Marijuana, also called weed, has been used for thousands of years for medicinal, spiritual, and recreational purposes. Several states have legalized marijuana for recreational and medicinal purposes. 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 orally (by mouth) in the form of a tablet.

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

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

• Nausea
• Diarrhea
• Changes in hair growth
• Anemia (low levels of iron in your blood)
• Changes in vision
• Changes in your heart rhythm
• Muscle weakness

What Is Weed?

“Weed” is a common term for cannabis, which is also known as marijuana. Although these terms are often used interchangeably, “cannabis” technically refers to a family of plants, while marijuana refers to the parts of cannabis plants that contain active compounds called cannabinoids.

One of the best-known cannabinoids in marijuana is delta-9 tetrahydrocannabinol (THC). THC is the chemical responsible for the psychoactive effects (the “high”) that many people associate with marijuana use.

Cannabis can be used in several forms:

• Inhaling by smoking or vaping
• Eating cannabis-infused products, such as edibles, capsules, oils, or tinctures
• Placing oils or tablets under the tongue for faster absorption into the bloodstream
• Applying creams, balms, salts, or oils to the skin, usually to ease localized pain

Medical Marijuana

Some people use marijuana or related products for medical reasons. One popular compound found in cannabis is cannabidiol (CBD). Unlike THC, CBD does not cause a high. It’s often marketed for its potential to help with anxiety, sleep, and pain, although more research is still needed.

Medical marijuana and CBD are sometimes used to help manage:

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

Negative Effects of Marijuana Use

While marijuana may offer symptom relief for some people, it also comes with potential risks. These effects can vary depending on the dose, frequency of use, and the individual’s overall health. Using marijuana in high doses or over a long period of time may increase the chance of experiencing negative effects.

Possible negative effects of marijuana include:

• Lung damage — Smoking marijuana can irritate the lungs and cause respiratory problems, such as chronic bronchitis and lung infections. This can be especially concerning for people with lupus, since the condition can already affect the lungs.
• Memory and concentration problems — Marijuana use may make it harder to focus, learn, and remember new information.
• Mental health changes — Marijuana can worsen psychiatric symptoms in some people, including anxiety, depression, or even psychosis (losing touch with reality).
• Impaired judgment and coordination — Using marijuana may affect decision-making, reaction time, and coordination, increasing the risk of accidents or injury.
• Heart and blood pressure changes — Marijuana may cause a temporary rise in heart rate and a drop in blood pressure. These changes can be risky for people with existing cardiovascular problems (those affecting the heart and blood vessels), which can occur in some people with lupus.
• Cannabis withdrawal — People who use marijuana regularly may experience withdrawal symptoms when they stop. These can include irritability, mood swings, trouble sleeping, and reduced appetite.

Keep in mind that not everyone reacts to marijuana the same way. Some people may feel only mild effects, while others may experience symptoms that interfere with daily life. If you’re living with lupus, it’s important to weigh the risks — especially if marijuana use might worsen symptoms or interact with your treatments.

Potential Interactions Between Hydroxychloroquine and Marijuana

Marijuana is not well-documented to interact with hydroxychloroquine. However, there aren’t 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 medications, like hydroxychloroquine, are metabolized and decrease how well they work.

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

Both hydroxychloroquine and THC are processed by the liver. Because of this, taking both at the same time may affect how long THC stays in your system. You might feel more high than expected, or the effects might last longer than usual.

One MyLupusTeam member shared that they had felt more high than expected after smoking marijuana shortly after taking hydroxychloroquine — and wondered if others noticed something similar: “When you smoke after taking your dose, does it make you trip or get too high, etc.?” they asked. “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.”

It’s possible to feel stronger psychoactive effects when marijuana is used alongside hydroxychloroquine. Everyone’s body reacts differently, so it's important to be aware of how these substances may interact and to talk with your doctor if you’re concerned.

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.

Cardiovascular disease is the leading cause of death in people living with lupus. Because of this, it’s important to be cautious when combining substances like hydroxychloroquine and marijuana, which both affect the cardiovascular system.

If you’re considering marijuana while taking hydroxychloroquine, talk with your doctor about your heart health and personal risk factors.

The Bottom Line

If you’re taking hydroxychloroquine, using marijuana — including smoking, vaping, or consuming edibles — may come with risks. Marijuana can interact with how hydroxychloroquine works in your body, especially in the liver and cardiovascular system. Smoking marijuana, in particular, may also increase the risk of lung complications, which is especially important for people living with lupus.

It’s important to be honest with your healthcare provider about any marijuana use — how much, how often, and how you use it. This helps them guide your treatment, manage potential drug interactions, and ensure your lupus medications are as effective as possible.

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On MyLupusTeam, people share their experiences with lupus, get advice, and find support from others who understand.

Have you spoken with your healthcare provider about smoking weed while taking hydroxychloroquine? Let others know in the comments below.