Severe Nausea

Benefits of Cannabis: Cannabis has been shown to be effective in reducing the symptoms of nausea, particularly in patients receiving chemotherapy for cancer treatment.

Risks of Cannabis: There are no specific considerations in this patient group.

Suggested Initial Therapy [Inhaled Cannabis]: inhaled cannabis works within minutes and is preferred for acute symptoms. Flower strains high in the Limonene terpene will be more effective. Vape cartridges are convenient and discrete. Delta-8-THC is more effective than Delta-9-THC in relieving nausea whilst having less of an euphoric effect. Use as needed.

Suggested Initial Therapy [Tinctures]: Tinctures should be considered for patients with long lived nausea symptoms since they have a longer duration of effect. CBG tinctures are not recommended for nausea as they will reverse some of the antinausea effects of CBD.

• CBD Tincture: start at 8mg dose of a whole plant extract, use every 12 hours. The CBD will help with baseline daily symptoms.
• Δ9-THC Tincture: use a “sativa” Δ9-THC tincture to fully leverage the entourage effect. Start at a 2.5mg THC dose administered with or without CBD tinctures.
• Δ8-THC Tincture: Start at a 12.5mg Δ8-THC dose administered with or without CBD tinctures.

Titration of Doses: after 7 days of therapy, adjustment of dose may be considered. Tincture doses are modified based on response. Increases of 25% - 50% should be considered based on the patient’s response every week or two. If side effects are experienced, the last dose administered which was well tolerated should be used.