#95 Landmark Clinical Evidence
Peer-reviewed human research with direct implications for cannabis medicine practice.
This review examines formulation and fabrication approaches for oral mucosal delivery of cannabinoids, a route that offers advantages including avoidance of hepatic first-pass metabolism and potential for faster onset compared to traditional oral ingestion. The authors discuss various technological platforms such as sublingual films, mucoadhesive patches, and spray formulations designed to optimize bioavailability and therapeutic efficacy while maintaining consistent dosing. Oral mucosal delivery may particularly benefit patients requiring rapid symptom relief, such as those with breakthrough pain or acute anxiety, and could improve medication adherence by reducing dosing frequency. However, the clinical utility of these formulations remains limited by variable absorption through oral mucosa, continued lack of standardized manufacturing practices, and sparse clinical trials comparing mucosal routes to established cannabinoid delivery methods. For clinicians considering cannabinoid therapy, understanding that mucosal formulations represent an emerging option with theoretical advantages but limited real-world evidence is important for setting appropriate patient expectations. Clinicians should await further clinical validation and regulatory guidance before widely recommending oral mucosal cannabinoid products to their patients.
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