Pharmacokinetics of oral tetrahydrocannabinol and cannabidiol in humans: a systematic critical review

ABSTRACT: Background. The therapeutic potential of cannabis has aroused a growing interest among health professionals. Currently, medicines and phytotherapeutics containing cannabis derivatives such as tetrahydrocannabinol (THC) and cannabidiol (CBD) are marketed; however, the pharmacokinetic data o...

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Autores:
Díaz Vélez, Luisa Fernanda
Tipo de recurso:
Tesis
Fecha de publicación:
2021
Institución:
Universidad de Antioquia
Repositorio:
Repositorio UdeA
Idioma:
eng
OAI Identifier:
oai:bibliotecadigital.udea.edu.co:10495/20885
Acceso en línea:
http://hdl.handle.net/10495/20885
Palabra clave:
Farmacocinética
Cannabinoides
Cannabidiol
Cannabis
Marihuana medicinal
Pharmacokinetics
Cannabinoids
Medical marijuana
Dronabinol
http://id.nlm.nih.gov/mesh/D010599
http://id.nlm.nih.gov/mesh/D002186
http://id.nlm.nih.gov/mesh/D002185
http://id.nlm.nih.gov/mesh/D002188
http://id.nlm.nih.gov/mesh/D064086  
http://id.nlm.nih.gov/mesh/D013759  
Rights
embargoedAccess
License
http://creativecommons.org/licenses/by-nc-nd/2.5/co/
id UDEA2_d8a66afaa7670563e0fdac460338b9de
oai_identifier_str oai:bibliotecadigital.udea.edu.co:10495/20885
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dc.title.spa.fl_str_mv Pharmacokinetics of oral tetrahydrocannabinol and cannabidiol in humans: a systematic critical review
title Pharmacokinetics of oral tetrahydrocannabinol and cannabidiol in humans: a systematic critical review
spellingShingle Pharmacokinetics of oral tetrahydrocannabinol and cannabidiol in humans: a systematic critical review
Farmacocinética
Cannabinoides
Cannabidiol
Cannabis
Marihuana medicinal
Pharmacokinetics
Cannabinoids
Medical marijuana
Dronabinol
http://id.nlm.nih.gov/mesh/D010599
http://id.nlm.nih.gov/mesh/D002186
http://id.nlm.nih.gov/mesh/D002185
http://id.nlm.nih.gov/mesh/D002188
http://id.nlm.nih.gov/mesh/D064086  
http://id.nlm.nih.gov/mesh/D013759  
title_short Pharmacokinetics of oral tetrahydrocannabinol and cannabidiol in humans: a systematic critical review
title_full Pharmacokinetics of oral tetrahydrocannabinol and cannabidiol in humans: a systematic critical review
title_fullStr Pharmacokinetics of oral tetrahydrocannabinol and cannabidiol in humans: a systematic critical review
title_full_unstemmed Pharmacokinetics of oral tetrahydrocannabinol and cannabidiol in humans: a systematic critical review
title_sort Pharmacokinetics of oral tetrahydrocannabinol and cannabidiol in humans: a systematic critical review
dc.creator.fl_str_mv Díaz Vélez, Luisa Fernanda
dc.contributor.advisor.none.fl_str_mv Zuluaga Salazar, Andrés Felipe
Zapata Ospina, Juan Pablo
dc.contributor.author.none.fl_str_mv Díaz Vélez, Luisa Fernanda
dc.contributor.researcher.none.fl_str_mv Otálvaro Gallego, Julián David
Rodríguez Peña, Sandra Liliana
dc.subject.mesh.none.fl_str_mv Farmacocinética
Cannabinoides
Cannabidiol
Cannabis
Marihuana medicinal
Pharmacokinetics
Cannabinoids
Medical marijuana
Dronabinol
topic Farmacocinética
Cannabinoides
Cannabidiol
Cannabis
Marihuana medicinal
Pharmacokinetics
Cannabinoids
Medical marijuana
Dronabinol
http://id.nlm.nih.gov/mesh/D010599
http://id.nlm.nih.gov/mesh/D002186
http://id.nlm.nih.gov/mesh/D002185
http://id.nlm.nih.gov/mesh/D002188
http://id.nlm.nih.gov/mesh/D064086  
http://id.nlm.nih.gov/mesh/D013759  
dc.subject.meshuri.none.fl_str_mv http://id.nlm.nih.gov/mesh/D010599
http://id.nlm.nih.gov/mesh/D002186
http://id.nlm.nih.gov/mesh/D002185
http://id.nlm.nih.gov/mesh/D002188
http://id.nlm.nih.gov/mesh/D064086  
http://id.nlm.nih.gov/mesh/D013759  
description ABSTRACT: Background. The therapeutic potential of cannabis has aroused a growing interest among health professionals. Currently, medicines and phytotherapeutics containing cannabis derivatives such as tetrahydrocannabinol (THC) and cannabidiol (CBD) are marketed; however, the pharmacokinetic data of these products are scant. Objective. The aim of this review was to systematically collect the data published in this area. Methods. A systematic review of the literature was carried out in the PUBMED / MEDLINE, Current Contents, LILACS, Scielo databases, in search of all the articles that included THC and CBD pharmacokinetic data in humans, administered orally with exact doses. Results. After applying inclusion criteria, 14 studies were found. In general, it is described that absorption increases in the company of high-fat foods, repeated doses prolonged the half-life, the products have extensive body distribution, and liver damage increased the maximum concentration reached by derivatives, forcing reduction in the dose. Kidney failure does not significantly influence the pharmacokinetics of CBD. The maximum doses used were 35 mg of THC and up to 6000 mg of CBD. No serious adverse events were reported. However, due to the differences between formulations in the net content of the derivatives, the purity of the products and the heterogeneity of the population, it is not possible to generalize the pharmacokinetic parameters of these studies. Conclusion. More and better studies are required to establish a safer and more effective dosage for each medicinal cannabis formulation. Keywords: Medical Marijuana, cannabis, cannabinoids, cannabidiol, pharmacology, pharmacokinetics. PROSPERO registration number: CRD42019125831 Key Points: - Knowledge about the temporal course of the concentrations and quantities in the body of cannabis derivatives and metabolites is needed for a safe prescription of cannabinoids. - More studies with greater power in their methodological design are required in order to make recommendations for population use of medicinal cannabis.
publishDate 2021
dc.date.accessioned.none.fl_str_mv 2021-07-15T16:30:58Z
dc.date.available.none.fl_str_mv 2021-07-15T16:30:58Z
dc.date.issued.none.fl_str_mv 2021
dc.type.spa.fl_str_mv info:eu-repo/semantics/other
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dc.type.redcol.spa.fl_str_mv http://purl.org/redcol/resource_type/COther
dc.type.local.spa.fl_str_mv Tesis/Trabajo de grado - Monografía - Especialización
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dc.identifier.uri.none.fl_str_mv http://hdl.handle.net/10495/20885
url http://hdl.handle.net/10495/20885
dc.language.iso.spa.fl_str_mv eng
language eng
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dc.format.extent.spa.fl_str_mv 17
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dc.publisher.place.spa.fl_str_mv Medellín, Colombia
institution Universidad de Antioquia
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repository.name.fl_str_mv Repositorio Institucional Universidad de Antioquia
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spelling Zuluaga Salazar, Andrés FelipeZapata Ospina, Juan PabloDíaz Vélez, Luisa FernandaOtálvaro Gallego, Julián DavidRodríguez Peña, Sandra Liliana2021-07-15T16:30:58Z2021-07-15T16:30:58Z2021http://hdl.handle.net/10495/20885ABSTRACT: Background. The therapeutic potential of cannabis has aroused a growing interest among health professionals. Currently, medicines and phytotherapeutics containing cannabis derivatives such as tetrahydrocannabinol (THC) and cannabidiol (CBD) are marketed; however, the pharmacokinetic data of these products are scant. Objective. The aim of this review was to systematically collect the data published in this area. Methods. A systematic review of the literature was carried out in the PUBMED / MEDLINE, Current Contents, LILACS, Scielo databases, in search of all the articles that included THC and CBD pharmacokinetic data in humans, administered orally with exact doses. Results. After applying inclusion criteria, 14 studies were found. In general, it is described that absorption increases in the company of high-fat foods, repeated doses prolonged the half-life, the products have extensive body distribution, and liver damage increased the maximum concentration reached by derivatives, forcing reduction in the dose. Kidney failure does not significantly influence the pharmacokinetics of CBD. The maximum doses used were 35 mg of THC and up to 6000 mg of CBD. No serious adverse events were reported. However, due to the differences between formulations in the net content of the derivatives, the purity of the products and the heterogeneity of the population, it is not possible to generalize the pharmacokinetic parameters of these studies. Conclusion. More and better studies are required to establish a safer and more effective dosage for each medicinal cannabis formulation. Keywords: Medical Marijuana, cannabis, cannabinoids, cannabidiol, pharmacology, pharmacokinetics. PROSPERO registration number: CRD42019125831 Key Points: - Knowledge about the temporal course of the concentrations and quantities in the body of cannabis derivatives and metabolites is needed for a safe prescription of cannabinoids. - More studies with greater power in their methodological design are required in order to make recommendations for population use of medicinal cannabis.RESUMEN: Introducción. El potencial terapéutico del cannabis ha despertado un interés creciente entre los profesionales de la salud. Actualmente se comercializan medicamentos y fitoterápicos que contienen derivados del cannabis como el tetrahidrocannabinol (THC) y el cannabidiol (CBD); sin embargo, los datos farmacocinéticos de estos productos son escasos. Objetivo. El objetivo de esta revisión fue recopilar sistemáticamente los datos publicados en esta área. Métodos. Se realizó una revisión sistemática de la literatura en las bases de datos PUBMED / MEDLINE, Current Contents, LILACS, Scielo, en búsqueda de todos los artículos que incluían datos farmacocinéticos de THC y CBD en humanos, administrados por vía oral con dosis exactas. Resultados. Tras aplicar los criterios de inclusión, se encontraron 14 estudios. En general, se describe que la absorción aumenta en compañía de alimentos ricos en grasas, las dosis repetidas prolongan la vida media, los productos tienen una distribución corporal extensa y el daño hepático aumenta la concentración máxima alcanzada por los derivados, obligando a reducir la dosis. La insuficiencia renal no influye significativamente en la farmacocinética del CBD. Las dosis máximas utilizadas fueron 35 mg de THC y hasta 6000 mg de CBD. No hubo eventos graves reportados. Sin embargo, debido a las diferencias entre formulaciones en el contenido neto de los derivados, la pureza de los productos y la heterogeneidad de la población, no es posible generalizar los parámetros farmacocinéticos de estos estudios. Conclusión. Se necesitan más y mejores estudios para establecer una dosis más segura y eficaz para cada formulación de cannabis medicinal. Palabras clave: Marihuana medicinal, cannabis, cannabinoides, cannabidiol, farmacología, farmacocinética. Puntos clave: - Es necesario conocer el curso temporal de las concentraciones y cantidades en el organismo de los derivados y metabolitos del cannabis para una prescripción segura de cannabinoides.17application/pdfengN/Ainfo:eu-repo/semantics/otherhttp://purl.org/coar/resource_type/c_46echttp://purl.org/redcol/resource_type/COtherTesis/Trabajo de grado - Monografía - EspecializaciónN/Ainfo:eu-repo/semantics/embargoedAccesshttp://creativecommons.org/licenses/by-nc-nd/2.5/co/http://purl.org/coar/access_right/c_f1cfhttps://creativecommons.org/licenses/by/4.0/FarmacocinéticaCannabinoidesCannabidiolCannabisMarihuana medicinalPharmacokineticsCannabinoidsMedical marijuanaDronabinolhttp://id.nlm.nih.gov/mesh/D010599http://id.nlm.nih.gov/mesh/D002186http://id.nlm.nih.gov/mesh/D002185http://id.nlm.nih.gov/mesh/D002188http://id.nlm.nih.gov/mesh/D064086  http://id.nlm.nih.gov/mesh/D013759  Pharmacokinetics of oral tetrahydrocannabinol and cannabidiol in humans: a systematic critical reviewMedellín, ColombiaEspecialista en Toxicología ClínicaEspecializaciónFacultad de Medicina. Especialización en Toxicología ClínicaUniversidad de AntioquiaORIGINALDiazLuisa_2021_RevisionCannabisMedicinal.pdfDiazLuisa_2021_RevisionCannabisMedicinal.pdfTrabajo de grado de especializaciónapplication/pdf982588http://bibliotecadigital.udea.edu.co/bitstream/10495/20885/1/DiazLuisa_2021_RevisionCannabisMedicinal.pdfcff3670f24a08dba3260e502387e3142MD51CC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; charset=utf-8823http://bibliotecadigital.udea.edu.co/bitstream/10495/20885/3/license_rdfb88b088d9957e670ce3b3fbe2eedbc13MD53LICENSElicense.txtlicense.txttext/plain; charset=utf-81748http://bibliotecadigital.udea.edu.co/bitstream/10495/20885/4/license.txt8a4605be74aa9ea9d79846c1fba20a33MD5410495/20885oai:bibliotecadigital.udea.edu.co:10495/208852021-07-15 11:38:19.682Repositorio Institucional Universidad de Antioquiaandres.perez@udea.edu.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