Tylenol is one of the most common over-the-counter pain-relieving medications. It treats various everyday ailments, like mild to moderate pain, colds, muscle aches, menstrual cramps, and headaches.
Alternatively, many consumers have also pointed to marijuana’s ability to ease symptoms of these conditions. As cannabis legalization continues to spread nationally and globally, access to and curiosity about cannabis has grown, leaving many people wondering: is it safe to take Tylenol and smoke weed at the same time?
Before you run off to try the combination, remember that medications have the potential to interact in unexpected ways, and cannabis and Tylenol are no different. There are potential risks and medical considerations to keep in mind before you decide to use the popular pain reliever along with cannabis.
What Is Tylenol?
Tylenol is a brand-name medication with acetaminophen as its active ingredient. Acetaminophen is classified as a pain reliever (analgesic) and fever reducer (antipyretic), and they are the two primary reasons why people turn to Tylenol for relief.
Acetaminophen can also be found labeled as:
- Panadol
- Actamin
- Feveral
- Temra Quicklets
Other common cold medications, like DayQuil and NyQuil, also contain acetaminophen in concentrated amounts.
The most common uses of medication like Tylenol are in treating muscle aches, headaches, backaches, mild arthritis, menstrual cramps, toothaches, colds, and sore throats.
Acetaminophen’s ability to treat various ailments makes it a common medication that is prescribed and kept on hand by many adults. On average, 23% of U.S. adults (or 52 million consumers) use medication with the active ingredient acetaminophen every week, according to the Consumer Healthcare Products Association.
Products containing acetaminophen are over-the-counter medications, making them easily obtainable by consumers, even if they weren’t prescribed by a physician. Although generally regarded as safe, some side effects may occur when taking acetaminophen, including:
- Itching or swelling (especially of the face, tongue, or throat)
- Trouble breathing
- Skin reddening, blisters, or rash
- Severe dizziness
- Nausea
- Loss of appetite
These types of medications process through the liver. In small doses, they don’t cause significant damage to the organ, but they can in high-doses.1 Patients should speak with a doctor if they plan to take Tylenol or acetaminophen products if they:
- Have liver disease
- Are breastfeeding
- Are taking other medications with acetaminophen as an active ingredient
Interactions Between Tylenol and Weed
Acetaminophen medications, like Tylenol, have been consumed in combination with cannabis for quite some time. Both acetaminophen and cannabis have shown the ability to reduce pain and are easy to access for many people. Minimal adverse side effects have been reported when combining the two, leading some physicians to believe that there isn’t a significant cause for concern. However, some physicians recommend exercising caution because of how cannabis and acetaminophen both interact with the endocannabinoid system (ECS).
Acetaminophen produces a metabolite that acts on the ECS, a system that plays a role in regulating pain and body temperature.2 One study conducted on rats found that their ability to process a single drug, like acetaminophen, gabapentin, or morphine, was not affected by the ECS. But when the rats were given acetaminophen in combination with other medications, specifically gabapentin and morphine, the ECS did affect the body's response. In this case, a combination of Tylenol and other medications increased analgesic effects by binding to ECS receptors.3
A 2021 literature review focused on the current studies on how CBD interacts with various drugs, including acetaminophen. CBD is processed in the liver, and it has shown the potential to be beneficial to the organ in some cases. The findings of the review suggest that, while CBD and Tylenol may not damage the liver when taken independently, they may do so if combined. However, researchers also noted that some research does contradict this.4
These studies demonstrate that there may be a relationship between cannabis and acetaminophen and how they are processed in the body when taken simultaneously. The effects of combining cannabis and Tylenol could depend on the individual’s physiology and other medications they are taking.
It is best to take caution when combining cannabis and Tylenol because both medications interact with the ECS and liver. Physicians especially warn those with liver conditions, breastfeeding, or taking other medications to be cautious.
Can I Combine Tylenol and Weed?
Research is conflicting and anecdotal evidence suggests that most people can take cannabis and Tylenol without issue. And although there isn’t any research proving cannabis can enhance the pain-relieving effects of Tylenol, some patients and practitioners theorize that the combination may increase pain relief.
The adverse effects of combining Tylenol and cannabis are mild, with very few, if any, severe reactions ever recorded. That said, medical professionals recommend that people are mindful of the potential risks when mixing Tylenol and cannabis. Both drugs help with various pain symptoms, are processed through the liver, and their effects rely on their interaction with the ECS and other neurological pathways.
Patients with liver conditions, who are breastfeeding, or are taking other medications should speak with their physicians before mixing cannabis and Tylenol, since these situations may present a higher risk of negative reactions when mixing cannabis and acetaminophen.
Further research is needed to understand how cannabis and acetaminophen medications like Tylenol interact to affect the body and pain sensation.
Tylenol or Medical Marijuana: Which is Better for Migraines and Pain Relief?
People reach for the Tylenol bottle for various aches and pains, but headaches are one of the most common reasons people turn to the over-the-counter medication for relief. Likewise, cannabis has demonstrated the potential to alleviate symptoms of similar conditions, leading people to wonder which option is better when seeking pain relief.
Some research has shown that, although acetaminophen may provide some relief from aches and pains, it is generally ineffective at providing long-term relief from severe pain without damaging the liver.5 Headaches that develop into more severe or chronic conditions, like migraines, may require more intense medication than Tylenol.
So is cannabis a viable alternative?
Cannabis is not always a treatment people think of when they get a headache, but it may be able to provide relief. And if a headache does develop into a migraine, cannabis may be able to treat symptoms such as nausea. One study reported that cannabis reduced some patients' headache and migraine symptoms by 50%. Although, its effectiveness gradually reduced over time with usage.6
Which option works best for you will depend on your needs and the doctor’s recommendation.
Cannabis can be intoxicating, depending on the dosage, and it can adversely affect your ability to participate in other activities throughout the day. However, some consumers may find it to be more effective in alleviating severe headaches. Tylenol can be taken throughout the day without any impact on your ability to function at work or on the go. It is a gentle short-term solution for benign headaches, but it shouldn’t be taken frivolously as overuse could result in liver damage.
Consult with your doctor if you are concerned about which treatment may be the better option for you.
Conclusion
The research regarding the effects of mixing Tylenol and cannabis is limited and conflicting. While some studies find that cannabis and Tylenol can relieve pain more effectively when taken together, others say the combination can make you more sensitive to pain.7
Research also suggests that some people may experience damage to the liver when combining acetaminophen and CBD. Both drugs process through the liver and interact with ECS receptors that govern pain pathways.
Many people have taken Tylenol before, during, or after consuming cannabis with minimal or no issues. Still, given the potential risks and lack of concrete evidence about how the two drugs interact, mixing cannabis and Tylenol should be done cautiously and with the guidance of a qualified medical professional, especially if you have pre-existing liver conditions.
References
1 “Acetaminophen.” PubMed, National Institute of Diabetes and Digestive and Kidney Diseases, 2012, www.ncbi.nlm.nih.gov/books/NBK548162/#:~:text=Harmless%20at%20low%20doses%2C%20acetaminophen.
2 Högestätt, Edward D., et al. “Conversion of Acetaminophen to the Bioactive N-Acylphenolamine AM404 via Fatty Acid Amide Hydrolase-Dependent Arachidonic Acid Conjugation in the Nervous System.” Journal of Biological Chemistry, vol. 280, no. 36, Sept. 2005, pp. 31405–31412, https://doi.org/10.1074/jbc.m501489200. Accessed 13 Mar. 2021.
3 Hama, Aldric T., and Jacqueline Sagen. “Cannabinoid Receptor-Mediated Antinociception with Acetaminophen Drug Combinations in Rats with Neuropathic Spinal Cord Injury Pain.” Neuropharmacology, vol. 58, no. 4-5, Mar. 2010, pp. 758–766, https://doi.org/10.1016/j.neuropharm.2009.12.010. Accessed 16 Feb. 2023.
4 Balachandran, Premalatha, et al. “Cannabidiol Interactions with Medications, Illicit Substances, and Alcohol: A Comprehensive Review.” Journal of General Internal Medicine, 29 Jan. 2021, https://doi.org/10.1007/s11606-020-06504-8.
5 Machado, G. C., et al. “Efficacy and Safety of Paracetamol for Spinal Pain and Osteoarthritis: Systematic Review and Meta-Analysis of Randomised Placebo Controlled Trials.” BMJ, vol. 350, no. mar31 2, 31 Mar. 2015, pp. h1225–h1225, https://doi.org/10.1136/bmj.h1225.
6 Cuttler, Carrie, et al. “Short- and Long-Term Effects of Cannabis on Headache and Migraine.” The Journal of Pain, vol. 21, no. 5-6, Nov. 2019, www.jpain.org/article/S1526-5900(19)30848-X/fulltext, https://doi.org/10.1016/j.jpain.2019.11.001.
7 van Amerongen, G., et al. “Effect Profile of Paracetamol, Δ9-THC and Promethazine Using an Evoked Pain Test Battery in Healthy Subjects.” European Journal of Pain, vol. 22, no. 7, 25 Apr. 2018, pp. 1331–1342, https://doi.org/10.1002/ejp.1222. Accessed 29 Mar. 2023.
The information in this article and any included images or charts are for educational purposes only. This information is neither a substitute for, nor does it replace, professional legal advice or medical advice, diagnosis, or treatment. If you have any concerns or questions about laws, regulations, or your health, you should always consult with an attorney, physician or other licensed professional.
