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Drug Interactions between Ambien and cannabis

This report displays the potential drug interactions for the following 2 drugs:

  • Ambien (zolpidem)
  • cannabis

Interactions between your drugs

zolpidem

cannabis (Schedule I substance)

Applies to: Ambien (zolpidem) and cannabis

MONITOR: Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these effects, especially in elderly or debilitated patients. Sedation and impairment of attention, judgment, thinking, and psychomotor skills may increase.

MANAGEMENT: During concomitant use of these drugs, patients should be monitored for potentially excessive or prolonged CNS and respiratory depression. Cautious dosage titration may be required, particularly at treatment initiation. Ambulatory patients should be counseled to avoid hazardous activities requiring mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

References
  1. “Product Information. Belsomra (suvorexant).” Merck & Company Inc, Whitehouse Station, NJ.
  2. Plushner SL “Valerian: valeriana officinalis.” Am J Health Syst Pharm 57 (2000): 328-35
  3. Grabowski BS, Cady WJ, Young WW, Emery JF “Effects of acute alcohol administration on propranolol absorption.” Int J Clin Pharmacol Ther Toxicol 18 (1980): 317-9
  4. Driessen JJ, Vree TB, Booij LH, van der Pol FM, Crul JF “Effect of some benzodiazepines on peripheral neuromuscular function in the rat in-vitro hemidiaphragm preparation.” J Pharm Pharmacol 36 (1984): 244-7
  5. Feldman SA, Crawley BE “Interaction of diazepam with the muscle-relaxant drugs.” Br Med J 1 (1970): 336-8
  6. Miller LG “Herbal medicinals: selected clinical considerations focusing on known or potential drug-herb interactions.” Arch Intern Med 158 (1998): 2200-11
  7. MacLeod SM, Giles HG, Patzalek G, Thiessen JJ, Sellers EM “Diazepam actions and plasma concentrations following ethanol ingestion.” Eur J Clin Pharmacol 11 (1977): 345-9
  8. Hamilton MJ, Bush M, Smith P, Peck AW “The effects of bupropion, a new antidepressant drug, and diazepam, and their interaction in man.” Br J Clin Pharmacol 14 (1982): 791-7
  9. Stovner J, Endresen R “Intravenous anaesthesia with diazepam.” Acta Anaesthesiol Scand 24 (1965): 223-7
  10. “Product Information. Meridia (sibutramine).” Knoll Pharmaceutical Company, Whippany, NJ.
  11. Markowitz JS, Wells BG, Carson WH “Interactions between antipsychotic and antihypertensive drugs.” Ann Pharmacother 29 (1995): 603-9
  12. “Product Information. Trileptal (oxcarbazepine)” Novartis Pharmaceuticals, East Hanover, NJ.
  13. Ochs HR, Greenblatt DJ, Verburg-Ochs B “Propranolol interactions with diazepam, lorazepam and alprazolam.” Clin Pharmacol Ther 36 (1984): 451-5
  14. Ferslew KE, Hagardorn AN, McCormick WF “A fatal interaction of methocarbamol and ethanol in an accidental poisoning.” J Forensic Sci 35 (1990): 477-82
  15. “Product Information. Seroquel (quetiapine).” Zeneca Pharmaceuticals, Wilmington, DE.
  16. “Product Information. Precedex (dexmedetomidine)” Abbott Pharmaceutical, Abbott Park, IL.
  17. Cerner Multum, Inc. “Australian Product Information.” O 0
  18. “Product Information. Iopidine (apraclonidine).” Alcon Laboratories Inc, Fort Worth, TX.
  19. Naylor GJ, McHarg A “Profound hypothermia on combined lithium carbonate and diazepam treatment.” Br Med J 2 (1977): 22
  20. “Product Information. Xatral (alfuzosin).” Sanofi-Synthelabo Canada Inc, Markham, ON.
  21. Cerner Multum, Inc. “UK Summary of Product Characteristics.” O 0
  22. Sotaniemi EA, Anttila M, Rautio A, et al “Propranolol and sotalol metabolism after a drinking party.” Clin Pharmacol Ther 29 (1981): 705-10
  23. Tverskoy M, Fleyshman G, Ezry J, Bradley EL, Jr Kissin I “Midazolam-morphine sedative interaction in patients.” Anesth Analg 68 (1989): 282-5
  24. Divoll M, Greenblatt DJ, Lacasse Y, Shader RI “Benzodiazepine overdosage: plasma concentrations and clinical outcome.” Psychopharmacology (Berl) 73 (1981): 381-3
  25. “Product Information. Tasmar (tolcapone).” Valeant Pharmaceuticals, Costa Mesa, CA.
  26. “Product Information. Lexapro (escitalopram).” Forest Pharmaceuticals, St. Louis, MO.
  27. Greb WH, Buscher G, Dierdorf HD, Koster FE, Wolf D, Mellows G “The effect of liver enzyme inhibition by cimetidine and enzyme induction by phenobarbitone on the pharmacokinetics of paroxetine.” Acta Psychiatr Scand 80 Suppl (1989): 95-8
  28. “Product Information. Ultiva (remifentanil).” Mylan Institutional (formally Bioniche Pharma USA Inc), Canonsburg, PA.
  29. Lemberger L, Rowe H, Bosomworth JC, Tenbarge JB, Bergstrom RF “The effect of fluoxetine on the pharmacokinetics and psychomotor responses of diazepam.” Clin Pharmacol Ther 43 (1988): 412-9
  30. Stambaugh JE, Lane C “Analgesic efficacy and pharmacokinetic evaluation of meperidine and hydroxyzine, alone and in combination.” Cancer Invest 1 (1983): 111-7
  31. “Product Information. Rexulti (brexpiprazole).” Otsuka American Pharmaceuticals Inc, Rockville, MD.
  32. “Product Information. Fycompa (perampanel).” Eisai Inc, Teaneck, NJ.
  33. Greiff JMC, Rowbotham D “Pharmacokinetic drug interactions with gastrointestinal motility modifying agents.” Clin Pharmacokinet 27 (1994): 447-61
  34. Desager JP, Hulhoven R, Harvengt C, Hermann P, Guillet P, Thiercelin JF “Possible interactions between zolpidem, a new sleep inducer and chlorpromazine, a phenothiazine neuroleptic.” Psychopharmacology (Berl) 96 (1988): 63-6
  35. “Product Information. Artane (trihexyphenidyl).” Lederle Laboratories, Wayne, NJ.
  36. “Product Information. Ultram (tramadol).” McNeil Pharmaceutical, Raritan, NJ.

View all 36 references

Drug and food interactions

zolpidem

Applies to: Ambien (zolpidem)

GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of zolpidem. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

ADJUST DOSING INTERVAL: Administration of zolpidem with food may delay the onset of hypnotic effects. In 30 healthy subjects, administration of zolpidem 20 minutes after a meal resulted in decreased mean peak plasma drug concentration (Cmax) and area under the concentration-time curve (AUC) by 25% and 15%, respectively, compared to fasting. The time to reach peak plasma drug concentration (Tmax) was prolonged by 60%, from 1.4 to 2.2 hours.

MANAGEMENT: Patients receiving zolpidem should be advised to avoid the consumption of alcohol. For faster sleep onset, zolpidem should not be administered with or immediately after a meal.

References
  1. “Product Information. Ambien (zolpidem).” sanofi-aventis, Bridgewater, NJ.
  2. Yamreudeewong W, Henann NE, Fazio A, Lower DL, Cassidy TG “Drug-food interactions in clinical practice.” J Fam Pract 40 (1995): 376-84

cannabis (Schedule I substance)

Applies to: cannabis

GENERALLY AVOID: Alcohol may potentiate some of the pharmacologic effects of CNS-active agents. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills.

MANAGEMENT: Patients receiving CNS-active agents should be warned of this interaction and advised to avoid or limit consumption of alcohol. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.

References
  1. Gilman AG, Rall TW, Nies AS, Taylor P, eds. “Goodman and Gilman’s the Pharmacological Basis of Therapeutics. 8th ed.” New York, NY: Pergamon Press Inc. (1990):
  2. “Product Information. Fycompa (perampanel).” Eisai Inc, Teaneck, NJ.
  3. Warrington SJ, Ankier SI, Turner P “Evaluation of possible interactions between ethanol and trazodone or amitriptyline.” Neuropsychobiology 15 (1986): 31-7
  4. “Product Information. Rexulti (brexpiprazole).” Otsuka American Pharmaceuticals Inc, Rockville, MD.

View all 4 references

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See Also

  • Ambien Drug Interactions
  • Ambien General Consumer Information
  • Cannabis Drug Interactions
  • Drug Interactions Checker
Drug Interaction Classification
These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.

Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some mixtures of medications can lead to serious and even fatal consequences.

A Moderate Drug Interaction exists between Ambien and cannabis. View detailed information regarding this drug interaction.

Drug Interactions between Ambien and cannabis

This report displays the potential drug interactions for the following 2 drugs:

  • Ambien (zolpidem)
  • cannabis

Interactions between your drugs

zolpidem

cannabis (Schedule I substance)

Applies to: Ambien (zolpidem) and cannabis

Using zolpidem together with cannabis (Schedule I substance) may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Drug and food interactions

zolpidem

Applies to: Ambien (zolpidem)

You should avoid the use of alcohol while being treated with zolpidem. Alcohol can increase the nervous system side effects of zolpidem such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. Taking zolpidem with food may delay the onset of sleep. For faster sleep onset, zolpidem should not be taken with or immediately after a meal. This will make it easier for your body to absorb the medication. Talk to your doctor or pharmacist if you have any questions or concerns.

cannabis (Schedule I substance)

Applies to: cannabis

Alcohol can increase the nervous system side effects of cannabis (Schedule I substance) such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with cannabis (Schedule I substance). Do not use more than the recommended dose of cannabis (Schedule I substance), and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See Also

  • Ambien Drug Interactions
  • Ambien General Consumer Information
  • Cannabis Drug Interactions
  • Drug Interactions Checker
Drug Interaction Classification
These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.

Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some mixtures of medications can lead to serious and even fatal consequences.

A Moderate Drug Interaction exists between Ambien and cannabis. View detailed information regarding this drug interaction.