Drug & supplement interaction

Delta-9-tetrahydrocannabinol (thc) + Phenobarbital, Sodium Nitrate

Phenobarbital, Sodium Nitrate brand name: Soniphen.

Moderate Interaction
The bottom line Moderate

Phenobarbital, Sodium Nitrate 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 Phenobarbital, Sodium Nitrate

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. Phenobarbital, Sodium Nitrate 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 Phenobarbital, Sodium Nitrate

Phenobarbital, Sodium Nitrate 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

Here's the simple version: phenobarbital is a barbiturate, and one of its biggest jobs is to calm the brain down. THC can do some of that same calming too. So when you put them together, the slowing-down effects can stack on top of each other. That could mean feeling extra drowsy, foggy, dizzy, or unsteady on your feet, and in larger amounts it could even slow your breathing.

I'll be honest about the evidence here, it's mostly theoretical, based on how both act on the body rather than firm studies. Still, both are sedating, so it's worth taking seriously. Please don't start, stop, or change either one on your own. Check with your pharmacist or doctor first, and avoid driving until you know how the combination affects you.

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

Phenobarbital, Sodium Nitrate 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

Here's the gist: phenobarbital is a barbiturate, and like other barbiturates it's a strong central nervous system depressant that slows down your brain. THC (whether from cannabis or the prescription form, dronabinol) can add to that slowing-down effect and may also hang around in your body a bit longer. The concern is that the two together could pile up, leaving you more sedated than you'd expect.

In real terms, that might mean extra drowsiness, dizziness, slowed thinking, foggy memory, or feeling unsteady on your feet. Driving and operating machinery would be especially risky. I want to be honest, though: this is mostly theoretical and based on lab and animal studies, not strong human data, so it may not be a big deal for everyone. Still, please loop in your doctor or pharmacist before combining them.

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

Phenobarbital, Sodium Nitrate 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 simple version: phenobarbital is a strong, long-acting barbiturate that revs up a liver enzyme called CYP3A4. Since your body uses that same enzyme to break down THC, taking phenobarbital alongside cannabis could clear the THC out faster. In plain terms, the THC may feel weaker or wear off sooner than you'd expect, so you might not get the relief or effect you were after.

I want to be honest about the strength of this one. It's based on how these compounds behave on paper, not on solid human studies, so it's more of a theoretical heads-up than a proven problem. The bigger concern is that both phenobarbital and THC can make you drowsy, foggy, and unsteady, which adds up. Please loop in your doctor or pharmacist before combining 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.
Moderate

CYTOCHROME P450 2C9 (CYP2C9) INDUCERS

4 of 4

Phenobarbital, Sodium Nitrate 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 pairing. Phenobarbital is a barbiturate, and one thing it's well known for is revving up certain liver enzymes, including CYP2C9. Since your body uses CYP2C9 to help break down THC, taking phenobarbital regularly could speed up how fast THC is cleared. The practical result would be weaker THC effects, so you might notice less relief or feel like your usual amount just isn't doing much.

I'll be honest, this one is theoretical and based on how the drugs work, not on strong studies, so it's nothing to panic over. Just keep in mind that phenobarbital itself causes drowsiness, and combining it with THC can add to that sleepiness or foggy feeling. Loop in 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 Phenobarbital, Sodium Nitrate 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 Phenobarbital, Sodium Nitrate

This page covers Delta-9-tetrahydrocannabinol (thc) only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Phenobarbital, Sodium Nitrate 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 Phenobarbital, Sodium Nitrate page

“Phenobarbital with sodium nitrate (Soniphen) is a barbiturate, a heavy sedative used mainly for seizures, and its supplement list calls for real care before you add anything to it. Of the 141 ingredients on file, 78 pile extra sedation onto a drug that already slows breathing and reflexes, and six of the eight major-rated entries sit i…”

Reviewed by 2 · Jul 18, 2026

Open the Phenobarbital, Sodium Nitrate interaction page

How much people look this up

Where Delta-9-tetrahydrocannabinol (thc) and Phenobarbital, Sodium Nitrate 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

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

29 days ago today
Medication Phenobarbital, Sodium Nitrate
Steady interest

#2,686 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

We also checked Delta-9-tetrahydrocannabinol (thc) against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 1,732 medications checked with no known interaction — see the full Delta-9-tetrahydrocannabinol (thc) 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 Phenobarbital, Sodium Nitrate Together: Common Questions

Can you take Delta-9-tetrahydrocannabinol (thc) with Phenobarbital, Sodium Nitrate?
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 Phenobarbital, Sodium Nitrate?
Phenobarbital, Sodium Nitrate 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 Phenobarbital, Sodium Nitrate 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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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.