Food Supplements and Vitamins. Marijuana (Cannabis sativa)

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Background

Marijuana, hemp, and cannabis are common names for plants of the genus Cannabis . The term hemp is often used for cannabis strains grown specifically for production of paper, rope, and cloth. Other cannabis strains are used to make recreational and medicinal drugs. The major difference between the main types of cannabis plants is the amount of the psychoactive compound tetrahydrocannabinol (THC) they contain.
Cannabis has been used medicinally for approximately 5,000 years. The most widely used components of the herb in traditional medicine are the seed and seed oil. Cannabis sativa is widely used recreationally (inhaled or taken by mouth) to achieve increased feelings of well-being.
Cannabis has been studied for the treatment of a number of conditions, including eczema, epilepsy, chronic pain, insomnia, and symptoms of multiple sclerosis. The most significant benefits have been found in the treatment of chronic pain and symptoms of multiple sclerosis.
The two most studied cannabinoid compounds of Cannabis sativa are the psychoactive tetrahydrocannabinol (THC) and the nonpsychoactive cannabidiol (CBD).

Usage and Dosing

NB! The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Adults (18 years and older)

  • For nausea and vomiting, five milligrams/m 2 of body mass of dronabinol (Marinol®) has been taken by mouth before and after chemotherapy, for a total of 4-6 doses daily.
  • For weight loss and malnutrition associated with cancer, 2.5 milligrams of tetrahydrocannabinol (THC) with or without one milligram of cannabidiol has been taken by mouth for six weeks.
  • For eczema, hemp seed oil has been taken by mouth for 20 weeks.
  • For chronic pain, 2.5-120 milligrams of cannabis has been taken by mouth in divided doses.
  • For epilepsy, 200-300 milligrams of cannabidiol (CBD) has been taken by mouth daily for up to 4.5 months.
  • For insomnia, 160 milligrams of cannabidiol (CBD) has been taken by mouth.
  • For symptoms of multiple sclerosis, 2.5-10 milligrams of dronabinol (Marinol®) has been taken by mouth daily for three weeks. Capsules containing 15-30 milligrams of cannabis extract has been taken by mouth for 14 days. Two and one-half milligrams of tetrahydrocannabinol (THC), together with 0.9 milligrams of cannabidiol (CBD), has been taken by mouth. Cannabinoid-based Sativex® mouth spray has been used at a dose of 2.5-120 milligrams in divided doses. Eight sprays in three hours and up to 48 sprays in 24 hours have been used.
  • For schizophrenia, 40-1,280 milligrams of cannabidiol (CBD) has been taken by mouth daily for up to four weeks.
  • For glaucoma (high fluid pressure in the eye), single doses of five milligrams of tetrahydrocannabinol (THC) or 40 milligrams of cannabidiol (CBD) placed under the tongue have been used.

Children (under 18 years old)

There is no proven safe or effective dose for cannabis or cannabis-containing products in children.

Safety

NB! There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

Avoid with known allergy or hypersensitivity to cannabis, cannabinoids, or plants of the Cannabaceae family. Symptoms similar to hay fever and asthma have been reported.

Side Effects and Warnings

  • Cannabis may lower blood sugar levels. Caution is advised in patients with diabetes or hypoglycemia, and in those taking drugs, herbs, or supplements that affect blood sugar. Blood glucose levels may need to be monitored by a qualified healthcare professional, including a pharmacist, and medication adjustments may be necessary.
  • Cannabis may increase the risk of bleeding. Caution is advised in patients with bleeding disorders or those taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary.
  • Cannabis may cause low blood pressure. Caution is advised in patients taking herbs or supplements that lower blood pressure.
  • Drowsiness or sedation may occur. Use caution if driving or operating heavy machinery, if taking sedatives, barbiturates, or central nervous system depressants, or if consuming alcohol.
  • Cannabis may interfere with the way the body processes certain drugs, herbs, or supplements using the liver’s cytochrome P450 enzyme system. As a result, the levels of these agents may change in the blood and may cause increased or decreased effects or potentially serious adverse reactions. Patients taking any medications should check the package insert and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.
  • Use with caution in foods or supplements containing cannabis seeds or oil.
  • Use with caution in patients with liver disease, glaucoma, immune disorders, or a history of drug abuse or addictive behavior, or in patients taking agents for any of these conditions.
  • Use with caution in patients taking estrogen therapy, agents that may damage the liver, antipyrine, or p-glycoprotein-regulated drugs.
  • Avoid in individuals with asthma or byssinosis (lung disease).
  • Avoid inhalation or intravenous injection of cannabis.
  • Avoid use of cannabis products obtained illegally.
  • Avoid in patients who are pregnant or breastfeeding.
  • Avoid in patients with a known allergy or hypersensitivity to cannabis, cannabinoids, or plants of the Cannabaceae family.

Pregnancy and Breastfeeding

Avoid in women who are pregnant or breastfeeding. Research suggests the presence of significant risks to the fetus or developing infant or child.

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