Daily Dose Q&A

2024-09-10

Has any national drug administration approved a CBD-containing product for therapeutic use in conditions other than epilepsy?

Yes. The oromucosal spray Sativex (nabiximols) is a cannabis extract that contains the principal cannabinoids delta-9-tetrahydrocannibinol (THC) and cannabidiol (CBD) in a 50:50 ratio, as well as specific minor cannabinoids and other non-cannabinoid components. Regulatory approval has been obtained in numerous countries outside the United States for the treatment of multiple sclerosis symptoms (nerve pain, spasticity, overactive bladder, and other symptoms).

GW Pharmaceuticals website. Sativex. https://www.gwpharm.com/healthcare-professionals/sativex

2024-09-09

CBD oil products may be sold as full spectrum, broad spectrum, CBD isolate and whole plant CBD. What is the difference among the four types?

Full spectrum CBD extract contains CBD and other cannabinoids (including up to 0.3% THC), terpenes, and essential oils. Unlike full spectrum CBD, broad spectrum CBD does not contain THC, but it does contain the other components found in full spectrum CBD. CBD isolate is CBD in its molecular form, and is typically sold as 99+% pure. Whole plant CBD is similar to, but not the same as full spectrum CBD. Whole plant and full spectrum CBD contain a variety of cannabinoids; however, whole plant CBD will also contain fats, waxes, and other fibrous materials.

Norton M. To CBD or not to CBD?: What Pharmacists need to know. Pharmacy Today. AUG O1,2020; VOLUME 26, ISSUE 8: P41-55.

2024-09-06

What is the most common mode of administration of CBD?

According to an online survey, the most common method of CBD administration was sublingual, followed by vaping, oral ingestion of capsules and liquids, smoking, edibles, and topical administration.

Corroon J, Phillips JA. A cross-sectional study of cannabidiol users. Cannabis Cannabinoid Res 2018; 3(1):152–61.

2024-09-05

Other than pill form, in what forms is CBD sold?

There are multiple CBD product types, including CBD oils (for oral/sublingual administration or vaporization), gummy candies, joint balms, creams, lotions, and capsules. CBD is also being sold in food products, beverages and healthcare goods, including hair products and skincare products. CBD has even been marketed as an ingredient in sleeping masks and dog treats.

“Ads Pitching CBD as a Cure-all Are Everywhere. Oversight Hasn’t Kept Up.” The New York Times, Aug 13, 2019 – https://www.nytimes.com/2019/08/13/business/media/cbd-marijuana-fda.html – accessed March 29, 2023.

2024-09-04

CBD interacts with warfarin. Does this drug:drug interaction lead to an increased risk of bleeding or a decrease in warfarin’s anticoagulation effect?

The inhibition of CYP2C19 by CBD can increase levels of warfarin, and multiple reports have indicated that the interaction between warfarin and CBD results in a greatly increased risk of bleeding.

Treese NM, Flowers M. Pharmacist’s guide to CBD oil. US Pharm. 2020; 45(3):20-23. Welty TE, Chapman KE, Faught RE, Kotloski RJ. American Epilepsy Society (AES): Written Comments to Norman E. “Ned” Sharpless, MD, Acting Commissioner of Food and Drugs, U.S. Food and Drug Administration (FDA), Department of Health and Human Services (HHS): on Docket ID# FDA-2019-N-1482, Scientific Data and Information about Products Containing Cannabis or Cannabis-Derived Compounds; Public Hearing; Request for Comments: Submitted on: July 16, 2019. Epilepsy Currents 2019; 19(6):361-368. doi:10.1177/1535759719878716