Mixing any two drugs together can lead to dangerous interactions that cause harmful side effects. There are also times, however, when two drugs can be combined without considerable risk. Two drugs that are regularly taken together are weed and Tylenol with codeine.

Tylenol is commonly used to treat such ailments as muscle aches, headaches, and mild pain. Marijuana is also capable of easing pain symptoms, which is why some people combine weed and Tylenol that contains codeine.

Tylenol (Codeine)

To understand just how often these drugs are used, over 60 million Americans take Tylenol every week. In 2019, more than 48 million people took weed in some manner. Even though cannabis and Tylenol are often taken together, there’s always the possibility of an unexpected interaction. In this guide, you’ll discover what these interactions might be.

Basic Pharmacology

A. Weed (Cannabis)
Weed is comprised of more than 480 constituents. The primary ingredient that causes psychoactive effects is THC, which is taken directly from the Cannabis sativa plant. Cannabis is often taken as medical marijuana because of its many therapeutic uses. The most common uses include pain relief and anti-nausea. However, marijuana can also combat seizures, epilepsy, eating disorders, and cancer.

B. Tylenol with Codeine
Codeine is a type of opioid pain reliever that’s part of a class of medications known as opiate analgesics. The primary purpose of prescribing codeine is to treat pain. The drug works by altering how the nervous system and brain respond to pain.

Let’s say that codeine is taken to relieve a bout of coughing. In this scenario, the drug will limit the activity that occurs in the area of the brain that promotes coughing. Tylenol (acetaminophen) is often combined with codeine to boost the pain-relieving effects. Tylenol is able to change how a person’s body senses pain.

The primary uses of Tylenol with codeine include minor pains and aches, which extend to everything from arthritis and toothaches to menstrual cramps. There are three medications that shouldn’t be used when taking Tylenol with codeine, which include lonafarnib, pexidartinib, and pretomanid.

Interactions Between Cannabis and Codeine

Tylenol with codeine is often prescribed to reduce pain and other health issues that people might be suffering from. While codeine is able to relieve pain, it’s commonly used by itself as an ingredient in prescription-grade cough syrups. Tylenol cools the body and changes how the body feels pain. Codeine is also able to change how your body responds to pain, which is why these two medications are often put together.


If you take weed without any other drugs, you’ll experience various effects within your brain. The THC ingredient is capable of reacting with certain cell receptors to create a “high” sensation. The primary effects you’ll experience include:

  • An altered sense of time
  • Impaired memory
  • Impaired body movement
  • Mood changes
  • Issues with problem-solving and thinking

There are also certain physiological and psychological risks that occur when you take a high amount of Tylenol with codeine or cannabis. High doses of marijuana have the potential to cause hallucinations, delusions, or psychosis. You might also encounter an increased heart rate or vomiting.

Taking weed and Tylenol together is meant to produce a stronger pain-relieving effect. While there are no known harmful interactions between the two drugs, taking a high dose can lead to effects that you might not be ready for. Risks are present with nearly any medication a person can take, which is why it’s important to exercise caution when consuming all types of drugs.

Potential Risks and Side Effects

While it’s believed that taking weed and Tylenol with codeine together is relatively harmless, there are some potential risks and side effects that you should be on the lookout for, the primary of which include the following:

  • Impaired judgment and coordination
  • Respiratory depression
  • Drowsiness and decreased alertness
  • Risk of dependency or addiction

The most obvious concern is the risk of dependency or addiction. Because these drugs are designed to reduce pain, the potency of the pain reliever may cause the body to become more dependent on the drug over time. Eventually, you may need to take a higher dose to obtain the same effects.

Case Studies or Real-Life Examples

In 2017, a cross-sectional study was performed in Canada titled “Canadian Tobacco, Alcohol, and Drugs Survey”. The purpose of this study was to identify the association between cannabis and Tylenol with codeine.

Of the more than 15,000 respondents, around 3,338 used some amount of cannabis over the past 12 months. Among the people who took cannabis, more than 36% stated that they were using the drug for medical purposes. Respondents who took cannabis for medical reasons were around three times more likely to use codeine alongside it.

Cannabis test

Only a small number of studies have been performed on the effects of taking weed and Tylenol at the same time. None of these studies have tested the long-term effects. However, the 2017 survey found that many of the people who were taking cannabis for medical reasons were doing so to relieve substantial pain. Respondents who combined the two drugs were more likely to state that they were in fair or poor health.

A literature review that was taken in 2021 studied how weed interacts with acetaminophen. It was found that cannabidiol, which doesn’t contain THC, can boost the health of a person’s liver. In the years to come, additional studies will likely be performed to test how these two drugs interact with one another. For now, the interactions appear to be mild.

Medical Recommendations

Some healthcare professionals advise that people should be mindful of the various risks associated with mixing cannabis and Tylenol together. Since both of these drugs are processed in the liver, their effects can be combined to produce a more potent reaction, which is why caution is necessary.

If you have a liver condition or are currently breastfeeding, speak to your doctor before you mix these drugs together. You should also ask your doctor about mixing these drugs with any other medications you might be taking. Keep in mind that 393 drugs are capable of interacting with cannabis. Around 114 drugs can interact with Tylenol.

The combination of weed and Tylenol is legal in every state where weed is legal. Currently, 24 states have fully legalized weed, which means that combining these two drugs is legal.

There are also states that allow weed to be used for medicinal purposes or only allow CBD oil. For instance, weed can only be taken as CBD oil in Iowa and Indiana. There are only six states where this combination would be illegal because of the full illegality of weed, which include Idaho, Kansas, Nebraska, North Carolina, South Carolina, and Wyoming.

Legal Implications

Safe Use and Harm Reduction

If you have too much weed and Tylenol in your body, you may experience a type of poisoning. However, the overdose must be very large. The majority of these overdoses don’t cause immediate symptoms. There are four stages that occur during an overdose or negative interaction.

During stage one, you might not have symptoms. This stage lasts for several hours. Stage two occurs after 24-72 hours and can involve everything from vomiting to abdominal pain. In stage three, your vomiting could worsen. This stage occurs after a few days. Any test of your liver will show that the liver isn’t functioning properly. You might also notice jaundice, which is a yellowing of the skin.

The fourth and final stage occurs after five days. You could either fully recover or experience failure of your liver, which could prove fatal. In the event of an emergency, call 911 immediately. To safely and responsibly use these drugs together, only take small doses and ask your doctor for advice. It’s highly recommended that you discuss any substance use with your healthcare providers.


Weed and Tylenol with codeine are two of the most widely used drugs in the world, which is largely the result of both being relatively safe to use. In fact, many states have already legalized weed use. It’s possible, however, to become dependent on these drugs if you take large doses or consume them more often than you should. Substance use should always occur in a safe manner. If you notice any symptoms of an overdose, seek medical attention immediately. Call Long Island Interventions for more information.

References and Sources

1. https://www.drugs.com/drug-interactions/cannabis-with-tylenol-2758-0-11-12.html
2. https://jcannabisresearch.biomedcentral.com/articles/10.1186/s42238-022-00160-x
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC34324/
4. https://www.ncbi.nlm.nih.gov/books/NBK441917/
5. https://www.cdc.gov/marijuana/data-statistics.htm
6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5312634/
7. https://www.webmd.com/a-to-z-guides/medical-marijuana-faq
8. https://medlineplus.gov/druginfo/meds/a601005.html
9. https://reference.medscape.com/drug/tylenol-acetaminophen-343346
10. https://disa.com/marijuana-legality-by-state
11. https://www.northshore.org/healthy-you/qa-symptoms-of-overdosing-on-marijuana/

Published on: 2023-08-30
Updated on: 2024-06-21