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Medication Side Effects - Introduction

All medications may cause side effects. This includes over the counter medications like Tylenol or Advil. Just because a side effect is listed, does not mean it will happen, but it is important to keep in mind that almost every drug can have serious side effects that can cause bodily injury or harm. Many drugs including cannabinoids (FDA approved formulation or medicinal marijuana) and Tylenol can both:

1. Increased or decreased heart rate

2. Increased or decreased blood pressure

3. Make you feel happy or worsen feelings of depression 

4. Cause a severe allergic reaction making it difficult to breathe

5. Interact with any other medication you are taking making another medication ineffective or indirectly cause a side effect from the other medication ‘overworking’

The important thing is to always monitor how you feel and if any serious symptoms take place (chest pain, shortness of breath or difficulty breathing, suicidal thoughts, weakness) to call 911 or seek immediate medical attention. It may turn out that a serious symptom is a side effect or it might turn out that the symptom is not a side effect but occurred independently.

Most common side effects

The most common side effects of medical marijuana are mild dizziness, dry mouth and drowsiness.

Less common side effects include fast or irregular heartbeat, high and low blood pressure, slowed reaction times, short-term memory loss, trouble concentrating, confusion, decreased or increased anxiety, depression, suicidal thoughts, and lung irritation. 

Generally, alternative treatments (cannabinoids or other) that are experimental require closer supervision than traditional medications and patients with heart disease, liver disease, lung disease, pregnancy or a history of psychotic disorder or substance abuse should usually not use cannabinoids. 

Never drive or operate machinery under the influence of cannabinoids or any medication that can cause sleepiness, impair coordination, reaction time, or delay decision making. Also don’t combine these medications with any substances not limited to alcohol, benzodiazepines, cannabis, or opioids alone and/or with each other. Similarly, for any over-the-counter or prescription drug your are taking, is prescribed, or has previously been prescribed, it is important that you are certain that it does not impair concentration, coordination or cause drowsiness prior to driving, using machinery or carrying out activities that require sustained attention.

Never share any prescribed or recommended (‘prescribed’) medications or treatments (‘medications’) with others and to only obtain medications at state licensed facilities due to risks including contamination with cancer causing substances. 

For any medicine you are taking obtain handouts from a pharmacy or wherever it is being dispensed. Carefully review side effects and drug interaction information and keep a copy for your own record.

What to do if you have side effects

In general, if you ever develop serious side effects or symptoms such as chest pain, shortness of breath, suicidal thoughts (or if there is any uncertainty about whether a symptom is serious or not) call 911 or proceed to an emergency room.

Reducing side effects

My patients have a low rate of side effects because I have a conservative approach, start at formulations that are less likely to cause side effects with lower THC, adjust doses slowly and closely monitor patients for initial signs of any side effects.

We also monitor patients for interactions with other medications which may indirectly cause side effects or reduce the beneficial effects of other drugs by increasing or decreasing their drug levels.

My role in your care

I am part of your care team. My role is generally limited to treatment of your symptoms (ie pain) or to provide a second opinion to treat your symptom after your condition has been diagnosed. My care relies on other physicians.

I am not a substitute for a primary care doctor or other specialists that diagnose and treat a patient’s conditions.

Patient’s who see me must have a primary care doctor to manage any medical problems.

Therefore, if you have a question for me but you have tried to email me (preferable) or call me but you are unable to reach me, you should call primary care physician for any non-serious medical questions.

For your care to be effective it is also important that you follow up with your other physicians (or other care providers) within 1 month after any new treatment is prescribed. Following up with me every 1 – 3 months will also ensure that your treatment works.