Introduction
01
Dosage forms of medical cannabis: Flowers, extracts and finished dosage forms
In Germany, various dosage forms of medical cannabis can be prescribed: dried cannabis flowers, standardized full-spectrum extracts, dronabinol and cannabidiol formulas as well as finished dosage forms.1
Cannabis flowers
Dried whole or crushed flowers (shoot tips) of Cannabis sativa L.2 are used, whereby there are numerous subspecies, such as Cannabis indica. Cannabis sativa and indica differ not only in terms of their growth, but also in their effect.3 Thus, Cannabis sativa typically has higher tetrahydrocannabinol (THC) than cannabidiol (CBD) contents, Cannabis indica, on the other hand, a balanced THCCBD content.4
In recent decades, however, numerous hybrid plants have been bred by crossbreeding, which are more precisely referred to as sativa- and indica-dominant hybrids. In addition, there are various cultivated varieties, i.e. breeding forms with stable genetics and ingredients.3
Full-spectrum extracts
In addition to the two main active ingredients tetrahydrocannabinol (THC) and cannabidiol (CBD), all active ingredients of cannabis flowers such as terpenes are contained in the full-spectrum extracts.5
This is because cannabis full-spectrum extracts are the end product of the extraction of whole or crushed dried shoot tips of flowering female cannabis plants. The end product is a golden-brown viscous resin.
Flowers and extracts versus pure substances: Availability of accompanying substances
Since cannabis flowers and full-spectrum extracts, unlike some finished dosage forms or pure substances, contain the entirety of cannabinoids and terpenes5, they offer a very wide range of treatment options. The therapeutically desirable interactions between the ingredients in individual cases – such as between THC and CBD – are not given in the case of pure substances.
References
Status: 2021
Hoch E, Friemel CM, Schneider M. Cannabis: Potenzial und Risiko. Hoch E, Friemel CM, Schneider M. Cannabis: Potenzial und Risiko. Cannabis, Cannabinoide und das Endocannabinoidsystem 2019. https://link.springer.com/chapter/10.1007%2F978-3-662-57291-7_1 (last visited on 01 July 2021).
Monografie des Deutschen Arzneibuchs ‚Cannabisblüten – Cannabis flos‘
Decorte T, Potter G, Bouchard M. World Wide Weed: Global Trends in Cannabis Cultivation and its Control (2013).
McPartland J.M. (2017) Cannabis sativa and Cannabis indica versus “Sativa” and “Indica”. In: Chandra S., Lata H., ElSohly M. (eds) Cannabis sativa L. - Botany and Biotechnology. Springer, Cham. https://doi.org/10.1007/978-3-319-54564-6_4 (last visited on 01 July 2021).