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Routes of Administration, Pharmacokinetics and Safety of Medicinal Cannabis

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Medicinal Cannabis and CBD in Mental Healthcare

Abstract

There are four main routes of administration of medicinal cannabis: inhalation, the oral route, topical applications and ‘other routes’ (eg. suppositories, intranasal delivery). Each is associated with different onsets of action and durations of action due to their pharmacokinetic profiles. There are some safety issues associated with cannabis. Many of the safety concerns such as associations between cannabis use and conditions such as cannabis use disorder and various mental health conditions that have been raised in the literature relate to recreational smoking of cannabis. Cannabis is associated with a range of negative side effects that are typically dose-dependent, most of which relate to the tetrahydrocannabinol (THC) component. Cannabidiol (CBD) has less serious side effects than THC. In general, CBD has been found to be well tolerated and safe and does not cause addiction. Both CBD and THC can potentially interact with a range of pharmaceuticals because they are metabolised by many of the cytochrome P450 enzymes that metabolise pharmaceuticals. Clinical trials in epilepsy in which high doses of CBD are used in conjunction with typically several anti-epileptic medications have demonstrated that side effects can occur with certain drugs. However, whether drug-cannabis interactions are common in clinical practice has not been well established.

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    Kylie O’Brien

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    Philip Blair

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O’Brien, K., Blair, P. (2021). Routes of Administration, Pharmacokinetics and Safety of Medicinal Cannabis. In: Medicinal Cannabis and CBD in Mental Healthcare. Springer, Cham. https://doi.org/10.1007/978-3-030-78559-8_11

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