Natural Care Group

Medical Professionals

Medical cannabis.
Supporting
your practice.

Medical cannabis.
Supporting
your practice.

Natural Care's Guide to Prescribing and Administering Medical Cannabis
Click on any row to expand

CBD

Cannabidiol only

  • Analgesic
  • Anti-inflammatory
  • Antiemetic
  • Antispasmodic
  • Anti-epileptic
  • Anxiolytic
  • Reduces THC-induced psychoactivity/anxiety

CBD:THC

Cannabidiol and tetrahydrocannabinol blends

  • Analgesic
  • Anti-inflammatory
  • Antispasmodic
  • Antiemetic
  • Appetite stimulant
  • Soporific
  • Mood elevator
  • Decreases intestinal motility

CBD

Cannabidiol only

  • Anxiety
  • Depression
  • Chronic pain
  • Spasticity associated with MS, ALS and spinal cord injury
  • Epilepsy
  • Inflammation & inflammatory conditions, including IBS, ulcerative colitis, Crohn’s, fibromyalgia, rheumatoid arthritis
  • PTSD

CBD:THC

Cannabidiol and tetrahydrocannabinol blends

  • Chronic pain
  • Nausea & vomiting
  • Anorexia
  • Spasticity associated with MS, ALS and spinal cord injury
  • Inflammation & inflammatory conditions, including IBS, ulcerative colitis, Crohn’s, fibromyalgia, rheumatoid arthritis
  • Limited evidence suggests that THC in particular may be beneficial for insomnia, neuropathic pain, nausea/vomiting and PTSD. It is recommended to start with CBD and introduce 1:1 in the evenings if needed for insomnia, PTSD, etc.

CBD

Cannabidiol only

Cannabidiol exhibits biphasic properties –
most therapeutic effects are found at lower doses; slow titration may mitigate potential side effects.

  • Somnolence, changes in appetite/weight
  • In rare cases, may cause diarrhea

CBD:THC

Cannabidiol and tetrahydrocannabinol blends

Tetrahydrocannabinol exhibits biphasic properties – most therapeutic effects are found at lower doses; slow titration may mitigate potential side effects.

  • Anxiety, disorientation, intoxication, somnolence
  • May induce psychosis in susceptible individuals (personal or family history)
  • In rare cases, may cause orthostatic hypotension, depression, ataxia/dyscoordination, tachycardia, cannabis hyperemesis, diarrhea

CBD

Cannabidiol only

  • Unsuitable for pregnant and breastfeeding patients

CBD:THC

Cannabidiol and tetrahydrocannabinol blends

  • Acute psychosis, severe/unstable psychiatric conditions, actively suicidal
  • History of THC-induced hyperemesis
  • Under age 25
  • Severe cardiovascular, immunological, liver or kidney disease (especially in acute illness – can exacerbate arrhythmias)
  • Caution should be exercised in patients with history of drug or alcohol addiction (although recent evidence points to cannabis as potential harm reduction substitution)
  • Unsuitable for pregnant and breastfeeding patients

CBD

Cannabidiol only

Many interactions can be mitigated in complex patients with polypharmacy by slowly titrating.

  • CYP450 enzyme inhibitor
  • May interact with anti-epileptic drugs; close monitoring of AED levels and LFTs advised
  • Potent inhibitor of CYP3A4 and CYP2D6; may increase serum concentrations of macrolides, calcium channel blockers, benzodiazepines, cyclosporine, sildenafil (and other PDE5 inhibitors), antihistamines, haloperidol, antiretrovirals, and some statins (atorvastatin and simvastatin, but not pravastatin or rosuvastatin); may increase serum concentrations of SSRIs, tricyclic antidepressants, antipsychotics, beta blockers and opioids (including codeine and oxycodone)

CBD:THC

Cannabidiol and tetrahydrocannabinol blends

Many interactions can be mitigated in complex patients with polypharmacy by slowly titrating.

  • CYP450 enzyme inhibitor
  • CYP1A2 inducer (theoretically can decrease serum concentrations of clozapine, duloxetine, naproxen, cyclobenzaprine, olanzapine, haloperidol, and chlorpromazine)
  • Potential interaction with medications metabolized by P450 enzymes (2C9, 2C19, 3A4), including antidepressants, proton pump inhibitors, cimetidine, macrolides, antimycotics, calcium antagonists, HIV protease inhibitors, amiodarone, isoniazid.
  • The following drugs may decrease the availability of THC: carbamazepine, rifampicin, phenobarbital, phenytoin, primidone, rifabutin, St. John’s wort

CBD

Cannabidiol only

No reports of abuse or dependence; no public health risk.

CBD:THC

Cannabidiol and tetrahydrocannabinol blends

Minimal risk of dependence, similar to anxyolitics at 9%.
(Versus 21% for opioids, 23% for alcohol and 68% for tobacco.)

CBD

Cannabidiol only

Oils & capsules/softgels

  • Daytime dosing, no psychoactive effect
  • b.i.d to t.i.d. dosing
  • Start at 2.5mg/day
  • Titrate by 2.5 mg q 2-3 days as tolerated

*Unless you wish otherwise, a Natural Care RN will create a personalized dosing and titration schedule for every patient, with regular telephone check-ins and follow-up, at no charge.

CBD:THC

Cannabidiol and tetrahydrocannabinol blends

Oils & capsules/softgels

  • Nighttime dosing, mild psychoactive, sedating effects
  • At hs only to start
  • Start at 2.5 mg, titrate by 1mg q 2-3 days as tolerated and to desired effect

*Unless you wish otherwise, a Natural Care RN will create a personalized dosing and titration schedule for every patient, with regular telephone check-ins and follow-up, at no charge.

INHALATION

Flower, a.k.a. bud

ORAL INGESTION

Oils, capsules, softgels

INHALATION

Less than 5 min

ORAL INGESTION

30 min to 2 hrs

INHALATION

Less than 15 min

ORAL INGESTION

2 to 4 hrs

INHALATION

2 to 4 hrs

ORAL INGESTION

4 to 8 hrs

INHALATION

Ingestion methods are generally preferred for consistent dosing and longer impact. Some patients may desire inhalation for acute and breakout pain.

Vapourizing recommended
(not smoking).

ORAL INGESTION

Oils

Administered sublingually, swallowed or mixed with food.

Capsules & softgels

Ingested as usual.

INHALATION

Patients should be counselled not to drive for 4 hours after inhalation, or for 8 hours if euphoria is experienced.

ORAL INGESTION

Patients should be counselled not to drive for 6 hours after ingestion, or for 8 hours if euphoria is experienced.

Enhancing Your Practice

WHY REFER TO US?
Do you have a patient or client who could benefit from medical cannabis? Use our medical document to prescribe, and we'll provide a personalized cannabis medication plan and ongoing support for your patient. If you prefer, you can refer your patient or client directly to a Natural Care prescriber - it's easy, and we don't require your billing codes.
WHY JOIN OUR NETWORK?
Are you an MD or NP with expertise in aging, medical cannabis or both? We want to hear from you! Prescribers at Natural Care are supported by a team of team of patient care representatives and nurses. Plus, we provide ongoing medical cannabis education.