PharmD Discusses: Cannabis and Blood Thinners

Cannabis combined with blood thinning medications has become an increasing concern as Medical and Adult-Use cannabis are being legalized across the country. The fastest growing groups of Cannabis users are those 60+ years old. This group also happen to be the biggest consumers of polypharmacy (the simultaneous use of multiple drugs to treat a single ailment or condition). Many of these patients have medications that are blood thinners or can cause blood thinning side effects.

Typically pain, sleep, or anxiety medications are the ones patients are trying to decrease or discontinue. In the process of attempting to use cannabis to decrease some of these medications, patients are not aware that other interactions can occur. Not all of these medications interact the same way with cannabis. It can depend on what cannabinoids a patient is consuming.

THC does not have quite as significant effect on these medications as CBD. The more dangerous thing is CBD is seen as safe and is available over-the-counter. Many of these CBD products do not have any information on their testing and purity. This means that some CBD products can be unpredictable and might even contain heavy metals, molds/mildews, and pesticides. The best advice is to make sure they have a QR code that will provide RECENT testing information on the product. If they do not have that, move on to one that does.

With a quick Medscape.com drug interaction search, a patient can find that:

  • Coumadin (Warfarin): CBD & THC increase levels (potency) of the medication. CBD has a larger impact on the levels of Warfarin than THC
  • Plavix (Clopidogrel): CBD & THC decrease levels (potency) of the medication. CBD has a larger impact on levels of Clopidogrel
  • No interactions were found with: Pradaxa (Dabigatran), Eliquis (Apixaban), Xarelto (Rivaroxaban), Lovenox (Enoxaparin), and Aspirin

This does NOT mean that using cannabis may not impact these medications! All of the research on drug interactions with cannabis, specifically CBD and THC, is ongoing. This information is changing as more research is being completed. This is why it is imperative to do the research and make sure that the prescriber is aware that the patient is using cannabis, EVEN if “It’s only CBD”, as this may have impacts on medication interactions.

About the author:

Now working in cannabis, his years of pharmaceutical knowledge, drug to drug interactions and his quest for learning revealed the startling truth about this remarkable plant. Brian is one of only a handful of a growing number of pharmacists who are lending their knowledge of chemistry, drugs to cannabis therapeutics while satisfying his yearning to be more involved in the health of his patients!

Brian Essenter, Registered Pharmacist (RPh)

Business Owner – MM Consult CT

Brian was recently featured on United Patients Group’s Podcast – Be Informed. Be Well. with John Malanca

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