• Lourdes Poyatos, Ana Pilar Pérez-Acevedo, Esther Papaseit, Clara Pérez-Mañá, Soraya Martin, Olga Hladun, Adrià Siles, Marta Torrens, Francesco Paolo Busardo, and Magí Farré.
• Clinical Pharmacology Department, Hospital Universitari Germans Trias i Pujol and Institut de Recerca Germans Trias (HUGTiP-IGTP), 08916 Badalona, Spain.
• Medicina (Kaunas). 2020 Jun 23; 56 (6).

Background And ObjectiveChanges in cannabis legalization regimes in several countries have influenced the diversification of cannabis use. There is an ever-increasing number of cannabis forms available, which are gaining popularity for both recreational and therapeutic use. From a therapeutic perspective, oral cannabis containing Δ-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) is a promising route of administration but there is still little information about its pharmacokinetics (PK) effects in humans. The purpose of this systematic review is to provide a general overview of the available PK data on cannabis and THC after oral administration.MethodsA search of the published literature was conducted using the PubMed database to collect available articles describing the PK data of THC after oral administration in humans.ResultsThe literature search yielded 363 results, 26 of which met our inclusion criteria. The PK of oral THC has been studied using capsules (including oil content), tablets, baked goods (brownies and cookies), and oil and tea (decoctions). Capsules and tablets, which mainly correspond to pharmaceutical forms, were found to be the oral formulations most commonly studied. Overall, the results reflect the high variability in the THC absorption of oral formulations, with delayed peak plasma concentrations compared to other routes of administration.ConclusionsOral THC has a highly variable PK profile that differs between formulations, with seemingly higher variability in baked goods and oil forms. Overall, there is limited information available in this field. Therefore, further investigations are required to unravel the unpredictability of oral THC administration to increase the effectiveness and safety of oral formulations in medicinal use.

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