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Medicinal Cannabis Compounding

Cannabidiol (CBD) and tetrahydrocannabinol (THC) are the major constituents of the plant Cannabis Sativa and the most widely studied for potential benefits in many human medical ailments.

Pharmaceutical grade materials derived from this plant must pass tests to determine purity and lack of contaminants such as heavy metals, bacteria and pesticides. Rigorous testing is required to ensure standardisation of the extracted active ingredients.

CBD is a not a psychoactive component of the cannabis plant and hence on its own is classified as an S4 or prescription only product in Australia and can be prescribed by any registered medical practitioner, once thorough assessmenthas been carried out.

THC has psychoactive properties and is therefore classed as an S8 and requires approval from the state health departments before prescribing. No medicinal cannabis products of any type are subsidised through the PBS scheme in Australia.

When a medical practitioner has established the need for medicinal cannabis for a patient, there are a number of alternatives for that patient to access pharmaceutical grade medicinal cannabis. There are some differences in rules from state to state relating to cannabis prescribing.

Manufacturers of pharmaceutical grade CBD and THC have commercial products in set strengths, which can be accessed by prescribers on behalf of individual patients via the Special Access Scheme. Only one product is currently registered with the TGA at this point in time.

Where these products are not suitable, whether through dosage requirement, allergies or some other reason, tailor made products can be compounded for individual patients according to their specific needs.

Australian law allows for legally prescribed cannabis medicinal products to be compounded (made for a specific patient) and dispensed by approved compounding pharmacies.

The evidence base for the therapeutic uses of cannabis is still in the infancy stage, with many trials ongoing. There is growing interest, however, for its use in such conditions as anxiety, chronic pain, migraine, insomnia, chemotherapy induced nausea and fibromyalgia.

CBD with or without THC is usually taken orally as an oil, although it can be compounded for topical use also. Although ‘natural’, medicinal cannabis is not without side effects and can interact with a significant number of other medicines.

Close medical supervision is advised and your compounding pharmacist can also be a valuable source of information. Driving whilst taking medicinal cannabis is not recommended and not permitted at all if taking a product containing THC.