Cannabis capsule
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Cannabis Capsules: Therapeutic Potential and Pharmacokinetics
Introduction to Cannabis Capsules
Cannabis capsules, particularly those containing tetrahydrocannabinol (THC) and cannabidiol (CBD), are gaining attention for their potential therapeutic benefits. These capsules are used in various medical conditions, including cancer-related cachexia, multiple sclerosis, and chemotherapy-induced nausea and vomiting. This article synthesizes recent research on the efficacy, safety, and pharmacokinetics of cannabis capsules.
Therapeutic Benefits of Cannabis Capsules
Cancer-Related Cachexia and Anorexia Syndrome (CACS)
A pilot study investigated the effects of dosage-controlled cannabis capsules on CACS in advanced cancer patients. The study found that 17.6% of patients experienced a weight increase of ≥10% from baseline, with improvements in appetite, mood, and reductions in pain and fatigue1. These findings suggest that cannabis capsules could be beneficial in managing CACS, although larger studies are needed to confirm these results.
Multiple Sclerosis (MS)
In a randomized, double-blind, placebo-controlled crossover study, cannabis-extract capsules were evaluated for their efficacy in treating spasticity in MS patients. The study showed trends towards reduced spasm frequency and improved mobility, with tolerable side effects4. These results indicate that cannabis capsules might be a viable option for MS patients with persistent spasticity not responding to other treatments.
Chemotherapy-Induced Nausea and Vomiting (CINV)
A phase II/III trial assessed the efficacy of oral THC/CBD capsules in preventing CINV. The study found a significant increase in the proportion of patients achieving a complete response (no emesis and no use of rescue medications) with THC/CBD capsules compared to placebo6. This suggests that cannabis capsules could be an effective addition to anti-emetic regimens for patients undergoing chemotherapy.
Pharmacokinetics of Cannabis Capsules
Influence of Food and Sex Differences
A study on the pharmacokinetics of orally administered THC capsules revealed that high-fat meals significantly enhanced the time to peak plasma concentration and the area under the curve for both THC and its active metabolite, 11-OH-THC. Additionally, females exhibited higher peak plasma concentrations compared to males under fasted conditions2. These findings highlight the importance of considering dietary and sex differences when prescribing cannabis capsules.
Stability and Bioaccessibility
Research on chitosan-coated alginate microcapsules containing a full-spectrum cannabis extract demonstrated that these capsules maintain their cannabinoid profile when stored at 4°C in darkness. In vitro experiments showed a fast intestinal release of cannabinoids, ensuring medium-high bioaccessibility (57-77%) of therapeutically relevant compounds3. This indicates that such formulations could be effective for oral cannabis administration.
Variability in Pharmacokinetics
A systematic review of the pharmacokinetics of oral THC highlighted the high variability in THC absorption across different formulations, including capsules, tablets, baked goods, and oils. Capsules and tablets were found to have delayed peak plasma concentrations compared to other routes of administration10. This variability underscores the need for further research to optimize the effectiveness and safety of oral cannabis formulations.
Conclusion
Cannabis capsules show promise in treating various medical conditions, including CACS, MS, and CINV. However, their pharmacokinetics can be influenced by factors such as food intake and sex differences, and there is significant variability in THC absorption across different formulations. Further research is needed to standardize these formulations and fully understand their therapeutic potential and safety profiles.
Sources and full results
Most relevant research papers on this topic
The Effects of Dosage-Controlled Cannabis Capsules on Cancer-Related Cachexia and Anorexia Syndrome in Advanced Cancer Patients: Pilot Study
Dosage-controlled cannabis capsules may increase weight in advanced cancer patients without significant side effects, warranting a larger study.
Non-RCT
Rigorous JournalHuman Pharmacokinetic Parameters of Orally Administered Δ9-Tetrahydrocannabinol Capsules Are Altered by Fed Versus Fasted Conditions and Sex Differences.
THC capsules' pharmacokinetic parameters are altered by high-fat food, sex differences, and fasted conditions, with females showing greater peak plasma concentrations than males.
RCTChitosan-Coated Alginate Microcapsules of a Full-Spectrum Cannabis Extract: Characterization, Long-Term Stability and In Vitro Bioaccessibility
Chitosan-coated alginate microcapsules of a full-spectrum cannabis extract show medium-high bioaccessibility (55-77%) and long-term stability, making them suitable for designing full-spectrum oral formulations.
Efficacy, safety and tolerability of an orally administered cannabis extract in the treatment of spasticity in patients with multiple sclerosis: a randomized, double-blind, placebo-controlled, crossover study
Standardized Cannabis sativa plant extract may lower spasm frequency and increase mobility with tolerable side effects in MS patients with persistent spasticity not responding to other drugs.
RCT
Highly CitedCannabis Extract Oil SR Capsule
Cannabis Extract Oil SR Capsule provides analgesic effects, increases appetite, decreases chemotherapy-induced nausea and vomiting, and improves weight gain, while causing fewer psychoactive side effects compared to nonSR cannabinoid-containing oral formulations.
Cannabis extract for secondary prevention of chemotherapy-induced nausea and vomiting: Results of a phase II/III, placebo-controlled, randomised trial.
Oral THC/CBD significantly increases the proportion of patients achieving a complete response in chemotherapy-induced nausea and vomiting, and is well-tolerated by patients.
RCTCannabis-Based Oral Formulations for Medical Purposes: Preparation, Quality and Stability
The improved Cannabis oil extraction technique and standard procedure result in uniform, stable oral formulations with excellent stability, facilitating patient adherence to therapy.
Kannabinoideak eta polimeroak: hamaika aukera kapsula terapeutikoen garapenean
Polymeric matrixes effectively provide efficient oral administration of cannabinoids, highlighting the versatility of therapeutic cannabis.
Oral Cannabidiol does not Alter the Subjective, Reinforcing or Cardiovascular Effects of Smoked Cannabis
Oral CBD does not reduce the reinforcing, physiological, or positive subjective effects of smoked cannabis.
RCT
Very Rigorous JournalHighly CitedOral Administration of Cannabis and Δ-9-tetrahydrocannabinol (THC) Preparations: A Systematic Review
Oral THC absorption is highly variable, with higher variability in baked goods and oil forms, highlighting the need for further investigations to enhance effectiveness and safety in medicinal use.
Systematic ReviewRigorous Journal