trying... 38399459202402271424-82471722024Feb13Pharmaceuticals (Basel, Switzerland)Pharmaceuticals (Basel)Strategies to Improve Cannabidiol Bioavailability and Drug Delivery.24410.3390/ph17020244The poor physicochemical properties of cannabidiol (CBD) hamper its clinical development. The aim of this review was to examine the literature to identify novel oral products and delivery strategies for CBD, while assessing their clinical implications and translatability. Evaluation of the published literature revealed that oral CBD strategies are primarily focused on lipid-based and emulsion solutions or encapsulations, which improve the overall pharmacokinetics (PK) of CBD. Some emulsion formulations demonstrate more rapid systemic delivery. Variability in the PK effects of different oral CBD products is apparent across species. Several novel administration routes exist for CBD delivery that may offer promise for specific indications. For example, intranasal administration and inhalation allow quick delivery of CBD to the plasma and the brain, whereas transdermal and transmucosal administration routes deliver CBD systemically more slowly. There are limited but promising data on novel delivery routes such as intramuscular and subcutaneous. Very limited data show that CBD is generally well distributed across tissues and that some CBD products enable increased delivery of CBD to different brain regions. However, evidence is limited regarding whether changes in CBD PK profiles and tissue distribution equate to superior therapeutic efficacy across indications and whether specific CBD products might be suited to particular indications.O'SullivanSaoirse ElizabethSE0000-0002-1672-6610CanPharmaConsulting, Nottingham NG9 3BB, UK.JensenSanne SkovSSFertin Pharma, Dandyvej 19, 7100 Vejle, Denmark.KolliAditya ReddyAR0000-0002-4275-4260PMI R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, 2000 Neuchâtel, Switzerland.NikolajsenGitte NykjærGNFertin Pharma, Dandyvej 19, 7100 Vejle, Denmark.BruunHeidi ZieglerHZFertin Pharma, Dandyvej 19, 7100 Vejle, Denmark.HoengJuliaJVectura Fertin Pharma, 4058 Basel, Switzerland.engJournal ArticleReview20240213SwitzerlandPharmaceuticals (Basel)1012384531424-8247cannabidiolclinicaldiseasepharmacodynamicspharmacokineticsroute of administrationtissue distributionSaoirse Elizabeth O’Sullivan is a paid consultant to Vectura Fertin Pharma, Switzerland, and a paid employee of Artelo Biosciences, US. Sanne Skov Jensen, Gitte Nykjær Nikolajsen, and Heidi Ziegler Bruun are paid employees of Fertin Pharma, Denmark. Julia Hoeng is a paid employee of Vectura Fertin Pharma, Switzerland. Aditya Reddy Kolli is a paid employee of Philip Morris International, Switzerland.2024111202422202427202422411442024224114320242241192024213epublish38399459PMC1089220510.3390/ph17020244ph17020244O’Sullivan S.E., Jensen S.S., Nikolajsen G.N., Bruun H.Z., Bhuller R., Hoeng J. The therapeutic potential of purified cannabidiol. J. Cannabis Res. 2023;5:21. doi: 10.1186/s42238-023-00186-9.10.1186/s42238-023-00186-9PMC1026214837312194Perucca E., Bialer M. Critical aspects affecting cannabidiol oral bioavailability and metabolic elimination, and related clinical implications. CNS Drugs. 2020;34:795–800. doi: 10.1007/s40263-020-00741-5.10.1007/s40263-020-00741-532504461Cohen N.T., Bahar B., Conry J.A., Schreiber J.M. Variability in Serum Concentrations and Clinical Response in Artisanal Versus Pharmaceutical Cannabidiol Treatment of Pediatric Pharmacoresistant Epilepsy. J. Pediatr. Pharmacol. Ther. 2022;27:558–563. doi: 10.5863/1551-6776-27.6.558.10.5863/1551-6776-27.6.558PMC940017736042959Laux L.C., Bebin E.M., Checketts D., Chez M., Flamini R., Marsh E.D., Miller I., Nichol K., Park Y., Segal E., et al. Long-term safety and efficacy of cannabidiol in children and adults with treatment resistant Lennox-Gastaut syndrome or Dravet syndrome: Expanded access program results. Epilepsy Res. 2019;154:13–20. doi: 10.1016/j.eplepsyres.2019.03.015.10.1016/j.eplepsyres.2019.03.01531022635Millar S.A., Maguire R.F., Yates A.S., O’Sullivan S.E. Towards Better Delivery of Cannabidiol (CBD) Pharmaceuticals. 2020;13:219. doi: 10.3390/ph13090219.10.3390/ph13090219PMC755866532872355Kok L.Y., Bannigan P., Sanaee F., Evans J.C., Dunne M., Regenold M., Ahmed L., Dubins D., Allen C. Development and pharmacokinetic evaluation of a self-nanoemulsifying drug delivery system for the oral delivery of cannabidiol. Eur. J. Pharm. Sci. 2022;168:106058. doi: 10.1016/j.ejps.2021.106058.10.1016/j.ejps.2021.10605834763088Zgair A., Wong J.C., Lee J.B., Mistry J., Sivak O., Wasan K.M., Hennig I.M., Barrett D.A., Constantinescu C.S., Fischer P.M., et al. Dietary fats and pharmaceutical lipid excipients increase systemic exposure to orally administered cannabis and cannabis-based medicines. Am. J. Transl. Res. 2016;8:3448–3459.PMC500939727648135Feng W., Qin C., Chu Y., Berton M., Lee J.B., Zgair A., Bettonte S., Stocks M.J., Constantinescu C.S., Barrett D.A., et al. Natural sesame oil is superior to pre-digested lipid formulations and purified triglycerides in promoting the intestinal lymphatic transport and systemic bioavailability of cannabidiol. Eur. J. Pharm. Biopharm. 2021;162:43–49. doi: 10.1016/j.ejpb.2021.02.013.10.1016/j.ejpb.2021.02.01333677067Feng W., Qin C., Cipolla E., Lee J.B., Zgair A., Chu Y., Ortori C.A., Stocks M.J., Constantinescu C.S., Barrett D.A., et al. Inclusion of Medium-Chain Triglyceride in Lipid-Based Formulation of Cannabidiol Facilitates Micellar Solubilization In Vitro, but In Vivo Performance Remains Superior with Pure Sesame Oil Vehicle. Pharmaceutics. 2021;13:1349. doi: 10.3390/pharmaceutics13091349.10.3390/pharmaceutics13091349PMC847283034575426Brookes A., Jewell A., Feng W., Bradshaw T.D., Butler J., Gershkovich P. Oral lipid-based formulations alter delivery of cannabidiol to different anatomical regions in the brain. Int. J. Pharm. 2023;635:122651. doi: 10.1016/j.ijpharm.2023.122651.10.1016/j.ijpharm.2023.12265136720447Schwotzer D., Kulpa J., Trexler K., Dye W., Jantzi J., Irshad H., Ware M.A., Bonn-Miller M., McDonald J., Lefever T. Pharmacokinetics of Cannabidiol in Sprague-Dawley Rats After Oral and Pulmonary Administration. Cannabis Cannabinoid. Res. 2023;8:360–373. doi: 10.1089/can.2022.0121.10.1089/can.2022.012136301522Feng W., Qin C., Abdelrazig S., Bai Z., Raji M., Darwish R., Chu Y., Ji L., Gray D.A., Stocks M.J., et al. Vegetable oils composition affects the intestinal lymphatic transport and systemic bioavailability of co-administered lipophilic drug cannabidiol. Int. J. Pharm. 2022;624:121947. doi: 10.1016/j.ijpharm.2022.121947.10.1016/j.ijpharm.2022.12194735753538Nakano Y., Tajima M., Sugiyama E., Sato V.H., Sato H. Development of a Novel Nano-emulsion Formulation to Improve Intestinal Absorption of Cannabidiol. Med. Cannabis Cannabinoids. 2019;2:35–42. doi: 10.1159/000497361.10.1159/000497361PMC848931734676332Fu X., Xu S., Li Z., Chen K., Fan H., Wang Y., Xie Z., Kou L., Zhang S. Enhanced Intramuscular Bioavailability of Cannabidiol Using Nanocrystals: Formulation, In Vitro Appraisal, and Pharmacokinetics. AAPS PharmSciTech. 2022;23:85. doi: 10.1208/s12249-022-02239-3.10.1208/s12249-022-02239-335288801Jelinek P., Rousarova J., Rysanek P., Jezkova M., Havlujova T., Pozniak J., Kozlik P., Krizek T., Kucera T., Sima M., et al. Application of Oil-in-Water Cannabidiol Emulsion for the Treatment of Rheumatoid Arthritis. Cannabis Cannabinoid Res. 2022 doi: 10.1089/can.2022.0176.10.1089/can.2022.0176PMC1087482236342775Izgelov D., Shmoeli E., Domb A.J., Hoffman A. The effect of medium chain and long chain triglycerides incorporated in self-nano emulsifying drug delivery systems on oral absorption of cannabinoids in rats. Int. J. Pharm. 2020;580:119201. doi: 10.1016/j.ijpharm.2020.119201.10.1016/j.ijpharm.2020.11920132147493Cherniakov I., Izgelov D., Domb A.J., Hoffman A. The effect of Pro NanoLipospheres (PNL) formulation containing natural absorption enhancers on the oral bioavailability of delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) in a rat model. Eur. J. Pharm. Sci. 2017;109:21–30. doi: 10.1016/j.ejps.2017.07.003.10.1016/j.ejps.2017.07.00328736128Wang C., Dong C., Lu Y., Freeman K., Wang C., Guo M. Digestion behavior, in vitro and in vivo bioavailability of cannabidiol in emulsions stabilized by whey protein-maltodextrin conjugate: Impact of carrier oil. Colloids Surf. B Biointerfaces. 2023;223:113154. doi: 10.1016/j.colsurfb.2023.113154.10.1016/j.colsurfb.2023.11315436708645Shreiber-Livne I., Sulimani L., Shapira A., Procaccia S., Meiri D., Sosnik A. Poly(ethylene glycol)-b-poly(epsilon-caprolactone) nanoparticles as a platform for the improved oral delivery of cannabidiol. Drug Deliv. Transl. Res. 2023;13:3192–3203. doi: 10.1007/s13346-023-01380-1.10.1007/s13346-023-01380-137341881Hlozek T., Uttl L., Kaderabek L., Balikova M., Lhotkova E., Horsley R.R., Novakova P., Sichova K., Stefkova K., Tyls F., et al. Pharmacokinetic and behavioural profile of THC, CBD, and THC+CBD combination after pulmonary, oral, and subcutaneous administration in rats and confirmation of conversion in vivo of CBD to THC. Eur. Neuropsychopharmacol. 2017;27:1223–1237. doi: 10.1016/j.euroneuro.2017.10.037.10.1016/j.euroneuro.2017.10.03729129557Wang C., Wang J., Sun Y., Freeman K., McHenry M.A., Wang C., Guo M. Enhanced Stability and Oral Bioavailability of Cannabidiol in Zein and Whey Protein Composite Nanoparticles by a Modified Anti-Solvent Approach. Foods. 2022;11:376. doi: 10.3390/foods11030376.10.3390/foods11030376PMC883393235159526Berthold E.C., Kamble S.H., Kanumuri S.R.R., Kuntz M.A., Senetra A.S., Chiang Y.H., McMahon L.R., McCurdy C.R., Sharma A. Comparative Pharmacokinetics of Commercially Available Cannabidiol Isolate, Broad-Spectrum, and Full-Spectrum Products. Eur. J. Drug Metab. Pharmacokinet. 2023;48:427–435. doi: 10.1007/s13318-023-00839-3.10.1007/s13318-023-00839-337337087Sanchez de Medina A., Serrano-Rodriguez J.M., Diez de Castro E., Garcia-Valverde M.T., Saitua A., Becero M., Munoz A., Ferreiro-Vera C., Sanchez de Medina V. Pharmacokinetics and oral bioavailability of cannabidiol in horses after intravenous and oral administration with oil and micellar formulations. Equine Vet. J. 2023;55:1094–1103. doi: 10.1111/evj.13923.10.1111/evj.1392336624043Bartner L.R., McGrath S., Rao S., Hyatt L.K., Wittenburg L.A. Pharmacokinetics of cannabidiol administered by 3 delivery methods at 2 different dosages to healthy dogs. Can. J. Vet. Res. 2018;82:178–183.PMC603883230026641della Rocca G., Paoletti F., Conti M.B., Galarini R., Chiaradia E., Sforna M., Dall’Aglio C., Polisca A., Di Salvo A. Pharmacokinetics of cannabidiol following single oral and oral transmucosal administration in dogs. Front. Vet. Sci. 2023;9:1104152. doi: 10.3389/fvets.2022.1104152.10.3389/fvets.2022.1104152PMC985963236686155Polidoro D., Temmerman R., Devreese M., Charalambous M., Ham L.V., Cornelis I., Broeckx B.J.G., Mandigers P.J.J., Fischer A., Storch J., et al. Pharmacokinetics of Cannabidiol Following Intranasal, Intrarectal, and Oral Administration in Healthy Dogs. Front. Vet. Sci. 2022;9:899940. doi: 10.3389/fvets.2022.899940.10.3389/fvets.2022.899940PMC921521335754531Majimbi M., Brook E., Galettis P., Eden E., Al-Salami H., Mooranian A., Al-Sallami H., Lam V., Mamo J.C.L., Takechi R. Sodium alginate microencapsulation improves the short-term oral bioavailability of cannabidiol when administered with deoxycholic acid. PLoS ONE. 2021;16:e0243858. doi: 10.1371/journal.pone.0243858.10.1371/journal.pone.0243858PMC821119834138862Xu C., Chang T., Du Y., Yu C., Tan X., Li X. Pharmacokinetics of oral and intravenous cannabidiol and its antidepressant-like effects in chronic mild stress mouse model. Environ. Toxicol. Pharmacol. 2019;70:103202. doi: 10.1016/j.etap.2019.103202.10.1016/j.etap.2019.10320231173966Pang L., Zhu S., Ma J., Zhu L., Liu Y., Ou G., Li R., Wang Y., Liang Y., Jin X., et al. Intranasal temperature-sensitive hydrogels of cannabidiol inclusion complex for the treatment of post-traumatic stress disorder. Acta Pharm. Sin. B. 2021;11:2031–2047. doi: 10.1016/j.apsb.2021.01.014.10.1016/j.apsb.2021.01.014PMC834317234386336Zgair A., Lee J.B., Wong J.C.M., Taha D.A., Aram J., Di Virgilio D., McArthur J.W., Cheng Y.K., Hennig I.M., Barrett D.A., et al. Oral administration of cannabis with lipids leads to high levels of cannabinoids in the intestinal lymphatic system and prominent immunomodulation. Sci. Rep. 2017;7:14542. doi: 10.1038/s41598-017-15026-z.10.1038/s41598-017-15026-zPMC567407029109461Artelo Biosciences Pipeline. [(accessed on 14 September 2023)]. Available online: https://artelobio.com/pipeline/Medexus Pharmaceuticals and Vireohealth LLC Novel Methylated Cyclodextrin Complexes. Patent Number. CA2476833C. [(accessed on 14 September 2023)]. Available online: https://patents.google.com/patent/CA2476833C.Avecho. [(accessed on 14 September 2023)]. Available online: https://avecho.com.au/portfolio/cannabinoids/Aphios. [(accessed on 14 September 2023)]. Available online: https://aphios.com/investors/investors-overview/aphios-pharma-llc/Bruun H.Z., Boesen D.S., Nielsen B.P. Fast Disintegrating Cannabinoid Tablets. 2019. [(accessed on 14 September 2023)]. Available online: https://patents.google.com/patent/WO2020211915A1/Bruun H.Z., Boesen D.S., Eriksen A. Lozenge for Improved Delivery of Cannabinoids. 2019. [(accessed on 14 September 2023)]. Available online: https://patents.google.com/patent/CA3040532A1/en.Bruun H.Z., Boesen D.S., Eriksen A., Wittorff H. Oral Cannabinoid Tablet. 2019. [(accessed on 14 September 2023)]. Available online: https://patents.google.com/patent/US10925853B2.Knaub K., Sartorius T., Dharsono T., Wacker R., Wilhelm M., Schon C. A Novel Self-Emulsifying Drug Delivery System (SEDDS) Based on VESIsorb((R)) Formulation Technology Improving the Oral Bioavailability of Cannabidiol in Healthy Subjects. Molecules. 2019;24:2967. doi: 10.3390/molecules24162967.10.3390/molecules24162967PMC672074831426272Hosseini A., McLachlan A.J., Lickliter J.D. A phase I trial of the safety, tolerability and pharmacokinetics of cannabidiol administered as single-dose oil solution and single and multiple doses of a sublingual wafer in healthy volunteers. Brit. J. Clin. Pharmacol. 2021;87:2070–2077. doi: 10.1111/bcp.14617.10.1111/bcp.1461733075170Berl V., Hurd Y.L., Lipshutz B.H., Roggen M., Mathur E.J., Evans M. A Randomized, Triple-Blind, Comparator-Controlled Parallel Study Investigating the Pharmacokinetics of Cannabidiol and Tetrahydrocannabinol in a Novel Delivery System, Solutech, in Association with Cannabis Use History. Cannabis Cannabinoid Res. 2022;7:777–789. doi: 10.1089/can.2021.0176.10.1089/can.2021.0176PMC978461035787693Hobbs J.M., Vazquez A.R., Remijan N.D., Trotter R.E., McMillan T.V., Freedman K.E., Wei Y., Woelfel K.A., Arnold O.R., Wolfe L.M., et al. Evaluation of pharmacokinetics and acute anti-inflammatory potential of two oral cannabidiol preparations in healthy adults. Phytother. Res. 2020;34:1696–1703. doi: 10.1002/ptr.6651.10.1002/ptr.665132147925Patrician A., Versic-Bratincevic M., Mijacika T., Banic I., Marendic M., Sutlovic D., Dujic Z., Ainslie P.N. Examination of a New Delivery Approach for Oral Cannabidiol in Healthy Subjects: A Randomized, Double-Blinded, Placebo-Controlled Pharmacokinetics Study. Adv. Ther. 2019;36:3196–3210. doi: 10.1007/s12325-019-01074-6.10.1007/s12325-019-01074-631512143Devinsky O., Kraft K., Rusch L., Fein M., Leone-Bay A. Improved bioavailability with dry powder cannabidiol inhalation: A phase 1 clinical study. J. Pharm. Sci. 2021;110:3946–3952. doi: 10.1016/j.xphs.2021.08.012.10.1016/j.xphs.2021.08.01234400185De Pra M.A.A., Vardanega R., Loss C.G. Lipid-based formulations to increase cannabidiol bioavailability: In vitro digestion tests, pre-clinical assessment and clinical trial. Int. J. Pharm. 2021;609:121159. doi: 10.1016/j.ijpharm.2021.121159.10.1016/j.ijpharm.2021.12115934624443Izgelov D., Davidson E., Barasch D., Regev A., Domb A.J., Hoffman A. Pharmacokinetic investigation of synthetic cannabidiol oral formulations in healthy volunteers. Eur. J. Pharm. Biopharm. 2020;154:108–115. doi: 10.1016/j.ejpb.2020.06.021.10.1016/j.ejpb.2020.06.02132634571Bergeria C.L., Spindle T.R., Cone E.J., Sholler D., Goffi E., Mitchell J.M., Winecker R.E., Bigelow G.E., Flegel R., Vandrey R. Pharmacokinetic profile of ∆9-tetrahydrocannabinol, cannabidiol and metabolites in blood following vaporization and oral ingestion of cannabidiol products. J. Anal. Toxicol. 2022;46:583–591. doi: 10.1093/jat/bkab124.10.1093/jat/bkab124PMC928226935438179MacNair L., Kulpa J., Hill M.L., Eglit G.M.L., Mosesova I., Bonn-Miller M.O., Peters E.N. Sex Differences in the Pharmacokinetics of Cannabidiol and Metabolites Following Oral Administration of a Cannabidiol-Dominant Cannabis Oil in Healthy Adults. Cannabis Cannabinoid Res. 2023 doi: 10.1089/can.2022.0345.10.1089/can.2022.034537267269Taylor L., Gidal B., Blakey G., Tayo B., Morrison G. A phase I, randomized, double-blind, placebo-controlled, single ascending dose, multiple dose, and food effect trial of the safety, tolerability and pharmacokinetics of highly purified cannabidiol in healthy subjects. CNS Drugs. 2018;32:1053–1067. doi: 10.1007/s40263-018-0578-5.10.1007/s40263-018-0578-5PMC622370330374683Schoedel K.A., Szeto I., Setnik B., Sellers E.M., Levy-Cooperman N., Mills C., Etges T., Sommerville K. Abuse potential assessment of cannabidiol (CBD) in recreational polydrug users: A randomized, double-blind, controlled trial. Epilepsy Behav. 2018;88:162–171. doi: 10.1016/j.yebeh.2018.07.027.10.1016/j.yebeh.2018.07.02730286443Manini A.F., Yiannoulos G., Bergamaschi M.M., Hernandez S., Olmedo R., Barnes A.J., Winkel G., Sinha R., Jutras-Aswad D., Huestis M.A., et al. Safety and Pharmacokinetics of Oral Cannabidiol When Administered Concomitantly With Intravenous Fentanyl in Humans. J. Addict. Med. 2015;9:204–210. doi: 10.1097/ADM.0000000000000118.10.1097/ADM.0000000000000118PMC444928425748562Crippa J.A., Pereira Junior L.C., Pereira L.C., Zimmermann P.M., Brum Junior L., Rechia L.M., Dias I., Hallak J.E., Campos A.C., Guimaraes F.S., et al. Effect of two oral formulations of cannabidiol on responses to emotional stimuli in healthy human volunteers: Pharmaceutical vehicle matters. Braz. J. Psychiatry. 2022;44:15–20. doi: 10.1590/1516-4446-2020-1684.10.1590/1516-4446-2020-1684PMC882736234076067Williams N.N.B., Ewell T.R., Abbotts K.S.S., Harms K.J., Woelfel K.A., Dooley G.P., Weir T.L., Bell C. Comparison of Five Oral Cannabidiol Preparations in Adult Humans: Pharmacokinetics, Body Composition, and Heart Rate Variability. Pharmaceuticals. 2021;14:35. doi: 10.3390/ph14010035.10.3390/ph14010035PMC782505833418866Cherniakov I., Izgelov D., Barasch D., Davidson E., Domb A.J., Hoffman A. Piperine-pro-nanolipospheres as a novel oral delivery system of cannabinoids: Pharmacokinetic evaluation in healthy volunteers in comparison to buccal spray administration. J. Control. Release. 2017;266:1–7. doi: 10.1016/j.jconrel.2017.09.011.10.1016/j.jconrel.2017.09.01128890215Atsmon J., Cherniakov I., Izgelov D., Hoffman A., Domb A.J., Deutsch L., Deutsch F., Heffetz D., Sacks H. PTL401, a New Formulation Based on Pro-Nano Dispersion Technology, Improves Oral Cannabinoids Bioavailability in Healthy Volunteers. J. Pharm. Sci. 2018;107:1423–1429. doi: 10.1016/j.xphs.2017.12.020.10.1016/j.xphs.2017.12.02029287930Spindle T.R., Cone E.J., Goffi E., Weerts E.M., Mitchell J.M., Winecker R.E., Bigelow G.E., Flegel R.R., Vandrey R. Pharmacodynamic effects of vaporized and oral cannabidiol (CBD) and vaporized CBD-dominant cannabis in infrequent cannabis users. Drug Alcohol. Depend. 2020;211:107937. doi: 10.1016/j.drugalcdep.2020.107937.10.1016/j.drugalcdep.2020.107937PMC741480332247649Atsmon J., Heffetz D., Deutsch L., Deutsch F., Sacks H. Single-Dose Pharmacokinetics of Oral Cannabidiol Following Administration of PTL101: A New Formulation Based on Gelatin Matrix Pellets Technology. Clin. Pharmacol. Drug Dev. 2018;7:751–758. doi: 10.1002/cpdd.408.10.1002/cpdd.40829125702Haney M., Malcolm R.J., Babalonis S., Nuzzo P.A., Cooper Z.D., Bedi G., Gray K.M., McRae-Clark A., Lofwall M.R., Sparenborg S., et al. Oral Cannabidiol does not Alter the Subjective, Reinforcing or Cardiovascular Effects of Smoked Cannabis. Neuropsychopharmacology. 2016;41:1974–1982. doi: 10.1038/npp.2015.367.10.1038/npp.2015.367PMC490863426708108Guy G.W., Robson P.J. A Phase I, Open Label, Four-Way Crossover Study to Compare the Pharmacokinetic Profiles of a Single Dose of 20 mg of a Cannabis Based Medicine Extract (CBME) Administered on 3 Different Areas of the Buccal Mucosa and to Investigate the Pharmacokinetics of CBME per Oral in Healthy Male and Female Volunteers (GWPK0112) J. Cannabis Ther. 2004;3:79–120. doi: 10.1300/J175v03n04_01.10.1300/J175v03n04_01Vitetta L., Butcher B., Henson J.D., Rutolo D., Hall S. A pilot safety, tolerability and pharmacokinetic study of an oro-buccal administered cannabidiol-dominant anti-inflammatory formulation in healthy individuals: A randomized placebo-controlled single-blinded study. Inflammopharmacol. 2021;29:1361–1370. doi: 10.1007/s10787-021-00859-y.10.1007/s10787-021-00859-y34357480Stott C.G., White L., Wright S., Wilbraham D., Guy G.W. A phase I study to assess the effect of food on the single dose bioavailability of the THC/CBD oromucosal spray. Eur. J. Clin. Pharmacol. 2013;69:825–834. doi: 10.1007/s00228-012-1393-4.10.1007/s00228-012-1393-423052407Stott C., White L., Wright S., Wilbraham D., Guy G. A Phase I, open-label, randomized, crossover study in three parallel groups to evaluate the effect of Rifampicin, Ketoconazole, and Omeprazole on the pharmacokinetics of THC/CBD oromucosal spray in healthy volunteers. SpringerPlus. 2013;2:236. doi: 10.1186/2193-1801-2-236.10.1186/2193-1801-2-236PMC367111123750331Karschner E.L., Darwin W.D., Goodwin R.S., Wright S., Huestis M.A. Plasma Cannabinoid Pharmacokinetics following Controlled Oral Δ9-Tetrahydrocannabinol and Oromucosal Cannabis Extract Administration. Clin. Chem. 2011;57:66–75. doi: 10.1373/clinchem.2010.152439.10.1373/clinchem.2010.152439PMC371733821078841Lim S.Y., Sharan S., Woo S. Model-based analysis of cannabidiol dose-exposure relationship and bioavailability. Pharmacother J. Hum. Pharmacol. Drug Ther. 2020;40:291–300. doi: 10.1002/phar.2377.10.1002/phar.237732058609Sholler D.J., Spindle T.R., Cone E.J., Goffi E., Kuntz D., Mitchell J.M., Winecker R.E., Bigelow G.E., Flegel R.R., Vandrey R. Urinary Pharmacokinetic Profile of Cannabidiol (CBD), Δ9-Tetrahydrocannabinol (THC) and Their Metabolites following Oral and Vaporized CBD and Vaporized CBD-Dominant Cannabis Administration. J. Anal. Toxicol. 2022;46:494–503. doi: 10.1093/jat/bkab059.10.1093/jat/bkab059PMC912250534089060Paudel K.S., Hammell D.C., Agu R.U., Valiveti S., Stinchcomb A.L. Cannabidiol bioavailability after nasal and transdermal application: Effect of permeation enhancers. Drug Dev. Ind. Pharm. 2010;36:1088–1097. doi: 10.3109/03639041003657295.10.3109/0363904100365729520545522Ahmed B., Rizwanullah M., Mir S.R., Akhtar M.S., Amin S. Development of cannabidiol nanoemulsion for direct nose to brain delivery: Statistical optimization, in vitroandin vivoevaluation. BioMed. Mater. 2022;17:065009. doi: 10.1088/1748-605X/ac9267.10.1088/1748-605X/ac926736108625Samara E., Bialer M., Mechoulam R. Pharmacokinetics of cannabidiol in dogs. Drug Metab. Dispos. 1988;16:469–472.2900742Ohlsson A., Lindgren J.E., Andersson S., Agurell S., Gillespie H., Hollister L.E. Single-dose kinetics of deuterium-labelled cannabidiol in man after smoking and intravenous administration. Biomed. Environ. Mass Spectrom. 1986;13:77–83. doi: 10.1002/bms.1200130206.10.1002/bms.12001302062937482Varadi G., Zhu Z., Crowley H.D., Moulin M., Dey R., Lewis E.D., Evans M. Examining the Systemic Bioavailability of Cannabidiol and Tetrahydrocannabinol from a Novel Transdermal Delivery System in Healthy Adults: A Single-Arm, Open-Label, Exploratory Study. Adv. Ther. 2023;40:282–293. doi: 10.1007/s12325-022-02345-5.10.1007/s12325-022-02345-5PMC985987636308640Heineman J.T., Forster G.L., Stephens K.L., Cottler P.S., Timko M.P., De George B.R., Jr. A Randomized Controlled Trial of Topical Cannabidiol for the Treatment of Thumb Basal Joint Arthritis. J. Hand. Surg. Am. 2022;47:611–620. doi: 10.1016/j.jhsa.2022.03.002.10.1016/j.jhsa.2022.03.00235637038Xu D.H., Cullen B.D., Tang M., Fang Y. The effectiveness of topical cannabidiol oil in symptomatic relief of peripheral neuropathy of the lower extremities. Curr. Pharm. Biotechnol. 2020;21:390–402. doi: 10.2174/1389201020666191202111534.10.2174/138920102066619120211153431793418Berry-Kravis E., Hagerman R., Budimirovic D., Erickson C., Heussler H., Tartaglia N., Cohen J., Tassone F., Dobbins T., Merikle E., et al. A randomized, controlled trial of ZYN002 cannabidiol transdermal gel in children and adolescents with fragile X syndrome (CONNECT-FX) J. Neurodev. Disord. 2022;14:56. doi: 10.1186/s11689-022-09466-6.10.1186/s11689-022-09466-6PMC970088936434514Junaid M.S.A., Tijani A.O., Puri A., Banga A.K. In vitro percutaneous absorption studies of cannabidiol using human skin: Exploring the effect of drug concentration, chemical enhancers, and essential oils. Int. J. Pharmaceut. 2022;616:121540. doi: 10.1016/j.ijpharm.2022.121540.10.1016/j.ijpharm.2022.12154035124116Radwan-Pragłowska J., Janus Ł., Piątkowski M., Sierakowska A., Szajna E., Matýsek D., Bogdał D. Development of Stimuli-Responsive Chitosan/ZnO NPs Transdermal Systems for Controlled Cannabidiol Delivery. Polymers. 2021;13:211. doi: 10.3390/polym13020211.10.3390/polym13020211PMC782685533435623Sivesind T.E., Maghfour J., Rietcheck H., Kamel K., Malik A.S., Dellavalle R.P. Cannabinoids for the Treatment of Dermatologic Conditions. JID Innov. 2022;2:100095. doi: 10.1016/j.xjidi.2022.100095.10.1016/j.xjidi.2022.100095PMC884181135199092ZynerbaPharmaceuticals ZygelTM (ZYN002 Cannabidiol Gel) [(accessed on 14 September 2023)]. Available online: https://www.zynerba.com/in-development/zygel/Kolli A.R., Calvino-Martin F., Kuczaj A.K., Wong E.T., Titz B., Xiang Y., Lebrun S., Schlage W.K., Vanscheeuwijck P., Hoeng J. Deconvolution of systemic pharmacokinetics predicts inhaled aerosol dosimetry of nicotine. Eur. J. Pharm. Sci. 2023;180:106321. doi: 10.1016/j.ejps.2022.106321.10.1016/j.ejps.2022.10632136336278Spindle T.R., Cone E.J., Kuntz D., Mitchell J.M., Bigelow G.E., Flegel R., Vandrey R. Urinary Pharmacokinetic Profile of Cannabinoids Following Administration of Vaporized and Oral Cannabidiol and Vaporized CBD-Dominant Cannabis. J. Anal. Toxicol. 2020;44:109–125. doi: 10.1093/jat/bkz080.10.1093/jat/bkz080PMC715269431682266Mannila J., Jarvinen T., Jarvinen K., Jarho P. Precipitation complexation method produces cannabidiol/beta-cyclodextrin inclusion complex suitable for sublingual administration of cannabidiol. J. Pharm. Sci. 2007;96:312–319. doi: 10.1002/jps.20766.10.1002/jps.2076617051591Itin C., Barasch D., Domb A.J., Hoffman A. Prolonged oral transmucosal delivery of highly lipophilic drug cannabidiol. Int. J. Pharmaceut. 2020;581:119276. doi: 10.1016/j.ijpharm.2020.119276.10.1016/j.ijpharm.2020.11927632243971Tabboon P., Pongjanyakul T., Limpongsa E., Jaipakdee N. In Vitro Release, Mucosal Permeation and Deposition of Cannabidiol from Liquisolid Systems: The Influence of Liquid Vehicles. Pharmaceutics. 2022;14:1787. doi: 10.3390/pharmaceutics14091787.10.3390/pharmaceutics14091787PMC950313336145536Tabboon P., Pongjanyakul T., Limpongsa E., Jaipakdee N. Mucosal Delivery of Cannabidiol: Influence of Vehicles and Enhancers. Pharmaceutics. 2022;14:1687. doi: 10.3390/pharmaceutics14081687.10.3390/pharmaceutics14081687PMC941244436015313Chung S., Peters J.M., Detyniecki K., Tatum W., Rabinowicz A.L., Carrazana E. The nose has it: Opportunities and challenges for intranasal drug administration for neurologic conditions including seizure clusters. Epilepsy Behav. Rep. 2023;21:100581. doi: 10.1016/j.ebr.2022.100581.10.1016/j.ebr.2022.100581PMC982980236636458Matarazzo A.P., Elisei L.M.S., Carvalho F.C., Bonfílio R., Ruela A.L.M., Galdino G., Pereira G.R. Mucoadhesive nanostructured lipid carriers as a cannabidiol nasal delivery system for the treatment of neuropathic pain. Eur. J. Pharmaceut. Sci. 2021;159:105698. doi: 10.1016/j.ejps.2020.105698.10.1016/j.ejps.2020.10569833406408Virpax® Pharmaceuticals NobrXiol™. [(accessed on 14 September 2023)]. Available online: https://virpaxpharma.com/products/#NobrXiol.Barata L., Arruza L., Rodríguez M.-J., Aleo E., Vierge E., Criado E., Sobrino E., Vargas C., Ceprián M., Gutiérrez-Rodríguez A., et al. Neuroprotection by cannabidiol and hypothermia in a piglet model of newborn hypoxic-ischemic brain damage. Neuropharmacology. 2019;146:1–11. doi: 10.1016/j.neuropharm.2018.11.020.10.1016/j.neuropharm.2018.11.02030468796Fouad A.A., Jresat I. Therapeutic potential of cannabidiol against ischemia/reperfusion liver injury in rats. Eur. J. Pharmacol. 2011;670:216–223. doi: 10.1016/j.ejphar.2011.08.048.10.1016/j.ejphar.2011.08.04821930120Wong H., Cairns B.E. Cannabidiol, cannabinol and their combinations act as peripheral analgesics in a rat model of myofascial pain. Arch. Oral Biol. 2019;104:33–39. doi: 10.1016/j.archoralbio.2019.05.028.10.1016/j.archoralbio.2019.05.02831158702Moqejwa T., Marimuthu T., Kondiah P.P.D., Choonara Y.E. Development of Stable Nano-Sized Transfersomes as a Rectal Colloid for Enhanced Delivery of Cannabidiol. Pharmaceutics. 2022;14:703. doi: 10.3390/pharmaceutics14040703.10.3390/pharmaceutics14040703PMC903284935456536CardiolTherapeutics. [(accessed on 14 September 2023)]. Available online: https://www.cardiolrx.com/pipeline/Valeritas Cannabidiol (CBD) Effectively Delivered Subcutaneously with Valeritas Proprietary h-Patch™ Wearable Device in Preclinical Study. [(accessed on 14 September 2023)]; Available online: https://www.sec.gov/Archives/edgar/data/1619250/000161925019000087/exhibit991073019.htm.Spittler A.P., Helbling J.E., McGrath S., Gustafson D.L., Santangelo K.S., Sadar M.J. Plasma and joint tissue pharmacokinetics of two doses of oral cannabidiol oil in guinea pigs (Cavia porcellus) J. Vet. Pharmacol. Ther. 2021;44:967–974. doi: 10.1111/jvp.13026.10.1111/jvp.13026PMC1111407034658021Yocom A.F., O’Fallon E.S., Gustafson D.L., Contino E.K. Pharmacokinetics, safety, and synovial fluid concentrations of single- and multiple-dose oral administration of 1 and 3 mg/kg cannabidiol in horses. J. Equine Vet. Sci. 2022;113:103933. doi: 10.1016/j.jevs.2022.103933.10.1016/j.jevs.2022.10393335307550Child R.B., Tallon M.J. Cannabidiol (CBD) dosing: Plasma pharmacokinetics and effects on accumulation in skeletal muscle, liver and adipose tissue. Nutrients. 2022;14:2101. doi: 10.3390/nu14102101.10.3390/nu14102101PMC914646935631242Hatziagapiou K., Bethanis K., Koniari E., Christoforides E., Nikola O., Andreou A., Mantzou A., Chrousos G.P., Kanaka-Gantenbein C., Lambrou G.I. Biophysical Studies and In Vitro Effects of Tumor Cell Lines of Cannabidiol and Its Cyclodextrin Inclusion Complexes. Pharmaceutics. 2022;14:706. doi: 10.3390/pharmaceutics14040706.10.3390/pharmaceutics14040706PMC902729335456540Hernán Pérez de la Ossa D., Ligresti A., Gil-Alegre M.E., Aberturas M.R., Molpeceres J., Di Marzo V., Torres Suárez A.I. Poly-ε-caprolactone microspheres as a drug delivery system for cannabinoid administration: Development, characterization and in vitro evaluation of their antitumoral efficacy. J. Control. Release. 2012;161:927–932. doi: 10.1016/j.jconrel.2012.05.003.10.1016/j.jconrel.2012.05.00322580111Aparicio-Blanco J., Sebastián V., Benoit J.P., Torres-Suárez A.I. Lipid nanocapsules decorated and loaded with cannabidiol as targeted prolonged release carriers for glioma therapy: In vitro screening of critical parameters. Eur. J. Pharm. Biopharm. 2019;134:126–137. doi: 10.1016/j.ejpb.2018.11.020.10.1016/j.ejpb.2018.11.02030472144Jin Z., Zhan Y., Zheng L., Wei Q., Xu S., Qin Z. Cannabidiol-Loaded Poly Lactic-Co-Glycolic Acid Nanoparticles with Improved Bioavailability as a Potential for Osteoarthritis Therapeutic. ChemBioChem. 2023;24:e202200698. doi: 10.1002/cbic.202200698.10.1002/cbic.20220069836793188Schicho R., Storr M. Topical and Systemic Cannabidiol Improves Trinitrobenzene Sulfonic Acid Colitis in Mice. Pharmacology. 2012;89:149–155. doi: 10.1159/000336871.10.1159/000336871PMC366862122414698Duchi S., Ovadia H., Touitou E. Nasal administration of drugs as a new non-invasive strategy for efficient treatment of multiple sclerosis. J. Neuroimmunol. 2013;258:32–40. doi: 10.1016/j.jneuroim.2013.02.013.10.1016/j.jneuroim.2013.02.01323517929trying2... trying... trying2...
Strategies to Improve Cannabidiol Bioavailability and Drug Delivery. | LitMetric
Some products and ways to take cannabidiol (CBD) can help it work better in our bodies.
The review looked at different methods for delivering CBD, like using oils or special capsules, which can help it get into the bloodstream faster.
There are also new ways to take CBD, like through the nose or skin, but we still need more research to know if these methods are really better for treating different health problems.
Article Abstract
The poor physicochemical properties of cannabidiol (CBD) hamper its clinical development. The aim of this review was to examine the literature to identify novel oral products and delivery strategies for CBD, while assessing their clinical implications and translatability. Evaluation of the published literature revealed that oral CBD strategies are primarily focused on lipid-based and emulsion solutions or encapsulations, which improve the overall pharmacokinetics (PK) of CBD. Some emulsion formulations demonstrate more rapid systemic delivery. Variability in the PK effects of different oral CBD products is apparent across species. Several novel administration routes exist for CBD delivery that may offer promise for specific indications. For example, intranasal administration and inhalation allow quick delivery of CBD to the plasma and the brain, whereas transdermal and transmucosal administration routes deliver CBD systemically more slowly. There are limited but promising data on novel delivery routes such as intramuscular and subcutaneous. Very limited data show that CBD is generally well distributed across tissues and that some CBD products enable increased delivery of CBD to different brain regions. However, evidence is limited regarding whether changes in CBD PK profiles and tissue distribution equate to superior therapeutic efficacy across indications and whether specific CBD products might be suited to particular indications.