In the recent years since various governments around the world have approved the use of medicinal cannabis there has been an explosion of products and formulations available. With such a wide selection, it can be hard not just for patients, but also for doctors and pharmacists, to know which formulation is best.
Cannabis has been shown to have efficacy across a range of different medical conditions, from anxiety, to epilepsy, chronic pain, arthritis, insomnia, and chemotherapy-induced nausea.
Which formulation is best will depend on the condition being treated and the needs of the patient. What is best for one person may be ineffective or inappropriate for someone else.
The short answer is that there is no one best formulation. But read on below for a guide to the most common formulations, and how they work.
Topical cannabis formulations
Topical formulations, like creams, are best when they are used to treat inflammation in a particular region of the body. For example, where a patient has rheumatoid arthritis in the joints of their fingers.
Oil-dropper cannabis products
The use of an oil-dropper based product allows a patient to titrate up or down their dose depending on their needs. This can be particularly important when the patient has just started on cannabis and they don’t know how their body is going to respond to treatment.
Capsule cannabis doses
A capsule formulation may be best when an accurate, fixed dose of cannabis is needed, or when prolonged medical effects are needed. Capsule formulations can be developed as extended release products that can slowly deliver the active compounds in cannabis over a longer period of time when compared with oil-dropper products.
Inhaler cannabis formulations
Inhalation formulation may be best where a patient’s liver function is an issue. Liver disease and damage, such as cirrhosis, can affect the liver’s ability to metabolise drugs, which can result in too low or too high a dose of the active ingredients in the cannabis getting into the bloodstream. Liver metabolism can be bypassed by absorbing the cannabis in the lungs.
What medical professionals consider before they prescribe cannabis
As mentioned above, creams are best when used to treat inflammation in a particular region of the body.
For conditions where a systemic treatment is needed, then an inhalational or oral product may be best. After absorption from the lungs or stomach, the active ingredients will enter the blood stream where they are transported by the body to where they are needed.
When considering what is best with regard to oral delivery, there are three common options to choose from: hard capsules, liquid filled soft capsules, or oils delivered through a dropper.
Each case is different. Some patients may have difficulty swallowing and so a hard capsule may not be suitable for them. Likewise, it is unwise to administer capsules to babies or young children who are at risk of choking unless they have been taught how to swallow a pill. In both instances, an oil-based formulation dispensed in a dropper would probably be best.
Lung absorption may also be best when a fast onset of action is needed, as may be the case for patient’s experiencing chronic pain. The effects of cannabis through inhalational products can be felt very rapidly, whereas oral formulations can sometimes take a significant amount of time before they start to work.
Now consider an adult patient who has a lung condition, such as asthma or chronic obstruction pulmonary disease. With either medical condition, smoking or vaping cannabis could potentially aggravate the person’s condition. It would also not be appropriate for an underage patient to be prescribed whole flower cannabis for the purpose of smoking it.
So there is no one best formulation for cannabis, and companies would be wise to always offer a variety of products to suit the needs of their customers.
