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Does Cannabis Interact with Antibiotics?

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Can I Use Marijuana When I’m on Antibiotics?

Most people do not experience a significant interaction when combining cannabis with antibiotics. However, patients should be aware that medication interactions CAN occur with cannabis. Interactions between marijuana and antibiotics are not common but are possible. Here’s what could happen…

Interactions Between Marijuana & Antibiotics

As far as we know, cannabis does not reduce the effectiveness of antibiotics. (Incidentally, cannabis actually has antibacterial properties itself.)

However, because weed can increase the blood levels of some medicines, it can also increase the risk of side-effects. For most people, this increase is insignificant, however, it differs from person-to-person.

Maybe your best friend, Sue, didn’t have an issue, but that doesn’t necessarily mean the same will hold true for you. The thing is, Cytochrome P450 (CYP450) differs genetically, so you and Sue might have different versions, which means medications might be processed differently resulting in different reactions.

Can I use cannabis on antibiotics?

Cytochrome CYP450

Cytochrome P450 is the enzyme in the liver that metabolizes cannabinoids and some antibiotics. If you want to learn more about Cytochrome CYP450, I have a comprehensive article here: Cannabis & Zoloft.

Poly-Pharmacy Presents the Same Issue

It should be noted that medication interactions due to the CYP450 pathway are common. Every day, patients are prescribed numerous medications that all utilize the same pathway without consideration of overtaxing the system. The use of multiple prescription medications can present the same issues as marijuana combined with prescription medication.

Can I smoke weed while taking antibiotics?


Yes, cannabis can interact with some antibiotics, but usually, it’s insignificant. There’s no documented evidence of a dangerous interaction, however using cannabis may increase the risk of side effects from some medications (and that can be unpleasant and theoretically dangerous). As far as we know, cannabis does not decrease the effectiveness of antibiotics and may act as an antibiotic itself.

Patients who choose to combine marijuana and antibiotics should be aware of the potential side-effects of all medications prescribed. As always, medication use, including medical marijuana, should be discussed with your licensed healthcare provider.

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Here’s how I answered this question on Quora:

Is it considered dangerous to smoke weed while on antibiotics?

Have you ever heard the warnings not to mix grapefruit juice and when taking some medications?

For example, when a patient is taking some cholesterol medications they are advised NOT to drink grapefruit juice. This is because grapefruit juice increases the level of the medication. For some medications, like blood thinner warfarin, this can be dangerous.

So you’re smart to be concerned. Marijuana is a medication, after all, and one should always use caution when mixing medications.

The truth is, we can’t say for certain. We haven’t been able to research weed since 1937, so a lot of these questions are still waiting to be answered.

Clinically, I haven’t read of any case studies of an antibiotic interaction, however, this is what you need to know.

Marijuana inhibits a specific enzyme in the liver, cytochrome p450. This enzyme is used by many medications – including some antibiotics.

So – using some macrolide antibiotics, (including troleandomycin, erythromycins, josamycin, flurithromycin, roxithromycin, clarithromycin, miocamycin, and midecamycin) could potentially interact with marijuana.

What this means is that the effect of the medications will be increased. That also means you’d be at a higher risk of experiencing side effects and adverse reactions from the antibiotics.

Intestinal issues and cardiac side effects have been noted with some macrolide antibiotics. It should be noted that there’s research suggesting marijuana might impact the heart as well.

Guess what else affects CP450? Grapefruit juice.

Grapefruit juice isn’t bad. It just needs to be used with caution. If someone won’t give up their grapefruit juice, the doctor needs to monitor their blood levels a little more closely. The same should be done with marijuana.

Always use caution when mixing meds.

Sweetest regards,

Jessie Gill, RN


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  • Can I use cannabis while taking antibiotics?



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