Can you use marijuana if you take hydroxyzine?

Cannabis might interact with hydroxyzine (Vistaril), a prescription allergy medication. Taking the two together may increase your risk of certain side effects, including dizziness and drowsiness. Understanding the risks of combining them can help you make a plan to manage your health.   

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What is hydroxyzine?

Hydroxyzine is a prescription antihistamine medication used to treat allergies. It’s also sometimes used to help manage:

• Anxiety
• Nausea and vomiting (except for in pregnant people)
• Sleep difficulties

How does hydroxyzine work?

Histamine is a compound that your body produces when you’re exposed to allergens like pollen or pet dander. When histamine is released into your bloodstream, it triggers an inflammatory response and can bring on symptoms such as:

• Itchiness
• Runny nose
• Watery eyes
• Difficulty breathing

This is known as an allergic reaction. Antihistamines like hydroxyzine block histamines to reduce these symptoms.

When used as directed, hydroxyzine is generally considered safe and effective. But it may cause side effects, including:

• Drowsiness
• Dizziness
• Fast heartbeat
• Blurred vision
• Impaired motor function
• Dry mouth and throat
• Constipation

Sticking with the dose recommended by your doctor or the amount listed on the medication label can help lower your risk of experiencing these side effects.

Is it safe to mix hydroxyzine and weed?

Combining cannabis and hydroxyzine may increase your risk of certain side effects, such as:

• Drowsiness
• Dizziness
• Impaired motor function
• Fast heartbeat

Both substances can cause sedation. Combining them may increase this risk. It’s best to avoid driving after taking them together. 

Hydroxyzine is not recommended to people over the age of 65 because it can cause sedation. Combining it with cannabis can increase the risk of falling in seniors. 

Cannabis may inhibit the levels of liver enzymes that help your body break down and metabolize medications like hydroxyzine. This can increase levels of the medication in your bloodstream. So combining them might also prolong or strengthen the effects of hydroxyzine.   

Before you combine cannabis with hydroxyzine, talk to your doctor to create a safe dosing plan.

Can I have CBD with hydroxyzine?

Cannabidiol (CBD) is a non-intoxicating cannabis compound. It’s commonly used to help treat health issues such as:

• Pain
• Anxiety
• Inflammation
• Insomnia

CBD can cause drowsiness, which can add to the potentially sedating effects of hydroxyzine.

CBD is also one of several cannabis compounds that may lower liver enzymes that help metabolize hydroxyzine. This might make hydroxyzine’s effects last longer in your body.

Benefits of combining hydroxyzine with cannabis

Cannabis may help relieve the symptoms of certain health issues that hydroxyzine is often used to treat, such as:

• Anxiety
• Insomnia
• Nausea and vomiting

If you’re taking hydroxyzine to treat one of these health concerns, cannabis may further help relieve your symptoms. In some cases, you may even be able to reduce your hydroxyzine intake. If you’re using cannabis alongside hydroxyzine, discuss any changes in symptom control or medication needs with your healthcare provider.

How to take hydroxyzine and marijuana

If you’re a cannabis user who is considering hydroxyzine, ask your doctor whether it’s safe to combine them.  

You can also consider these safety tips: 

• Be cautious when dosing: Taking higher doses than recommended of cannabis and hydroxyzine together may increase your risk of certain side effects. To lower your risk, stick to the recommended dose amounts of both cannabis and hydroxyzine. Your doctor may be able to help you develop a safe dosing plan. 
• Space out each dose: Try to avoid having both substances peak in your system at the same time. The effects of hydroxyzine can peak in 2 hours and lasts for 4 to 6 hours. When inhaled, the effects of cannabis can peak in 5 to 20 minutes and last for 2 to 3 hours. Cannabis edibles can peak within 1 to 2 hours and last for 8 to 10 hours. 

• Consider your other medications: If you’re taking other medications, ask your doctor if it’s safe to combine them with hydroxyzine and cannabis.

The takeaway: Use caution when combining cannabis and hydroxyzine

While hydroxyzine is commonly used to treat allergic reactions, both cannabis and hydroxyzine may help ease anxiety, insomnia, nausea, and vomiting. 

However, taking them together may increase your risk of certain side effects, including drowsiness and dizziness.

If you’re concerned about how these substances may interact with one another, ask your doctor or a Leafwell telepharmacist for more guidance and a safe dosing schedule.

Resources

• Cannabinoid interactions with cytochrome P450 drug metabolism: A full-spectrum characterization. https://pubmed.ncbi.nlm.nih.gov/34181150/
• Cannabidiol, a major phytocannabinoid, as a potent atypical inhibitor for CYP2D6. https://pubmed.ncbi.nlm.nih.gov/21821735/
• Hydroxyzine. https://www.sciencedirect.com/topics/medicine-and-dentistry/hydroxyzine
• Hydroxyzine. https://www.ncbi.nlm.nih.gov/books/NBK548128/
• In vitro characterization of cytochrome P450 2D6 inhibition by classic histamine H1 receptor antagonists. https://pubmed.ncbi.nlm.nih.gov/9616188/

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