Drug & supplement interaction

Cannabis + Esomeprazole, Naproxen

Esomeprazole, Naproxen brand name: Vimovo.

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

Esomeprazole, Naproxen falls into 4 drug categories that Cannabis can interact with; the most serious is rated moderate. Theoretically, cannabis might increase the levels and adverse effects of CYP2C9 substrates.

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

Cannabis and Esomeprazole, Naproxen

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. Esomeprazole, Naproxen 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

CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES

1 of 4

Why this applies to Esomeprazole, Naproxen

Esomeprazole, Naproxen falls under CYTOCHROME P450 2C9 (CYP2C9) SUBSTRATES — the group Cannabis interacts with.

Theoretically, cannabis might increase the levels and adverse effects of CYP2C9 substrates.
In vitro research shows that the cannabis constituents delta-9-tetrahydrocannabinol (THC), cannabidiol (CBD), and cannabinol moderately inhibit the CYP2C9-mediated 7-hydroxylation of S-warfarin in a concentration-dependent manner. In vitro research also shows that cannabis extracts modestly inhibit the CYP2C9 metabolism of tolbutamide; extracts providing the specific cannabinoids CBD and cannabigerol (CBG) had stronger inhibitory effects than extracts containing THC and CBD.
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

Vimovo combines naproxen (an anti-inflammatory pain reliever) with esomeprazole (a stomach acid blocker that helps protect your gut). The naproxen part is cleared partly by a liver enzyme called CYP2C9. Lab studies suggest compounds in cannabis (THC and CBD) can mildly slow that enzyme down. In theory, that could let naproxen build up a bit and make its side effects more likely, things like stomach upset, heartburn, an ulcer or bleeding risk, fluid retention, or kidney strain.

Here's the honest part: this is based only on test-tube research, not real patients, so the real-world effect is uncertain and may be small. It's still worth mentioning to your pharmacist or doctor, especially if you use cannabis regularly or take Vimovo daily, so they can watch for any tummy or kidney issues.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Damkier P, Lassen D, Christensen MMH, Madsen KG, Hellfritzsch M, Pottegård A. Interaction between warfarin and cannabis. Basic Clin Pharmacol Toxicol. 2019;124(1):28-31. PubMed
  2. Treyer A, Reinhardt JK, Eigenmann DE, Oufir M, Hamburger M. Phytochemical comparison of medicinal cannabis extracts and study of their CYP-mediated interactions with coumarinic oral anticoagulants. Med Cannabis Cannabinoids. 2023;6(1):21-31. PubMed
Moderate

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

2 of 4

Esomeprazole, Naproxen also falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES.

Theoretically, cannabis may increase the levels and adverse effects of CYP3A4 substrates.
In vitro research shows that cannabis can inhibit the activity of CYP3A4 enzymes, which might decrease the metabolism of CYP3A4 substrates. In vitro research also shows that cannabis extracts modestly inhibit the CYP3A4 metabolism of testosterone; extracts providing the specific cannabinoids CBD and cannabigerol (CBG) had stronger inhibitory effects than extracts containing THC and CBD.
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

Vimovo combines two medicines: esomeprazole (a stomach acid reducer) and naproxen (an anti-inflammatory pain reliever). The concern here is that cannabis may block a liver enzyme called CYP3A4 that helps clear these drugs. If that enzyme slows down, levels of the medication could creep up a bit, which in theory might mean more of naproxen's typical side effects, like stomach upset, heartburn, or, with heavier or longer use, stomach irritation and a higher bleeding risk.

That said, this is based only on lab and test-tube research, not on real patients, so it's a weak, theoretical signal rather than something proven. Neither drug here is a prodrug, so the direction makes sense. I wouldn't lose sleep over it, but it's worth mentioning to your pharmacist or doctor, especially if you use cannabis regularly.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Pellinen, P., Honkakoski, P., Stenback, F., Niemitz, M., Alhava, E., Pelkonen, O., Lang, M. A., and Pasanen, M. Cocaine N-demethylation and the metabolism-related hepatotoxicity can be prevented by cytochrome P450 3A inhibitors. Eur.J Pharmacol 1-3-1994;2 PubMed
  2. Treyer A, Reinhardt JK, Eigenmann DE, Oufir M, Hamburger M. Phytochemical comparison of medicinal cannabis extracts and study of their CYP-mediated interactions with coumarinic oral anticoagulants. Med Cannabis Cannabinoids. 2023;6(1):21-31. PubMed
Moderate

ANTICOAGULANT/ANTIPLATELET DRUGS

3 of 4

Esomeprazole, Naproxen also falls under ANTICOAGULANT/ANTIPLATELET DRUGS.

Theoretically, cannabis might increase the risk of bleeding when used concomitantly with anticoagulant/antiplatelet drugs.
In vitro research shows that the cannabis constituents delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) inhibit platelet aggregation.
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

Vimovo is a combo of naproxen (an NSAID pain reliever) and esomeprazole (a stomach-acid blocker added to protect against ulcers). The interaction concern here lands on the naproxen side. Naproxen already nudges up bleeding risk a bit because it makes platelets (the cells that help your blood clot) less sticky and can irritate the stomach lining.

Lab studies suggest THC and CBD may also make platelets less likely to clump together. So in theory, pairing cannabis with Vimovo could add to bleeding risk, showing up as easy bruising, nosebleeds, or stomach upset. Keep in mind this is theoretical and based only on test-tube data, so it's a gentle caution, not an alarm. Watch for unusual bruising or bleeding and check with your pharmacist or doctor.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Levy, R., Schurr, A., Nathan, I., Dvilanski, A., and Livne, A. Impairment of ADP-induced platelet aggregation by hashish components. Thromb.Haemost. 12-31-1976;36(3):634-640. DOI
  2. Formukong, E. A., Evans, A. T., and Evans, F. J. The inhibitory effects of cannabinoids, the active constituents of Cannabis sativa L. on human and rabbit platelet aggregation. J.Pharm.Pharmacol. 1989;41(10):705-709.
Moderate

CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES

4 of 4

Esomeprazole, Naproxen also falls under CYTOCHROME P450 2C19 (CYP2C19) SUBSTRATES.

Cannabis may increase levels of drugs metabolized by CYP2C19.
Research shows that cannabidiol (CBD), a constituent of cannabis, inhibits CYP2C19. In clinical studies and case reports, cannabidiol use resulted in significant increases in the serum levels of topiramate, methadone, citalopram, omeprazole, and N-desmethylclobazam, the primary active metabolite of clobazam. These chemicals are metabolized by CYP2C19. Concomitant use of cannabis with CYP2C19 substrates may increase the risk for adverse effects from these substrates.
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

Vimovo combines two medicines: esomeprazole (an acid-reducing PPI) and naproxen (an anti-inflammatory pain reliever). The esomeprazole half is cleared by a liver enzyme called CYP2C19. The CBD in cannabis can slow that enzyme down, so esomeprazole may hang around at higher levels than usual. For a stomach-protecting drug like this, that is usually not dangerous, though you might notice more of its typical effects, such as headache or digestive upset.

Keep in mind this concern is theoretical, based on how the drugs behave rather than strong human studies, and it mainly applies to concentrated CBD products, not an occasional puff. The naproxen part isn't really affected here. Still, mention your cannabis use to your pharmacist or doctor so they can keep an eye on things.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Harvey DJ. Absorption, distribution, and biotransformation of the cannabinoids. Marijuana and Medicine. 1999;91-103. DOI
  2. Bornheim LM, Everhart ET, Li J, Correia MA. Characterization of cannabidiol-mediated cytochrome P450 inactivation. Biochem Pharmacol 1993;45(6):1323-31. PubMed
  3. Gaston TE, Bebin EM, Cutter GR, Liu Y, Szaflarski JP; UAB CBD Program. Interactions between cannabidiol and commonly used antiepileptic drugs. Epilepsia. 2017 Sep;58(9):1586-92. PubMed
  4. Devinsky O, Marsh E, Friedman D, et la. Cannabidiol in patients with treatment-resistant epilepsy: an open-label interventional trial. Lancet Neurol. 2016 Mar;15(3):270-8.
  5. Geffrey AL, Pollack SF, Bruno PL, Thiele EA. Drug-drug interaction between clobazam and cannabidiol in children with refractory epilepsy. Epilepsia. 2015 Aug;56(8):1246-51. PubMed
  6. Madden K, Tanco K, Bruera E. Clinically Significant Drug-Drug Interaction Between Methadone and Cannabidiol. Pediatrics. 2020;e20193256. PubMed
  7. Anderson LL, Doohan PT, Oldfield L, et al. Citalopram and Cannabidiol: In Vitro and In Vivo Evidence of Pharmacokinetic Interactions Relevant to the Treatment of Anxiety Disorders in Young People. J Clin Psychopharmacol. 2021. PubMed
  8. Nasrin S, Watson CJW, Perez-Paramo YX, Lazarus P. Cannabinoid Metabolites as Inhibitors of Major Hepatic CYP450 Enzymes, with Implications for Cannabis-Drug Interactions. Drug Metab Dispos 2021;49(12):1070-1080. PubMed
  9. Bansal S, Zamarripa CA, Spindle TR, et al. Evaluation of Cytochrome P450-Mediated Cannabinoid-Drug Interactions in Healthy Adult Participants. Clin Pharmacol Ther 2023.

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, 1,108 moderate, 25 minor known drug interactions in our database — the Esomeprazole, Naproxen one above is among them. If you take anything else, check it against the full list below.

Major 2 Moderate 1,108 Minor 25 No known interaction 1,695 (incl. Esomeprazole, Naproxen)
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 Esomeprazole, Naproxen

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 Esomeprazole, Naproxen, 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 Esomeprazole, Naproxen

This page covers Cannabis only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Esomeprazole, Naproxen page lists 348 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Asarabacca (major), Beer (major), Danshen (major) and Grapefruit (major).

By severity: 9 major · 283 moderate · 56 minor.

From our pharmacist’s overview on the Esomeprazole, Naproxen page

“Bleeding risk is the thread running through nearly this whole page. Vimovo pairs naproxen, an anti-inflammatory that already makes stomach bleeding more likely, with esomeprazole on board to shield the gut, and most of the supplements flagged here could push that bleeding risk higher still.”

Reviewed by 2 · Jul 18, 2026

Open the Esomeprazole, Naproxen 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 Esomeprazole, Naproxen 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 Esomeprazole, Naproxen 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%

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

29 days ago today
Medication Esomeprazole, Naproxen
Steady interest

#1,956 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
1,108Moderate
25Minor
1,694No known interaction
2 Major 1,108 Moderate 25 Minor 1,694 No interaction
Major

2 interactions

Moderate

1,108 interactions

Showing 60 of 1,108 moderate interactions — see all 1,108 on the Cannabis page.

Minor

25 interactions

No interaction 1,694 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 1,694 medications checked with no known interaction — see the full Cannabis list.

See the full Cannabis interactions page
See every supplement checked against Esomeprazole, Naproxen, 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 Esomeprazole, Naproxen supplement interactions › Every supplement checked against Esomeprazole, Naproxen, 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 Esomeprazole, Naproxen Together: Common Questions

Can you take Cannabis with Esomeprazole, Naproxen?
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 Esomeprazole, Naproxen?
Esomeprazole, Naproxen 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 Esomeprazole, Naproxen 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 Esomeprazole, Naproxen 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.