Drug & supplement interaction

Delta-9-tetrahydrocannabinol (thc) + Bellafoline, Phenobarbital

Bellafoline, Phenobarbital brand names: Belladenal, Belladenal-S.

Moderate Interaction
The bottom line Moderate

Bellafoline, Phenobarbital falls into 4 drug categories that Delta-9-tetrahydrocannabinol (thc) can interact with; the most serious is rated moderate. Theoretically, THC 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

Delta-9-tetrahydrocannabinol (thc) and Bellafoline, Phenobarbital

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

Why Are There 4 Interactions?

Delta-9-tetrahydrocannabinol (thc) interacts with whole categories of medication. Bellafoline, Phenobarbital falls into 4 of those categories, so it can interact with Delta-9-tetrahydrocannabinol (thc) 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 Bellafoline, Phenobarbital

Bellafoline, Phenobarbital falls under CNS DEPRESSANTS — the group Delta-9-tetrahydrocannabinol (thc) interacts with.

Theoretically, THC might have additive effects if used with other CNS depressants.
Cannabis containing THC can have CNS depressant effects. Combining THC with other CNS depressants might result in additive or synergistic effects.
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

Belladenal contains phenobarbital, a barbiturate that calms the brain and nervous system. THC has its own calming, sedating side. When you put the two together, those effects can stack up. This isn't about one slowing down or speeding up the other in your liver; it's simply two things that both make you drowsy pulling in the same direction.

So the realistic concern is feeling extra sleepy, foggy, dizzy, or unsteady, with slower reactions and poorer focus (a real problem for driving). I'll be honest: this combo is flagged as a theoretical additive effect based on how both work, not strong proof. Still, please don't start or stop either one on your own. Loop in your pharmacist or doctor first.

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

Bellafoline, Phenobarbital also falls under BARBITURATES.

Theoretically, THC might increase the levels and adverse effects of barbiturates.
Some research shows that synthetic THC (dronabinol) increases the elimination half-life of pentobarbital by 4 hours when dosed concomitantly. Also, in animal research, THC potentiated pentobarbital-induced sleep by more than three-fold.
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

Belladenal contains phenobarbital, a barbiturate that calms the brain and can make you sleepy. THC works on its own receptors in the brain, but the concern here is that the two together may pile up the sedation. Some lab and animal work suggests THC can slow how the body clears barbiturates and may deepen and lengthen their sleep-inducing effect. That could mean more drowsiness, foggy thinking, slowed breathing, dizziness, or trouble waking up than you'd expect from your usual dose.

Keep in mind this is mostly theoretical and based on lab and animal studies, so it may not happen to everyone. Still, both substances slow you down, so I wouldn't take chances. Please check with your pharmacist or doctor before combining them, especially if you drive or feel extra sleepy.

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. Kimura T, Takaya M, Usami N, Watanabe K, Yamamoto I. ?9-Tetrahydrocannabinol, a major marijuana component, enhances the anesthetic effect of pentobarbital through the CB1 receptor. Forensic Toxicol. 2019;37(1):207-214. DOI
Moderate

CYTOCHROME P450 3A4 (CYP3A4) INDUCERS

3 of 4

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

Theoretically, CYP3A4 inducers might reduce the levels and clinical effects of THC.
THC 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 for this combo. Your medication contains phenobarbital, which is a well-known booster of a liver enzyme called CYP3A4. THC happens to be broken down by that same enzyme. So when phenobarbital revs up CYP3A4, your body can clear THC faster than usual, which may leave the THC feeling weaker or shorter-lasting than you'd expect.

To be honest, this is a theoretical interaction based on how the drugs work, not on strong studies, so I wouldn't lose sleep over it. The bigger real-world concern is that both can make you drowsy, foggy, or unsteady. If you use both, mention it to your pharmacist or doctor so they can watch for excess sedation and make sure your phenobarbital is doing its job.

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

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

Theoretically, drugs that are CYP2C9 inducers might decrease the levels and clinical effects of THC.
THC 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 gist for this combo. The phenobarbital in your Belladenal is a classic enzyme 'speed-up' agent, meaning it pushes your liver to work faster, including the CYP2C9 pathway that helps break down THC. So when these two are on board together, your body may clear the THC more quickly than usual. In plain terms, the THC could feel weaker or wear off sooner, so you might not get the relief or effect you were expecting.

I'll be honest with you: this is a theoretical interaction based on how the drugs behave in the lab, not something proven in real patients, so I don't want you to panic. Still, since phenobarbital is a strong inducer, it's worth a quick chat with your pharmacist or doctor before mixing them.

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

Delta-9-tetrahydrocannabinol (thc) Also Interacts With Other Medications

Delta-9-tetrahydrocannabinol (thc) has 761 moderate, 336 minor known drug interactions in our database — the Bellafoline, Phenobarbital one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Delta-9-tetrahydrocannabinol (thc)

Covers the 2,830 medications we’ve checked against Delta-9-tetrahydrocannabinol (thc). Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Bellafoline, Phenobarbital

This page covers Delta-9-tetrahydrocannabinol (thc) only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Bellafoline, Phenobarbital page lists 141 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 · 115 moderate · 18 minor.

From our pharmacist’s overview on the Bellafoline, Phenobarbital page

“Phenobarbital, the sedative half of Bellafoline (Belladenal), already slows the brain, so I treat this interaction list as one to respect rather than skim. More than half of the 141 entries, alcohol among them, add their own sedation on top of the drug's, which can deepen drowsiness and, in the worst pairings, suppress breathing.”

Reviewed by 2 · Jul 18, 2026

Open the Bellafoline, Phenobarbital interaction page

How much people look this up

Where Delta-9-tetrahydrocannabinol (thc) and Bellafoline, Phenobarbital 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 Delta-9-tetrahydrocannabinol (thc)
Top half

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

29 days ago today
Medication Bellafoline, Phenobarbital
Top 25%

#450 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 Delta-9-tetrahydrocannabinol (thc)

What is Delta-9-tetrahydrocannabinol (thc)?

Delta-9-tetrahydrocannabinol (thc)
  • Chronic or nerve pain
  • Nausea and vomiting from chemotherapy
  • Appetite loss and weight loss
  • Muscle spasticity
  • Sleep problems
  • Anxiety and stress

THC is the main mind-altering compound in cannabis and is best known for causing a 'high.' A prescription form (dronabinol) is approved for chemotherapy-related nausea and appetite loss, but for most other uses the evidence is mixed or limited, and THC can impair thinking and driving. It should be avoided in pregnancy and breastfeeding and used only with medical guidance.

Read the full Delta-9-tetrahydrocannabinol (thc) monograph & all interactions
Keep checking

Other Drugs & Delta-9-tetrahydrocannabinol (thc)

Browse every other medication we’ve checked against Delta-9-tetrahydrocannabinol (thc) — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
761Moderate
336Minor
1,732No known interaction
Moderate

761 interactions

Showing 60 of 761 moderate interactions — see all 761 on the Delta-9-tetrahydrocannabinol (thc) page.

Minor

336 interactions

Showing 60 of 336 minor interactions — see all 336 on the Delta-9-tetrahydrocannabinol (thc) page.

No interaction 1,732 drugs checked — show the list
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

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Pharmacist Counseling Corner

Taking Delta-9-tetrahydrocannabinol (thc) and Bellafoline, Phenobarbital Together: Common Questions

Can you take Delta-9-tetrahydrocannabinol (thc) with Bellafoline, Phenobarbital?
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 Delta-9-tetrahydrocannabinol (thc) and Bellafoline, Phenobarbital?
Bellafoline, Phenobarbital belongs to more than one drug category, and Delta-9-tetrahydrocannabinol (thc) 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 Delta-9-tetrahydrocannabinol (thc) and Bellafoline, Phenobarbital 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

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