Marijuana, also called weed, has been used for thousands of years for medicinal, spiritual, and recreational purposes. Several states have legalized medicinal marijuana due to its potential therapeutic uses. The decriminalization of recreational marijuana is also becoming increasingly common. Decriminalization means making something that was once considered a crime, like using or selling recreational marijuana, less serious by reducing or removing the punishments for it.

With a decrease in regulation, some people with lupus have begun using marijuana more often, leading to a variety of questions. One MyLupusTeam member asked, “Is it OK to use marijuana while taking hydroxychloroquine (Plaquenil)? Does it prevent Plaquenil from working?”

Keep in mind that using marijuana while taking medications like hydroxychloroquine can be risky and have serious consequences.

What Is Hydroxychloroquine?

Hydroxychloroquine is used to treat lupus, an autoimmune disease that can cause inflammation and damage in various parts of the body, including the skin, joints, and organs. Hydroxychloroquine is usually taken by mouth in the form of a tablet.

Hydroxychloroquine works to treat lupus by calming the immune system and reducing inflammation, which can not only help prevent flares but also improve the long-term management and outcomes of the disease. A

lthough hydroxychloroquine is an effective treatment for lupus and is often well-tolerated, it sometimes causes side effects, including:

• Skin changes such as an itchy rash and darkening of the skin
• Changes in hair growth
• Anemia (low levels of iron in your blood)
• Changes in vision
• Changes in your heart rhythm
• Tiredness
• Dizziness

What Is Weed? How Do People Use It?

“Weed” is a common term for cannabis, which is also known as “marijuana.” Although these terms are interchangeable most of the time, “cannabis” technically refers to a family of plants, and marijuana refers to the parts of cannabis plants that contain chemicals such as cannabinoids. One of the cannabinoids found in marijuana is delta-9 tetrahydrocannabinol (THC). THC is one of the main chemicals in marijuana that causes psychoactive effects (feeling “high”).

Marijuana may be consumed by:

• Inhaling by smoking or vaping
• Ingesting cannabis-infused products such as edibles, capsules, oils, or tinctures
• Placing tablets or oils sublingually (under the tongue) to be absorbed into the bloodstream
• Topically (on the skin) through creams, salts, oils, or balms, typically for helping treat pain

Medical Marijuana

Like CBD, marijuana is used occasionally as medicine. Although more research is needed to support the use of medical marijuana, it is reported to help treat:

• Nausea
• Appetite loss
• Psychiatric and mental health disorders
• Sleep issues
• Chronic pain

Negative Effects of Marijuana Use

While there may be some beneficial uses of marijuana, it is not without risks. It can have negative effects on both short-term and long-term health, especially when used in high doses or over a long period of time. A few of the negative effects of marijuana use include:

• Lung damage — Smoking marijuana can irritate the lungs and cause respiratory problems, such as chronic bronchitis and lung infections. This is especially relevant to those with lupus, as lupus itself can damage your lungs.
• Impaired memory and concentration — Marijuana use can make it difficult to learn and remember new information.
• Psychiatric effects — Marijuana use can cause or make psychiatric symptoms worse, including anxiety, depression, and psychosis.
• Impaired judgment and decision-making — Marijuana use can impair judgment and decision-making, which can increase the risk of accidents and injuries.
• Cardiovascular effects — Marijuana use can cause a temporary increase in heart rate and a decrease in blood pressure. This can be dangerous for people with pre-existing heart conditions such as those with lupus.
• Cannabis withdrawal — Some people who use marijuana often experience cannabis withdrawal after stopping marijuana. Symptoms of cannabis withdrawal include mood swings, sleep disruptions, and loss of appetite.

The negative effects of marijuana use can vary depending on the individual and the dose and frequency. Some people may experience more severe side effects than others. For those with lupus, the negative effects of marijuana alone may affect your quality of life enough to avoid using it.

Potential Interactions Between Hydroxychloroquine and Marijuana

Marijuana is not reported to interact with hydroxychloroquine. However, there is not enough research or clinical trials to definitively say whether using marijuana while taking hydroxychloroquine is safe. There are several ways that marijuana may interact with hydroxychloroquine.

THC Can Change How Well Hydroxychloroquine Works

Hydroxychloroquine is metabolized in your liver, which is when it’s turned into the active form of the medicine. Using marijuana can interfere with how hydroxychloroquine is metabolized and decrease how well it works.

Hydroxychloroquine Can Increase the Time It Takes To Remove THC From Your Blood

The liver is also important for removing THC from your blood, so taking marijuana and hydroxychloroquine at the same time could lead to feeling more high than you expected or for a longer time.

One MyLupusTeam member asked, “I was wondering if anyone has had any experiences with weed and [hydroxychloroquine] interacting with each other? Like when you smoke after taking your dose, does it make you trip or get too high, etc.? I haven’t really been able to find anything about it on Google, but I just want to hear people’s experiences. I was wondering if that’s what happened to me or if I just smoked too much, too fast.”

This member might have been experiencing increased psychoactive effects due to an interaction between marijuana and hydroxychloroquine.

Both Hydroxychloroquine and Marijuana Can Affect Your Cardiovascular System

Hydroxychloroquine and marijuana both affect how your heart works. Hydroxychloroquine can change how your heart beats and its regular rhythm. Marijuana can also increase your heart rate and lower your blood pressure. Lupus is known to cause cardiovascular disease, which is the number one cause of death in patients with lupus. For this reason, mixing marijuana and hydroxychloroquine is not recommended if you have lupus.

The Bottom Line

If you’re taking hydroxychloroquine, marijuana is likely not recommended. It’s important to be honest with your doctor and health care providers about your use of marijuana. They need to know how much you use and how often to help manage your medications so you can prevent and treat potential drug interactions and to maximize the effectiveness of your current lupus treatments.

Talk With Others Who Understand

MyLupusTeam is the social network for people with lupus and their loved ones. On MyLupusTeam, more than 222,000 members come together to ask questions, give advice, and share their stories with others who understand life with lupus.

Are you taking hydroxychloroquine to treat your lupus symptoms? What has your doctor said about smoking weed while taking it? Share your experience in the comments below, or start a conversation by posting on your Activities page.