Can You Safely Use Marijuana While Taking Azithromycin?

• There is limited clinical data related to drug interactions between cannabis and antibiotics—including azithromycin, a common prescription used to treat bronchitis, sexually transmitted diseases, and other infections.
• While it’s probably safe to combine cannabis and azithromycin, be sure to consult your prescribing provider, pharmacist, or medical cannabis provider before combining these medicines.
• If you’d like to avoid potential interactions between azithromycin and cannabis, consider alternatives to medical marijuana during your course of antibiotics.

Azithromycin and weed—is it safe to use both at the same time?

It’s difficult to say. While there is some evidence to suggest that macrolide antibiotics (like azithromycin) can increase the side effects of cannabis, this might not be true for azithromycin specifically.

This guide is here to help you assess the risks of this combination and the alternatives available.

Azithromycin in a Nutshell

There are a few important things to know about azithromycin:

• It’s the same as a “Z-Pak” – If you’ve been prescribed a “Z-Pak” before, you’ve taken azithromycin before—azithromycin is the generic name for this drug.
• It’s a macrolide antibiotic – There are a wide variety of antibiotics on the market today, and macrolides are just one category. Other macrolides include clarithromycin and erythromycin.
• It’s not a CYP3A4 inhibitor – Without getting into complex biology, azithromycin doesn’t interact with a liver and intestine enzyme called CYP3A4. This will be important to remember later.
• It’s widely prescribed – Macrolides (including azithromycin) are widely prescribed for numerous infections—everything from pneumonia to ear infections and tonsillitis. They’re especially useful for patients with allergies to other common antibiotics (including penicillin-based drugs).

Like many other antibiotics, azithromycin fights infections by limiting the growth of bacteria in the body.

Antibiotics and Cannabis: Is There a Connection?

There isn’t an overwhelming body of clinical data related to cannabis drug interactions.

However, a few small studies have determined that cannabis may interact negatively with:

• Ketoconazole (an antifungal formula)
• Verapamil (a blood pressure medication)
• Fluoxetine (an antidepressant)
• Macrolide antibiotics

Let’s zoom in on the last item: macrolide antibiotics could produce negative effects when taken with cannabis (specifically, an intensification of cannabis side effects like drowsiness and psychoactivity).

However, unlike other drugs in this class, azithromycin doesn’t interact with CYP3A4 (the liver and intestinal enzyme we mentioned above). Researchers have only identified negative interactions with CYP3A4 inhibitor macrolides—so, that rules out azithromycin, in theory.

While researchers haven’t identified negative interactions between cannabis and azithromycin in lab settings, they’re not impossible. So, how should you approach the (relatively unknown) risks of this combination?

What to Do If You Combine Cannabis with Azithromycin

Before you combine any drugs (prescription medications, supplements, or all-natural remedies like cannabis), have an open conversation with your healthcare provider about your intentions.

There are a few important things to remember ahead of this conversation:

• Your provider is there to help – Even if your provider doesn’t approve of medical cannabis use, they can still help you find a solution that mitigates your risks. One way to optimize your experience in healthcare is to find a cannabis-informed provider—a clinician in TeleLeaf’s network, for instance.
• Your conversations with your healthcare provider are private – Even if you’re using cannabis without legal authorization, your provider will not reveal your personal health information (including your cannabis use) to law enforcement. Doing so would be a violation of federal law.
• Keep an open mind – If your provider recommends changing your medication regimen during antibiotic treatment (even if that means pausing cannabis use temporarily), do your best to follow their instructions to the letter. At the end of the day, your provider is trying to help you weigh the benefits and risks of individual medical interventions to meet your needs—they want you to get better.

If your healthcare provider advises you to continue your medical cannabis treatment during your course of antibiotics, you should still take a few extra steps:

• Monitor your symptoms – Keep an eye out for any unexpected responses to your usual cannabis routine—increased dry mouth, drowsiness, and other potential side effects. While mild side effects are unlikely to be dangerous, seek medical attention if any of these become severe.
• Choose an appropriate method – If you’re taking azithromycin for a throat, tonsil, or lung infection, this might not be the best time to roll up a joint. While cannabis can have anti-inflammatory properties, smoking can be irritating for some patients. Try to choose an administration method that doesn’t interfere with your overall comfort. While they feature different onset times, edibles, sublingual tinctures, and topicals will all introduce cannabinoids into your system.
• Keep cannabis alternatives on hand – After your first or second dose, you might come to the conclusion that the weed and azithromycin combination just doesn’t agree with your body. Luckily, you can stop using cannabis at any time without any risks of withdrawals. We recommend keeping some cannabis alternatives on hand just in case you have a negative reaction (we’ll explore these in a later section).

Potential Benefits of Combining Cannabis with Azithromycin

How might combining medical marijuana and azithromycin benefit you?

Depending on numerous factors (like your chosen strain and your unique physiological responses to the combination), you might unlock:

• Increased appetite – Being sick can interfere with your appetite. Whether you don’t feel like eating or infection has altered your sense of taste, cannabis’s well-known appetite stimulation effect (“the munchies”) could help you maintain normal eating patterns and get the nutrients you need to recover.
• Improved sleep – Cannabis can help you achieve more restful, restorative sleep—or it might help you wind down before bed. Since infections can interfere with your sleep patterns, you may be able to maintain your normal slumber schedule with a little help from nature’s best sleep aid. Plus, sleep deprivation can have a negative effect on your immune system; using cannabis to improve your sleep could help you bolster your immunity when it matters most.
• Decreased fatigue – Fatigue is a very common symptom of bacterial infections. After all, your body is using ample energy for immune responses—you might feel like you’re running on empty as your body fights to evict pesky bacterial invaders. Luckily, many strains of the cannabis plant can actually be stimulating instead of sleep-inducing. Consider using these for daytime energy support (especially if you’re working from home as you recover).

Alternatives to Cannabis During Antibiotic Treatment

So, your provider doesn’t recommend using cannabis while you’re on azithromycin—or maybe you had a negative reaction to the combination on the first day of your course.

No matter why you might opt to abstain until you’re done with your antibiotics, you might want to have some alternatives available at home for wellness support:

• Soothing teas – If you primarily use cannabis for sleep support, consider replacing your medical marijuana dose with a cup of soothing tea. Chamomile, lavender, and valerian root teas offer all-natural drowsiness (and there’s no denying the cozy comfort a hot beverage can provide).
• Pain-relieving topicals – For chronic pain patients, missing out on the pain-relieving properties of medical marijuana might vastly impact their quality of life. If you need to pause your cannabis treatment, consider replacing your dose with a natural pain relief topical. Ingredients like capsaicin (a warming compound) and menthol (a cooling formula) are naturally derived and offer fast, effective pain relief.
• Caffeine – Using cannabis to fight fatigue and boost energy? Consider replacing your daily dose with a low-caffeine beverage: green teas, black teas, and yerba mate are all excellent choices (that usually don’t provoke the jitters like a cup of coffee might).
• Meditative practices – If you use cannabis to find your zen zone, practice mindfulness, or ease your racing thoughts, consider turning to holistic practices like meditation when you need to pause your marijuana routine.

TeleLeaf: Your Connection to Medical Cannabis Care

Whether you’re looking for healthcare experts with medical cannabis knowledge, advice ahead of an antibiotics treatment, or a recommendation for a medical marijuana card, turn to TeleLeaf: the best online medical marijuana card service on the market today.

Our network of licensed providers has their fingers on the pulse of all things cannabis care. Plus, they can help you during every step of your journey—from your initial recommendation to your tenth renewal.

Getting started is easy. Reach out to us to explore your medical cannabis options.

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