Can You Safely Combine Weed and Prednisone?

We all know that weed and prednisone can affect our bodies differently when used separately. But if you’re dealing with a pretty nasty bout of inflammation, perhaps you are curious about what happens if you combine them.

Is it safe and particularly beneficial to do so? Or will it enhance the frustrating side effects commonly associated with prednisone use? We did some digging to find out the potential risks and benefits of combining cannabis and prednisone. Here’s what we found out.

What Is Prednisone?

Prednisone is a medication that belongs to a class of drugs known as corticosteroids, commonly used to treat inflammation. It can treat a wide range of conditions, including allergies, cancers, asthma, arthritis, skin conditions, and other autoimmune diseases like Crohn’s disease, ulcerative colitis, and rheumatoid arthritis. Common side effects include:

• Increased appetite
• Weight gain
• Insomnia
• Mood swings
• Dizziness
• Headaches
• Hyperglycemia (high blood sugar)

Prednisone works best with short-term use. Long-term use can cause serious side effects such as osteoporosis (bone loss leading to weakness and increased fracture risk), high blood pressure, adrenal suppression, skin fragility, slow wound healing, glaucoma, or cataracts. For most people, however, the health benefits of short-term prednisone use outweigh the potential risks.

How Does Prednisone Work?

Prednisone is actually a prodrug, meaning it first needs to be activated by the liver into prednisolone. The activated prednisolone then works by suppressing immune cell  responses and tightening blood vessels, which helps reduce inflammation. 

It does this by entering immune cells and binding to specialized receptors in the nucleus, which prevents the release of inflammatory substances. 

These  actions help relieve symptoms such as swelling, pain, and redness. In addition, prednisone decreases the immune system’s response to prevent organ transplant rejections. It also has specific anticancer mechanisms, and may relieve nausea and vomiting.

What Are Potential Risks Associated With Taking Prednisone?

Since corticosteroids’ primary mechanism involves suppressing the immune system, infections are more likely to develop in patients who take them. Prednisone users should avoid being around sick people, crowded places, and sharing food and drinks if they have been taking it for a long time. They should also take recommended vaccinations (i.e., pneumonia, COVID-19, and flu) to prevent infections. Furthermore, patients taking certain potentially dangerous medicines, like Coumadin (warfarin) or Lasix (furosemide), should discuss with their healthcare providers whether they can take these drugs along with prednisone.

Patients will be instructed to take prednisone in the mornings with food to avoid stomach pain. While unlikely if taken as prescribed, an overdose of steroids like prednisone can cause general symptoms like abdominal pain, nausea and vomiting, dizziness, drowsiness, ringing in the ears, headaches, and abnormal eye movements. Taking cannabis simultaneously with prednisone may increase this risk.

You should also speak to your doctor if you are pregnant, thinking of becoming pregnant, or breastfeeding, as research shows using prednisone while pregnant has been linked to birth defects and low birth weight. Also, be sure to follow your doctor’s instructions exactly when taking prednisone and tapering off high dosages. Sudden discontinuation of corticosteroids can result in adrenal failure or even death.

Are There Any Risks of Using Weed and Prednisone Together?

The latest research shows that cannabis and prednisone can be used simultaneously with caution due to the moderate risk of interaction. They can still be used if the short-term benefit outweighs the risk and the patient is closely monitored for signs of steroid toxicity. This is because cannabis and corticosteroids influence the same metabolic enzymes, causing a bottleneck in their metabolism and excretion, thus increasing exposure to the steroid. 

As part of the process of drug metabolism, the body uses a family of enzymes known as the cytochrome P450 enzymes, which allow our bodies to make use of the medications we take. The enzyme appears along the critical pathways of the body’s gastrointestinal tract, primarily in the liver. There, the active ingredients of drugs change into simpler forms our cells can use. Moreover, since CBD breaks down in the liver by the same enzymes, it might affect how other substances break down there as well.

So, research shows while corticosteroids suppress CYP3A, CBD also suppresses CYP3A. In turn, this may exacerbate the systemic side effects of corticosteroids. Your healthcare provider may decrease the dose of steroids if they know you take cannabinoids, or if side effects appear.

It should also be noted that patients should choose safe consumption methods throughout their treatment process since heavy cannabis smoking may contribute to decreased bone density (especially if you’re on steroids), increasing the likelihood of fractures and osteoporosis. The best option for these patients is to consume cannabis edibles or vaporize flower instead of smoking.

>> Learn more on alternatives to smoking cannabis: How to Get High Without Smoking: 8 Ways to Consume Cannabis.

Does Cannabis Work Better Than Prednisone for Treating Pain?

In recent years, more and more research has been conducted on cannabis’ anti-inflammatory effects. All cannabinoids, including cannabigerol (CBG), CBD, and tetrahydrocannabinolic acid (THCA), naturally possess anti-inflammatory properties. However, could you use one or more of these as an alternative to prednisone?

Simply put, no. Prednisone, for example, is a potent and effective corticosteroid widely used with extensive scientific and clinical understanding. Nevertheless, while there is evidence of the anti-inflammatory properties of cannabinoids, research exists mainly in cultured cells (test tubes) or mice due to the decades-long prohibition of marijuana.

For years, prohibition prevented the study of the anti-inflammatory properties of cannabis alone, which raises the question of whether humans would benefit from it exclusively. Using cannabis to treat inflammation is likely to yield the best outcome when used along with conventional treatment, not in place of it.

Final Takeaway

Although more research may help us understand the full extent of how weed and prednisone work together, it seems that cannabis and prednisone are powerful allies against inflammation. While it is promising that the two work well together, there is still a moderate risk for interaction worth looking out for and mentioning to your provider. 

Always consult your doctor or pharmacist before starting or stopping any medications, especially steroids. Tell them if you are taking cannabis, which may affect the dose they give you. The last thing you want is to experience any unpleasant side effects and dangers associated with increased steroid exposure or abruptly stopping corticosteroid therapy.

Note: The content on this page is for informational purposes only and is not intended to be professional medical advice. Do not attempt to self-diagnose or prescribe treatment based on the information provided. Always consult a physician before making any decision on the treatment of a medical condition.