Medical Marijuana

[Samuel Kirton]

Hi Buckeyegoodguy,
Using only the comment you provided above and the info you shared in your profile, I would offer a different viewpoint.
You wrote “he will Not and says He can Not recommend Medical Marijuana . That is because there are no Profits in Med. MJ Big Pharm can not make any $$$$“. Later in your comments you wrote “…and Smoke MMJ Vapes in the evening”.
Anything you are smoking, even using a vape, is going to be contraindicated for IPF. Now, I will agree that everyone’s journey is unique, and the way their body responds is what makes their journey unique. I sense that this is why your doctor will not recommend medical marijuana and has nothing to do with the profit margins for pharma. You are introducing the output of a vape cartridge to your lungs, and vaping carries its own risks for lung injury.
For those considering a transplant, the use of medical marijuana, whether smoked or consumed using a vape, will likely eliminate you from consideration for a transplant. I have noticed the questions on the forms I complete that questions about smoking also reference vaping.
Sam… (edited)

[Bcoddy]

I take edibles. It really helps me with the anxiety. I doubt that it is helping my disease. I would never consider vaping or smoking as even strong perfumes give me fits at times. My Dr knows I use regularly and has said nothing about it affecting transplant except I would have to stop some weeks prior. I am unsure if I want to endure that anyway.

[antny]

Well Buck, kudos to you for sharing . I was diagnosed with IPF in early 2020 and had no symptoms till last year .Ive lost 40 lbs off my normal 160 lbs frame. I eat a 10 mg gummy around noon most days . It does help me feel a lot more relaxed and even somewhat cheery. I live in California where it’s legal so I go on line, order it and a driver delivers to my front door. I made the driver laugh when I said “it’s a big improvement over meeting in a dark alley”.lol. At this stage of my life (78 yrs old) with a debilitating disease I say to all “whatever gets you through the night”. I have no idea how long I’ll last but whatever it is, I want to be comfortable . My Pulmonologists both civilian and VA say because IPF is non linear, they have no idea either . So to you I say thanks for giving me a bit more encouragement that I could have more time than the 3-5 yr prognosis.

[Linda Maguire]

I have been living with IPF for 10 years with no progression of the disease. I am not on any medication other than Omeprazole to treat silent reflux. I think smoking or vaping ANYTHING is damaging to your lungs!! If you want to use Medical MJ, I would suggest an edible rather than vaping!! I doubt that this is what is keeping you alive, and also don’t believe your MD won’t recommend it because of Big Pharma! Each individual has to make their own choices, however I think proper diet & regular, cardio exercise are key to slowing progression of IPF.

[buckeyegoodguy]

I hear you but edibles are NOT going to affect the area of the lungs with the growth / scaring forming on the lungs. I think the Vape is attacking the scaring head on and slowing the growth . My Polmanary DR said he has not seen anything like it in 35 years and to keep up what ever it is I’m doing. What do I know ??? My Faith is a big part but I truly believe MM is helping

[cpfeln]

I was approved for Ofev. I have never been so sick. Even at a low dose nausea medication did not work. Primary suggested 5 mg thc gummies. Legal in Nevada. I am back on Ofev and my pulmonologist said it’s safe to take 5 to 10 mg with all the other medications I’m on. It was a game changer for me. It has also helped my night time cough. I do not smoke or vape.I also don’t drive. I have a prescription from my doctor for it. I personally believe anything that helps with lung disease or chemotherapy, is not for everyone, but should be considered.

[earl haywood]

I also have had IPF since 2012 and still going strong. I haven’t use cannabis since 1989 but I did above and beyond my share. I give my longevity to faith and prayer. 😀 But who knows what cannabis might contribute to the.slowing of the disease of fibrosis. Still here and counting

[John K. Grubb]

I was diagnosed with IPF in early 2022 and started OFEV in April of 2022. Overall I am pretty stable. Years ago I used to smoke marijuana occasionally – love the mellow feeling; however, with my lung disease I will not smoke or vape anything. About twice a week I will eat 5mg of gummy bear (delta 9) about 2 hours before bedtime. You do not get the mellow feeling of smoking or vaping. However, you kind of enter into a pleasant drunk state, slowly drift off to sleep and usually sleep for about 8 hours. If for some reason you wake up before 8 hours, be careful because you will be drunk.

[Laureen]

Can I ask a question? What benefit are you getting from edibles? I’m just curious. I’m not a fan of the way they make me feel, I get anxiety really bad, and that’s only eating half an edible. I have been on several medication combinations and now am on Ofev, for about 9 years now. About a year ago I had to go from 150 mg 2x day to just once a day. I thought maybe the edibles would reduce the nausea. I was actually diagnosed in 2002, and have been very fortunate it has progressed very slowly.

[buckeyegoodguy]

23 years WOW…You keep doing what you’re doing. I do not use edibles only vape for my lungs.

[angelyn]

I find this very interesting as I started using Medical Marijuana last December. I use the edibles and the topical. I began using it for arthritis/bursitis/ tendonitis pain and I can say without a doubt it works! I rub the topical directly on the pain. The edible gummies I use at night to help me sleep. How do you tolerate the vape? Does it make your cough. What about your mental awareness? Do you become drowsy? In Florida I have to see a medical marijuana doctor, which is expensive and not covered by my insurance or medicare. I also must purchase from a state authorized facility. For me it is expensive, but well worth the money.

[Larry70]

My pulmonologist was ok with gummies and tincture but specifically warned again smoking in any form. I take a mild dose, 1/3 of a 10mg gummy or about 2mg of a tincture with Delta9 thc. usually take it once in the morning and again at night before bed. I get a mild buzz from it, which I like as it enhances my mood, makes me more productive most times and most importantly for my IPF – helps me do my exercises for both my arthritic knees as well as for general cardiovascular fitness with my exercise bike (as long as I have some good music to work out with) I otherwise hate it and struggle for the motivation to exercise. I’m not going to be eligible for a lung transplant anyway (I heard that even taking just edibles might be problematic with some transplant centers) The one thing that gave me pause was a warning label on a tincture that I bought (Lazarus THC Tincture) that said you shouldn’t use it if you’re taking any medication where eating grapefruit was contraindicated. (which Ofev and my statin both say not to take) I asked my pulmonologist who said he has lots of patients who take CBD without problem. I don’t think there’s been any real clinical studies that verify this one way or another so I decided not to worry. (however, I’ll post seperately what an AI had to say about this for anyone interested.)

[Larry70]

THC is a potential contraindication when taking a medication that prohibits eating grapefruit. Both grapefruit and THC can interfere with the same liver enzymes responsible for metabolizing certain drugs, which can lead to dangerously high or low drug levels in your body. [1, 2, 3, 4, 5]

How the interaction works

The key to understanding this drug-drug interaction is the cytochrome P450 (CYP450) enzyme system, particularly the CYP3A4 enzyme.

• Grapefruit’s effect: Grapefruit contains compounds called furanocoumarins that block the action of the CYP3A4 enzyme in the intestinal wall. This prevents the enzyme from breaking down medication before it enters your bloodstream. The result is an increased concentration of the drug in your body, which can lead to amplified side effects and toxicity.
• THC’s effect: THC and its metabolites also interact with the CYP450 system, including the CYP3A4 enzyme. Depending on the dosage and individual factors, THC can act as an enzyme inhibitor, slowing down drug metabolism in a manner similar to grapefruit. [3, 6, 7, 8, 9]

Potential risks

For medications metabolized by CYP3A4, combining them with THC can increase the drug’s effects and potentially lead to serious health complications, similar to the risks associated with a grapefruit interaction. [10, 11, 12, 13]

This can result in a range of adverse effects, such as:

• Increased drug toxicity: Some medications have a narrow therapeutic index, meaning the difference between a safe and toxic dose is very small. A sudden increase in drug concentration could be dangerous or even fatal.
• Enhanced side effects: Sedatives, for instance, can cause increased sleepiness, while statins could cause muscle damage if their concentration in the blood becomes too high.
• Unpredictable drug effects: The combination can make it difficult for doctors to predict how much of a drug is reaching your system, disrupting treatment. [2, 6, 11, 12, 14]

Important considerations

• Consult a healthcare professional: Because drug interactions can be complex and vary by individual, you should always consult a doctor or pharmacist about the safety of using THC alongside any prescription medication.
• Variability of cannabis products: The concentration of THC, as well as other cannabinoids like CBD, can vary significantly depending on the cannabis product. Many unregulated products on the market do not have standardized dosages, making interactions more unpredictable.
• Grapefruit is often the warning sign: A medication label warning you against grapefruit is a clear signal that the drug is likely metabolized by the CYP3A4 pathway. This should be a red flag for anyone considering using THC, as it suggests a high potential for a similar, if not worse, interaction. [1, 6, 12, 15, 16]

AI responses may include mistakes.

[1] https://leafwell.com/blog/cannabis-drug-interactions

[2] https://www.aafp.org/pubs/afp/issues/2006/0815/p605.pdf

[3] https://www.papharmacists.com/page/medicalcannabisinteractions

[4] https://www.goodrx.com/drugs/safety/grapefruit-juice-interactions

[5] https://www.ucea.ac.uk/_entity/annotation/d98ad1aa-fdba-ef11-a72f-7c1e5266826b/d78574f9-20c3-4dcc-8d8d-85cf5b7ac141

[6] https://www.tandfonline.com/doi/full/10.1080/17512433.2022.2148655

[7] https://nutritionj.biomedcentral.com/articles/10.1186/1475-2891-6-33

[8] https://www.drugs.com/article/grapefruit-drug-interactions.html

[9] https://www.drugs.com/article/grapefruit-drug-interactions.html

[10] https://pmc.ncbi.nlm.nih.gov/articles/PMC10824494/

[11] https://www.mayoclinicproceedings.org/article/S0025-6196(11)64645-4/fulltext

[12] https://www.drugs.com/article/grapefruit-drug-interactions.html

[13] https://www.sharp.com/health-news/marijuana-and-prescription-drugs-a-dangerous-combination

[14] https://www.cannabisclinicians.org/2024/07/10/drug-interactions-with-cannabis/

[15] https://asanarecovery.com/thca-side-effects-a-comprehensive-guide-to-benefits-risks-and-safety/

[16] https://ch-api.healthhub.sg/api/public/content/07ea4cb96fe545bf8a4b4f418c2821d1?v=7c855afb

[Sally Schindel]

Many thanks to Larry for good and important information about drug interactions. So much is unknown and untested about cannabis interactions. The grapefruit connection is interesting. I experienced a rash interaction from my usual pirfenidone (Esbriet) use while daily consuming grapefruit.

[Adele Friedman]

Yes, thank you, Larry for drug interactions. It’s hard for me to believe that with all the publicity about lung harm from both vaping and smoking, people still believe it’s benign or even helpful. As for the comment about one’s doctor not recommending something that could help you because of their desire to aid pharma profits…if I were a physician, I would be quite insulted by that. Most doctors want to do right by their patients; the vast majority. It’s very easy to decide some action we have taken, or don’t take, made some difference in our outcomes. But one person experiencing something like this does not exactly constitute clinical research. You don’t even know if vaping had any effect, never mind a positive effect. As I said, research is quite clear that inhaling the chemical compounds in vape products has done harm to many. Any given person can have a good or bad reaction to specific drugs, or other therapies. Not everyone who smoked cigarettes gets lung cancer. That doesn’t mean it doesn’t increase your odds.

[Regina Bolyard]

I took a class on medical marijuana offered by University of Colorado. It does appear to have bronchodilating properties. I do not recall if this was quantified with PFT or if it was strictly anecdotal. The classification of cannabis as a schedule 1 drug has been a detriment to broad and in depth study of its effects. One problem with studying a psychoactive drug is that human participants will feel those effects and that can introduce bias. So it is impossible to conduct a randomized double blind study to achieve reliable data.

I will include a link to one of the course materials my professor recommended. It reports the current state of evidence on the health effects of cannabis and cannabanoids. It is from 2017 but I know of nothing more recent.

I personally choose to avoid any inhaled irritants. I have traction bronchiectasis due to bronchocentric fibrosis and am extremely sensitive to chemicals and smoke.

https://nap.nationalacademies.org/read/24625

nap.nationalacademies.org

Front Matter | The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research | The National Academies Press

Read chapter Front Matter: Significant changes have taken place in the policy landscape surrounding cannabis legalization, production, and use. During the...

[cpfeln]

My pulmonologist said the grapefruit medication reaction generally is not an issue if you wait at least 4 hours after consuming grapefruit or cannabis products. He also says it is more important for me to be able to take Ofev than worry about any interaction. I had to completely stop taking the only type of medication for CPFE. I am in stage 4 and have chosen to do it as comfortably as possible with edibles as prescribed. There will always benefits and risks for medication. I think you have to go over those risks and benefits with your doctor. I have heard repeatedly about the problems people face with taking Ofev and Esbrit? I tried several prescription medications for nausea, vomiting and diarrhea. Nothing really worked for me other than gummies. Please DO NOT drive after use of any cannabis products.

[Gloria M Wheeler]

There are many in my support group who have been under care greater than 13 years!! You are not the lone ranger there!! The Marijuana industry is akin to Big Pharma!! Huge Profits and additionally, MJ gets promoted on its efficacy in several disease processes without any scientific backing!! It may work for you–or not!! You have no way of knowing what your progression would have been without it-possibly better on another drug. It sounds like you’ve had progression of your IPF on MJ. I and several others I’ve talked to have had little or no progression on OFEV. Granted others have had significant progression and many have died. No OFEV is not idea; but, at least has science backing its ability to slow progression!! I too feel this country needs to get a handle on Big Pharma and medical costs in this country. We also need to get a handle on folks purporting a magic pill without strong, well-constructed research and evidence for alternative drugs.

Minimally, you should probably stick to edibles!! At least, then, you would not be adding another insult to your lungs!! Hoping that you continue to feel a benefit from your marijuana.