Cannabis-based medicinal products: summary of NICE guidance

• Published in: BMJ (Online) 2020-04, Vol.369, p.m1108-m1108
• Main Authors: Chang-Douglass, Stacey, Mulvihill, Caroline, Pilling, Steve
• Format: Article
• Language: English
• Subjects: Antiemetics; Antiemetics - therapeutic use; Antineoplastic Agents - adverse effects; Breast feeding; Cannabidiol; Cannabidiol - therapeutic use; Cannabinoid Receptor Agonists - therapeutic use; Cannabinoids; Cannabis; Cardiovascular diseases; Central nervous system; Chemotherapy; Chronic pain; Chronic Pain - drug therapy; Clinical decision making; Contraceptives; Decision making; Decision Making, Shared; Dronabinol - analogs & derivatives; Dronabinol - therapeutic use; Drug abuse; Drug and Narcotic Control; Drug Resistant Epilepsy - drug therapy; Epilepsies, Myoclonic - drug therapy; Humans; Lennox Gastaut Syndrome - drug therapy; Medical Marijuana - therapeutic use; Multiple Sclerosis - complications; Muscle Spasticity - drug therapy; Muscle Spasticity - etiology; Nausea; Nausea - chemically induced; Nausea - drug therapy; Needs Assessment; Physicians, Primary Care; Practice Guidelines as Topic; Pregnancy; Specialization; Tetrahydrocannabinol; THC; United Kingdom; Vomiting; Vomiting - chemically induced; Vomiting - drug therapy
• ISSN: 1756-1833; 1756-1833
• DOI: 10.1136/bmj.m1108

Do not offer CBD to manage chronic pain in adults unless as part of a clinical trial In September 2018, in light of the UK chief medical officer’s review and in response to the Advisory Council on the Misuse of Drugs advice, ministers in the UK announced changes to the existing regulations on cannabis-based medicinal products (CBMPs). Current and past use of cannabis (including any over-the-counter and online products) History of substance misuse, including the illicit use of cannabis Potential for dependence, diversion, and misuse (in particular with delta-9-tetrahydrocannabinol (THC)) Mental health and medical history (in particular, liver impairment, renal impairment, cardiovascular disease) Potential for interaction with other medicines—for example, central nervous system depressants and other centrally active drugs, antiepileptics, and hormonal contraceptives Pregnancy and breastfeeding. The responsibilities of all parties (the initiating specialist prescriber, the other prescriber(s), the patient, and family and/or carers) The nature and frequency of monitoring and how this will be recorded When treatment might be stopped, for example, if it is not effective How suspected or known adverse reactions will be managed How communication will be managed between the initiating specialist prescriber, the other prescriber, the patient, and family and/or carers How the treatment will be funded How care will be maintained when the patient, initiating specialist prescriber, or other prescriber moves location (including transition to adult services). CBD spray should be initiated and supervised by a physician with specialist expertise in treating spasticity due to multiple sclerosis, in line with its marketing authorisation.