Medical Cannabis Titration Guide

OVERVIEW
ÎÎ Specific dosages for using cannabis as a pharmaceutical agent
have yet to be determined.
ÎÎ Dosing for cannabis is highly individualized and relies greatly on
titration — Trial and Error. This is due to the high variability in
concentrations of THC & CBD in different products.
ÎÎ Many different variables can affect the efficacy and safety
of cannabis such as age, genetics, medical condition, other
medications, and method of consumption. As well, THC and/
or CBD concentrations can have effects on both efficacy and
safety.
ÎÎ Not all cannabis products are created equal (mg/mL of CBD
and THC will vary), it is important for patients to take note of
the THC:CBD ratio.
ÎÎ Other compounds in cannabis can impact the effects felt.
Cannabis contains >100 cannabinoids and numerous non-
cannabinoid such as Terpenes, however the impacts of these
are not yet well understood.
ÎÎ There is no standard waiting time to drive after using cannabis. If
you are using cannabis, do not drive. Some effects of cannabis use
can last up to 24 hours, while other effects may fade more quickly.

INSTRUCTIONS
ÎÎ There currently is no uniform starting dose for cannabis products or uniform dosing information.
ÎÎ Patients are recommended to slowly titrate up to find their optimal dose (maximal therapeutic effects and minimal adverse effects).

Onset depends on mode of administration:

OIL (DROPS, CAPSULES, SPRAYS) DRIED CANNABIS (SMOKING OR VAPORIZING)

öö Method of consumption: Oral or Oromucosal öö Method of consumption: Inhalation
öö Onset of effects: 30 minutes to 2 hours öö Onset of effects: seconds to minutes
öö Peak effect: within 4 hours öö Peak effect: within 30 minutes
öö Duration of effects: 12 hours or longer öö Duration of effects: 6 hours or longer

Common Adverse Effects:

THC Dry mouth Drowsiness Dizziness Impaired cognition Psychosis “feeling high”

Mild-moderate Diarrhea Serious Elevated

CBD Somnolence Dizziness
adverse events: and vomiting adverse events: aminotransferase levels
This chart comprises information from the following references:
1. Narang et al. 2008 2. Kleine-Brueggeney et al. 2015 3. Johnson et al 2010 4. Devinsky et al. 2018 5.Hoggart et al. 2015 6. McCoy et al. 2018

THE RIGHT THERAPEUTIC DOSAGE VARIES FROM ONE PATIENT TO ANOTHER!

ÎÎ Patients will need to take a proactive approach: keeping a diary ÎÎ The selected dose should minimize risks while maximizes benefits.
for tracking, and it is also important to set treatment goals with ÎÎ In line with Health Canada, we highly recommend to: start low,
patients. go slow!
ÎÎ Patients should be educated on the possible side effects and
contraindications before use.
ÎÎ Educate patients: Do not drive under the influence of cannabis START
or use alcohol or other sedating drugs.
GO
LOW SLOW
ÎÎ Many adverse effects can be decreased by lower dose, slow
titration and/or medical cannabis variety.

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 Aurora Oil Titration Guide
CBD BLEND: CBD DROPS (CBD 26-29 MG/ML + THC 1MG/ML)
CBD doses can be quite high, with limited adverse effects. Once a therapeutic dose is achieved, patients should be advised to continue
such regiment and follow up with their doctor as needed. Daily intake depends on the specific product consumed and should be used PRN.

Days Morning (mL) Midday (mL) Evening (mL) Total Daily Dose (mL)
1-3 0.1 0.1 0.1 0.3
4-6 0.2 0.2 0.2 0.6
7-9 0.3 0.3 0.3 0.9
10-12 0.4 0.4 0.4 1.2
13-15 0.5 0.5 0.5 1.5

THC BLEND: THC DROPS (THC 21-26MG/ML)

Increase dose by 0.1mL at night, until desired symptom relief is achieved. If desired effect is not achieved, refrain from redosing until the next
scheduled dose to avoid any complications. It is also advised to take THC 90 minutes before the desired effects is required, as the onset of
effects can take from 30 minutes to 4 hours. The patient should refrain from driving as there is no standard waiting time to drive after using
cannabis. Daily intake depends on the specific product consumed and should be used PRN.

Days Morning (mL) Midday (mL) Evening (mL) Total Daily Dose (mL)
1-3 - - 0.1 0.1
4-6 - - 0.2 0.2
7-9 - - 0.3 0.3
10-12 - - 0.4 0.4
13-15 - - 0.5 0.5

1:1 BLEND: 1:1 DROPS (CBD 13-16MG/ML + THC 13-16 MG/ML)

Increase dose by 0.1mL until optimal therapeutic dose is achieved. Patients should allow 4-5 hours in between doses and should refrain
from driving as there is no standard waiting time to drive after using cannabis. Daily intake depends on the specific product consumed
and should be used PRN.

Days Morning (mL) Midday (mL) Evening (mL) Total Daily Dose (mL)
1-3 0.1 0.1 0.1 0.3
4-6 0.2 0.2 0.2 0.6
7-9 0.3 0.3 0.3 0.9
10-12 0.4 0.4 0.4 1.2
13-15 0.5 0.5 0.5 1.5

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