Drug & supplement interaction

Cannabis + Butalbital, Phenobarbital, Secobarbital

Butalbital, Phenobarbital, Secobarbital brand name: Tribarb.

Moderate Interaction
Medically reviewed by · Updated October 2026
The bottom line Moderate

Butalbital, Phenobarbital, Secobarbital falls into 4 drug categories that Cannabis can interact with; the most serious is rated moderate. Theoretically, cannabis might have additive effects if used with other CNS depressants.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions4
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Cannabis and Butalbital, Phenobarbital, Secobarbital

These two interact in 4 distinct ways. Each one is explained separately below.

Why Are There 4 Interactions?

Cannabis interacts with whole categories of medication. Butalbital, Phenobarbital, Secobarbital falls into 4 of those categories, so it can interact with Cannabis in 4 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CNS DEPRESSANTS

1 of 4

Why this applies to Butalbital, Phenobarbital, Secobarbital

Butalbital, Phenobarbital, Secobarbital falls under CNS DEPRESSANTS — the group Cannabis interacts with.

Theoretically, cannabis might have additive effects if used with other CNS depressants.
Cannabis can have CNS depressant effects. Combining cannabis with other CNS depressants might result in additive or synergistic effects. A small clinical trial in healthy adults shows that inhaling a high-grade cannabis (Bedrocan International B.V., Veendam, The Netherlands) 100 mg, containing delta-9-tetrahydrocannabinol 21.8% and cannabinol 0.1%, modestly increases subjective feelings of sedation when compared with cannabis alone.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

The barbiturates in Tribarb (butalbital, phenobarbital, and secobarbital) are strong calming medicines that slow down your brain and nervous system. Cannabis, especially the THC part, can do something similar. When you put the two together, those sedating effects can stack up. You might feel more drowsy, foggy, or dizzy than usual, with slower reactions, poorer coordination, and trouble concentrating. In bigger doses, very slowed or shallow breathing is the main safety worry, so this combo is worth respecting.

To be fair, this concern is based mostly on how these substances work rather than on hard studies, and one small trial only found a modest bump in sedation. Still, I'd play it safe. Don't drive, and please talk with your doctor or pharmacist before mixing them.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Marinol Prescribing Information. Solvay Pharmaceuticals, Rev March 2008. Available at: http://www.solvaypharmaceuticals-us.com/static/wma/pdf/1/3/2/5/0/004InsertText500012RevMar2008.pdf (Accessed 2 July 2009).
  2. Hollister, L. E. Interactions of cannabis with other drugs in man. NIDA Res.Monogr 1986;68:110-116. DOI
  3. van Dam CJ, van der Schrier R, van Velzen M, et al. Inhaled Delta(9)-tetrahydrocannabinol does not enhance oxycodone-induced respiratory depression: randomised controlled trial in healthy volunteers. Br J Anaesth 2023;130(4):485-493.
Moderate

BARBITURATES

2 of 4

Butalbital, Phenobarbital, Secobarbital also falls under BARBITURATES.

Theoretically, cannabis might increase the levels and adverse effects of barbiturates.
Some research shows that synthetic delta-9-tetrahydrocannabinol (THC) increases the elimination half-life of pentobarbital by 4 hours when dosed concomitantly.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

If you take a barbiturate like phenobarbital, butalbital, or secobarbital and you also use cannabis, the concern here is mostly about overlap and timing. These medicines are strong central nervous system depressants, and cannabis (especially THC) can add to that sedating effect. Together they may leave you more drowsy, dizzy, foggy-headed, or slowed down than either one alone.

There is also a theoretical piece: in older research, THC made one barbiturate (pentobarbital) hang around a bit longer in the body. That could mean slightly stronger or longer-lasting effects. The evidence is thin and based on pharmacology, so I would not panic, but since barbiturates have a narrow safety margin, please loop in your doctor or pharmacist before combining them.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Marinol Prescribing Information. Solvay Pharmaceuticals, Rev March 2008. Available at: http://www.solvaypharmaceuticals-us.com/static/wma/pdf/1/3/2/5/0/004InsertText500012RevMar2008.pdf (Accessed 2 July 2009).
Moderate

CYTOCHROME P450 3A4 (CYP3A4) INDUCERS

3 of 4

Butalbital, Phenobarbital, Secobarbital also falls under CYTOCHROME P450 3A4 (CYP3A4) INDUCERS.

Theoretically, CYP3A4 inducers might reduce the levels and clinical effects of cannabis.
Delta-9-tetrahydrocannabinol (THC), an active constituent of cannabis, is a substrate of CYP3A4 enzymes.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist of this one. Barbiturates like phenobarbital, butalbital, and secobarbital are strong enzyme revvers. They tell your liver to make more of a worker called CYP3A4, and that same worker happens to break down THC, the main active part of cannabis. So when these two share your system, your body may clear the cannabis faster, meaning its effects (pain relief, relaxation, appetite, or the 'high') could feel weaker or shorter than you expect.

This is a theoretical concern based on how the drugs work, not solid human studies, so don't panic. The bigger real-world worry is the other direction: both cannabis and barbiturates can cause drowsiness and slowed thinking, so combining them can leave you very sedated. Please check with your doctor or pharmacist before mixing them.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Product information for Marinol. AbbVie. North Chicago, IL 60064. August 2017. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/018651s029lbl.pdf.
Moderate

CYTOCHROME P450 2C9 (CYP2C9) INDUCERS

4 of 4

Butalbital, Phenobarbital, Secobarbital also falls under CYTOCHROME P450 2C9 (CYP2C9) INDUCERS.

Theoretically, drugs that are CYP2C9 inducers might decrease the effects of cannabis.
Delta-9-tetrahydrocannabinol (THC), an active constituent of cannabis, is a substrate of CYP2C9 enzymes.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the key thing to understand: barbiturates like butalbital, phenobarbital, and secobarbital are known to speed up certain liver enzymes, including CYP2C9. Since THC (the main active compound in cannabis) is broken down partly by that same enzyme, these medicines could theoretically clear cannabis out of your system a bit faster. The practical result would be a weaker or shorter effect from the cannabis, not a stronger one.

I want to be honest with you, though: this is a theoretical concern based on how the enzymes work, not something proven in real people. There's also a more important point here, both barbiturates and cannabis cause drowsiness, slowed breathing, and impairment, so combining them can make you very sedated. Please talk with your doctor or pharmacist before mixing the two.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Product information for Marinol. AbbVie. North Chicago, IL 60064. August 2017. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/018651s029lbl.pdf.

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Cannabis Also Interacts With Other Medications

Cannabis has 2 major, 1,109 moderate, 25 minor known drug interactions in our database — the Butalbital, Phenobarbital, Secobarbital one above is among them. If you take anything else, check it against the full list below.

Major 2 Moderate 1,109 Minor 25 No known interaction 1,694 (incl. Butalbital, Phenobarbital, Secobarbital)
Taking anything else?

Check Another of Your Medications Against Cannabis

Covers the 2,830 medications we’ve checked against Cannabis. Pick one to open its full report.

From our Q&A

Questions About Cannabis or Butalbital, Phenobarbital, Secobarbital

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Cannabis or Butalbital, Phenobarbital, Secobarbital, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Butalbital, Phenobarbital, Secobarbital

This page covers Cannabis only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Butalbital, Phenobarbital, Secobarbital page lists 151 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Activated Charcoal (major), Beer (major), Gamma-hydroxybutyrate (ghb) (major) and Kava (major).

By severity: 8 major · 124 moderate · 19 minor.

From our pharmacist’s overview on the Butalbital, Phenobarbital, Secobarbital page

“Barbiturates leave little margin for error, and the butalbital, phenobarbital, and secobarbital combination sold as Tribarb is no exception, so its 151 supplement and herbal interactions deserve genuine care. Seventy-eight of those ingredients deepen the drug's sedation, which at the worst end means dangerously slowed breathing.”

Reviewed by 2 · Jul 18, 2026

Open the Butalbital, Phenobarbital, Secobarbital interaction page

One more smart check

Taking Cannabis as Part of a Dietary Supplement Product? Check It for Interactions

We hold 21 real supplement products containing Cannabis, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Cannabis. Your product may carry other ingredients that interact with Butalbital, Phenobarbital, Secobarbital too, on top of Cannabis — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Cannabis and Butalbital, Phenobarbital, Secobarbital Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Cannabis
Top 25%

#262 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Butalbital, Phenobarbital, Secobarbital
Top 5%

#103 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Cannabis

What is Cannabis?

Cannabis
  • Chronic pain
  • Nausea and vomiting from chemotherapy
  • Muscle spasticity (e.g., multiple sclerosis)
  • Anxiety and stress
  • Sleep problems
  • Appetite stimulation

Cannabis contains many active compounds, mainly THC (which causes a 'high') and CBD (which does not). Some uses, such as chemotherapy-related nausea, certain seizure disorders, and muscle spasticity, have meaningful evidence, while many other popular uses are not well proven. It can cause real side effects and impairment, so talk to your doctor or pharmacist and follow your local laws before using it.

Read the full Cannabis monograph & all interactions
Keep checking

Other Drugs & Cannabis

Browse every other medication we’ve checked against Cannabis — both the ones with a known interaction and the ones without. Select any drug for the full detail.

2Major
1,109Moderate
25Minor
1,693No known interaction
2 Major 1,109 Moderate 25 Minor 1,693 No interaction
Major

2 interactions

Moderate

1,109 interactions

Showing 60 of 1,109 moderate interactions — see all 1,109 on the Cannabis page.

Minor

25 interactions

No interaction 1,693 drugs checked — show the list

We also checked Cannabis against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 1,693 medications checked with no known interaction — see the full Cannabis list.

See the full Cannabis interactions page
See every supplement checked against Butalbital, Phenobarbital, Secobarbital, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Cannabis monograph › Uses, safety, and every drug interaction in one place Butalbital, Phenobarbital, Secobarbital supplement interactions › Every supplement checked against Butalbital, Phenobarbital, Secobarbital, ranked by severity Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Cannabis and Butalbital, Phenobarbital, Secobarbital Together: Common Questions

Can you take Cannabis with Butalbital, Phenobarbital, Secobarbital?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 4 interactions listed for Cannabis and Butalbital, Phenobarbital, Secobarbital?
Butalbital, Phenobarbital, Secobarbital belongs to more than one drug category, and Cannabis interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Cannabis and Butalbital, Phenobarbital, Secobarbital interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Butalbital, Phenobarbital, Secobarbital and Cannabis?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.