Can you smoke weed on Ozempic? Risks and safety tips

GLP-1 and cannabis use are both growing in the United States. Today, about 1 in 4 Americans over the age of 12 has consumed cannabis, and roughly 1 in 8 have taken a GLP-1 like Ozempic (semaglutide). If you fall into both categories, you’ve probably wondered, “Can you smoke weed on Ozempic?” 

Below, we review the current state of research on Ozempic and weed, answering common questions about how the two interact together and how to maximize safety when using GLP-1s and cannabis. 

Ozempic is not known to directly interact with weed, or cannabis, so in theory, it may be safe to smoke weed while taking the GLP-1. 

However, the combination hasn’t been well studied. And smoking weed on Ozempic may not be safe for everyone, especially if you’re taking Ozempic to lower your cardiovascular risk. Smoking cannabis has been associated with an increased risk of heart disease, heart attack, and stroke. The risk may be higher for those who smoke more often. 

But what if you’re taking Ozempic for another (non-heart-related) reason? It’s still worth talking to your healthcare provider before using cannabis while taking Ozempic or another GLP-1. 

That’s because both weed and GLP-1s can independently affect your appetite and gastrointestinal (GI) function. They both can also cause similar side effects, such as nausea, vomiting, and abdominal pain. 

In other words, combining the two substances can make appetite changes and GI side effects harder to predict — and potentially more uncomfortable.

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Can you use CBD or take edibles with Ozempic?

CBD and THC edibles are also not known to directly interact with Ozempic. However, Ozempic slows digestion, which can change how and when edibles or tinctures kick in. Meaning, it’s possible that edibles (or any consumed version of cannabis) may take longer to take effect when consumed during GLP-1 treatment. 

If you’re taking Ozempic off-label for weight loss, it’s worth noting that cannabis use (especially in the form of edibles) can increase levels of ghrelin (the “hunger hormone”), which may stimulate appetite. In other words, you may feel hungrier when using cannabis, especially in an edible. So, you may end up eating more when high, which can disrupt both your blood sugar levels and weight loss progress. 

“The ‘munchies’ can work directly against some of the appetite-regulating benefits of GLP-1 therapy,” says board-certified endocrinologist Omodamola Aje, MD. However, these effects can depend on the person and the dose of the drug.

Ozempic’s digestion-slowing effects could also change the high you experience on edibles, making effects feel less predictable, Dr. Aje says.

Marijuana is not known to directly interact with GLP-1 medications, such as Ozempic. However, using them together doesn’t come without risks. For example:

• Marijuana “munchies” can interfere with Ozempic’s effects on appetite and weight loss. THC, in particular, can stimulate your cravings for high-calorie foods, which are often the ones to avoid on Ozempic because they can increase GI side effects as well as derail any weight loss progress. And while the munchies can happen while smoking, a small study showed that eating your weed (i.e. edibles) has been linked to especially higher levels of ghrelin (the “hunger” hormone,) compared to smoking or vaping cannabis. 

• Marijuana may affect blood sugar control. Cannabis interacts with the endocannabinoid system, which helps regulate appetite and metabolic hormones, including insulin. Because research is mixed, it’s unclear whether marijuana changes how well Ozempic works. But its impact on appetite, eating habits, and blood sugar regulation could make diabetes management less predictable.

• Marijuana may worsen Ozempic’s side effects. Both substances can cause nausea, vomiting, and stomach discomfort. And, like Ozempic, cannabis may slow stomach emptying. So using them together may make GI symptoms worse. In frequent weed users, repeated vomiting could signal cannabinoid hyperemesis syndrome rather than a typical Ozempic side effect. Seek medical care for severe or persistent vomiting, since it can lead to dehydration or indicate a more serious complication.

• Marijuana may alleviate Ozempic-related nausea for some people.  Cannabis, particularly THC and CBD, has known antiemetic effects and is used by recreational and medical users alike to relieve nausea and vomiting. But again, we won’t know whether it has those effects on Ozempic-related nausea until more research is done on the two substances together. 

• Ozempic may make the marijuana high feel different or less rewarding. A study linked semaglutide (the active ingredient in Ozempic) to a 44% lower risk of developing cannabis use disorder. Researchers think this could be because Ozempic may dampen dopamine-driven reward signals, potentially reducing both cannabis (and food) cravings and the intensity of the high. However, the exact mechanism has not yet been established, and more research is needed. 

Honestly, we just don’t know if it’s safe to mix Ozempic and marijuana until we have more research. For now, the best person to answer this question is your healthcare provider. 

Even though Ozempic isn’t known to directly interact with marijuana, it’s possible that other drugs you’re taking do. For example, marijuana could change the way your body processes certain medications. And marijuana may not be safe to use if you have other health conditions. 

“My general advice is that patients should discuss cannabis use openly with their clinician, especially if they’re experiencing significant nausea, dehydration, or inconsistent eating while on therapy,” Dr. Aje says.

If you’re considering using cannabis while taking Ozempic, talk to a healthcare provider first. They know your medical history and can best assess whether it’s safe to use Ozempic and weed together. Your provider can also guide you on how to combine the two safely — assuming, of course, that weed is even legal in your state. 

Here are some other tips to consider:

1. Consult your healthcare provider. It bears repeating. Using marijuana with Ozempic may lead to unexpected side effects, cause unbalanced blood sugar levels, and slow your weight loss progress.

2. Monitor any changes to your treatment goals. Regularly monitor your blood sugar levels and track your weight loss progress to make sure weed isn’t slowing you down. 

3. Watch for worsening GI symptoms. Any persistent nausea or vomiting should be discussed with your healthcare provider. It could be an early warning sign of cannabinoid hyperemesis syndrome, a complication of Ozempic, or another health condition such as pancreatitis. 

4. Consider the form of cannabis and its strength. Your body may process cannabis differently now that you’re on Ozempic, especially if you’re using edibles, Dr. Aje says. Start with a low dose, and avoid heavy or daily use. Also, given the cardiovascular risks of smoking marijuana, you may consider minimizing your intake or opting for non-inhaled forms instead, such as tinctures. (Though it’s not guaranteed that doing so will eliminate the cardiovascular risks altogether.)

5. Stay hydrated. Drinking plenty of fluids can help minimize some of the side effects that Ozempic and cannabis have in common, such as nausea, diarrhea, and vomiting. 

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While cannabis isn’t known to directly interact with Ozempic, it’s still best to check with your healthcare provider before combining the two. They can determine if it’s safe based on your personal medical situation (that is, of course, if cannabis is legal in your state). If your provider gives you the go-ahead, here are some things to keep in mind: 

• The form matters. It may take longer to get high on edibles when you are on Ozempic, and the high itself may last longer. However, smoking and vaping may not be recommended if you have cardiovascular risk factors. 

• The “munchies” can disrupt weight loss. If you get hungry when you’re high, using weed on Ozempic may lead you to consume more calories than you planned to.

• It’s possible you may want to get high less often on Ozempic. GLP-1s have been shown to reduce people’s desire for alcohol, cannabis, nicotine, and opioids. Ozempic may also lower your risk of cannabis use disorder.

• Taking Ozempic and weed together can compound side effects. Both cause GI-related side effects, which may feel worse when you combine the two.

• Be careful when mixing cannabis and Ozempic. Start with a lower dose than you’re used to, stay hydrated, avoid daily use, and watch for any new or worsening GI symptoms.