toxicity.
Weed’s prominent compounds, CBD and THC, are metabolized by the enzyme CYP3A4. The psychoactive THC is additionally metabolized by CYP2C19 and CYP2C9.
When you mix muscle relaxers and weed, CBD and THC can induce or inhibit the metabolic process. CBD is a powerful inhibitor of CYP2D6 and CYP3A4, whereas THC induces CYP1A2.
Muscle Relaxants Drugs and Weed
Here’s a breakdown of muscle relaxers known to have drug-drug interactions with weed.
Methocarbamol and Weed
Methocarbamol or Robaxin is a well-researched prescription muscle relaxer for back pain. It’s also very affordable and comparatively less sedating. 44 % of people who use it report fast pain relief.
However, mixing the back muscle relaxer with weed can be a bad call. Because CBD and THC can inhibit the CYP liver enzymes metabolic activity, they can elevate Methocarbamol levels and thereby increase its sedative effects, leading to drowsiness, dizziness, and blurry vision.
Diazepam and Weed
Diazepam or valium is one of the muscle relaxers for pelvic floor dysfunction. It is also used to treat seizures, anxiety, and alcohol withdrawal to provide sedation before surgical procedures. Diazepam medication works by sedating the brain and nerves and is often accompanied by side effects such as muscle cramps and vomiting.
Speak to your doctor before mixing weed and diazepam. Using diazepam with weed can increase its sedative effects by inducing the liver metabolites responsible for its breakdown. Those who smoke weed and take the drug often report dizziness, confusion, drowsiness, and trouble concentrating. Among the elderly using weed and muscle relaxants, side effects can be as severe as impaired motor coordination and impaired thinking and judgment.
Carisoprodol and Weed
Carisoprodol is one of the many muscle relaxers for neck pain. It blocks pain sensations between your nerves and the brain. The medication is normally used together with physical therapy and rest to treat musculoskeletal conditions like pain or injury.
However, this is a schedule IV drug that gets rarely prescribed because it can be abused. If you are prescribed this medication, steer clear of weed for the period you will be taking it. The interactions can cause drowsiness and dizziness and increase the potentiality for addiction to Carisoprodol.
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Chlorzoxazone and Weed
If you have lower back pain or after spine surgery, your doctor may prescribe Chlorzoxazone. This is one of those muscle relaxants injections that are rarely prescribed because of the risk of acute liver toxicity. However, the medication is still largely used where there are no other options.
CBD inhibits CYP2D6 and CYP3A4 drug metabolites and may thus reduce the effectiveness of this medication. Side effects of mixing the muscle relaxant and weed include more headaches, tiredness, and increased risk of liver toxicity due to slowed metabolism of the drug.
Baclofen and Weed
Muscle relaxers and breastfeeding are highly discouraged by physicians. Instead, they may prescribe OTC painkillers. Even so, Baclofen is said to be one of the safest muscle relaxers for breastfeeding mothers because it carries little risk for infants. The medication is effective against spinal cord injuries, back pain, and multiple sclerosis or spinal cord injuries.
If you get a prescription for Baclofen when breastfeeding, it might be wise to avoid weed. First off, weed and breastfeeding pose grave risks to the infant, including slow weight gain and cognitive developmental problems—these happen when THC and CBD pass from the mother’s milk to the baby.
Second, combining weed and Baclofen can lead to side effects such as confusion, dizziness, and drowsiness. This cloud has a silver lining, though: scientists believe that Baclofen reduces the side effects and withdrawal symptoms of weed. However, the drug has not yet been greenlighted for use against marijuana dependence.
Muscle Relaxers and Alcohol
The above commonly prescribed muscle relaxants drugs don’t play nice with alcohol. Here is why: muscle relaxers depress or sedate the central nervous systems in the same way alcohol does. They slow down brain function, breathing, and heart rate. If you mix the two, you double these effects.
Side effects of mixing muscle relaxers and alcohol include seizures, slowed breathing, dizziness, and motor coordination problems.
If you add weed to the mix, the THC may elevate the high from the alcohol, while the CBD in it may intensify the sedative effects of muscle relaxants. No studies have been done on this.
A review paper in the American Journal of Health-System Pharmacy states:
If marijuana is used with alcohol and benzodiazepines (most muscle relaxants), the result can be “central nervous system depression,” which means reduced heart rate, reduced breathing, and loss of consciousness.
Need to safely use medical marijuana? Ask your doctor. If you are on any prescription, it may or may not interact with weed. Your doctor knows best.
Doctors can help to:
- Identify the popular adverse effects of mixing muscle relaxers and weed.
- Highlight contraindications when using medical marijuana
- Explain medical marijuana drug interactions based on your medical history or current prescriptions
- Describe central nervous system, respiratory, cardiovascular, musculoskeletal, neuropsychiatric, and other risks posed by weed drug interactions.
Medical marijuana can be used to get rid of muscle spasms. Click the button below to get your medical marijuana card.
Use a Medical Marijuana Card to Be on the Safe Side
Prescribed medical marijuana, where doctors are part of the conversation, can save you from adverse risks of cannabis drug interactions. At MDBerry, what we do best is helping you get a medical marijuana card from the comfort of your home.
It’s fast and easy to get your medical marijuana card with us. The short process entails completing your application online and talking to our licensed physicians. If you are approved, you get your medical cannabis certificate on the same day. If you are not approved, you get your money back.