If you’re already using cannabis to help deal with mild pain, can you take Advil with cannabis for an extra pain-alleviating boost? Finding an answer to this question is a bit tricky, and there’s limited scientific evidence to suggest whether Advil and weed will interact well or poorly, if at all.
In this article, we’ll look at the limited available evidence regarding the safety of consuming both substances at the same time, as well as what potential interactions exist between cannabis and Advil. We’ll also briefly touch on whether cannabis might serve as an alternative to Advil or other similar over-the-counter medications.
Advil, the most common of several brand names for the drug ibuprofen, is a type of nonsteroidal anti-inflammatory drug (NSAID), according to the Mayo Clinic, and it is typically “used to treat mild to moderate pain, and helps to relieve symptoms of arthritis (osteoarthritis, rheumatoid arthritis, or juvenile arthritis), such as inflammation, swelling, stiffness, and joint pain,” as well as fevers.
Ibuprofen has been around since 1969, according to an overview of the drug published in 2010, and is available over-the-counter in tablet and capsule forms. The most common side effects associated with ibuprofen are “gastric discomfort, nausea, and vomiting,” and these side effects are as common as they are with ibuprofen’s main predecessor, aspirin.
While ibuprofen and cannabis might both commonly be used to ease mild pain, the source of the potential interaction between the two substances doesn’t become obvious until you dig into the scientific literature.
Ibuprofen works by inhibiting the production of cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2). Both of these enzymes are involved in the production of “prostaglandins, bioactive compounds involved in processes such as fever and sensitivity to pain.” By inhibiting the production of these enzymes, ibuprofen can help to reduce fevers and pain.
The mechanism of cannabis in regard to pain relief occurs through the endocannabinoid system, and injured tissues actually produce several endocannabinoids. Under certain conditions, one of these endocannabinoids, called anandamide, “can be directly transformed by COX-2 into proalgesic prostamides,” which are a lipid substance similar to prostaglandins.
According to a 2011 article published in the Journal of Medicine and Life, this transformation can lead to interactions between the endocannabinoid system and Advil. While the article doesn’t explicitly explore how cannabis consumption might affect this interaction, the possibility for influence is certainly present.
“All the NSAIDs that inhibit COX-2 can influence the cannabinoid system because a possible important degradative pathway for anandamide and 2–arachidonoyl glycerol [another endocannabinoid] might involve COX-2,” the article’s authors conclude. “One of the causes for the variety of experimental results presented might be due to pharmacokinetic mechanisms, depending on the route of administration and the dose.”
There is extremely little high-quality information regarding interactions between cannabis and Advil or ibuprofen and whether you can safely consume both at the same time.
When there isn’t much information available to help you make wellness-related decisions — at least with relatively safe substances like ibuprofen and cannabis — the best thing you can do is pay attention to how your body responds to what you’re consuming.
For example, if you regularly consume a particular cannabis product and take an Advil, it would be important to note whether you feel any different from usual in terms of both your cannabis experience and the efficacy you’ve come to expect from Advil.
Just as for cannabis in general, it remains unclear whether you can or cannot take Advil with CBD. CBD interacts with the endocannabinoid system differently than THC does, there is no solid evidence to say specifically whether you might encounter an adverse reaction from consuming these substances together.
With that being said, there is evidence to support a connection between CBD and both COX-1 and COX-2.
According to a 2023 article reviewing the analgesic properties and mechanisms of CBD, the authors highlight previous studies that the “mechanism for the anti-inflammatory and analgesic properties of CBD… is mediated by an increase in the activity of both cyclooxygenase 1 (COX-1) and cyclooxygenase 2 (COX-2) which are major targets of non-steroidal anti-inflammatory drugs (NSAIDs).”
Again, if you plan to consume cannabis along with one or two Advil tablets, it will be worth paying attention to any signs of an adverse reaction from your body, including increased side effects of either substance.
In 2013, a study published in the journal Cell caught some media buzz when it claimed that the potential cognitive effects of cannabis consumption regarding memory and Alzheimer’s disease might be offset by consuming ibuprofen.
The interaction between Advil and THC in relation to the inhibition or production of cyclooxygenase enzymes discussed above is at the core of the study’s conclusion. According to the animal model used in the study, exposure to delta-9-THC increases levels of COX-2, which is associated with memory problems. Therefore, taking a drug that suppresses COX-2, such as Advil or another NSAID, could be an easy solution to reduce the risk of those memory problems.
As memory impairment might be a factor preventing some individuals from seeking medical cannabis for appropriate conditions, the authors argue that implementation of their discovery might help expand the applicability of medical cannabis.
Cannabis has been used to relieve pain for thousands of years. Chronic pain is frequently cited as a motivation for cannabis consumption, and some athletes rely on cannabis to aid in recovery after intense workouts.
This use case is supported by evidence (as well as centuries of user-reported efficacy), though researchers have sometimes wrestled with limitations associated with studying cannabis. Still, a review published by the National Academy of Sciences, Engineering, and Medicine found “substantial evidence that inhaled cannabis is effective for the treatment of chronic pain in adults.”
There aren’t many studies directly comparing the effectiveness of Advil and that of cannabis when it comes to relieving different types of pain. One study, however, did compare how well a cohort of female patients responded to ibuprofen versus CBD for treating pain from period cramps.
While the language used by the authors is vague, they do seem to argue that CBD could be “an interesting alternative to treat pain in women living with [primary dysmenorrhea] who do not respond to NSAIDs or who have unacceptable side effects related to them.”
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