Arthritis Foundation issues first CBD guidance

Takeaway

• The Arthritis Foundation has issued guidance for affected consumers interested in using cannabidiol (CBD)-based products for arthritis symptoms (e.g., pain, insomnia, anxiety).

Why this matters

• CBD is not a substitute for DMARD rheumatoid arthritis (RA) treatments.
• Advise patients interested in trying CBD to choose standardized, quality-controlled products manufactured in the United States, backed by a certificate of analyses.
• Aside from e-cigarettes and vaping lung injuries, no major safety issues have been found with the class of CBD products overall, when taken in moderate amounts.
• Potential drug-drug interactions may occur: corticosteroids, tofacitinib, naproxen, celecoxib, tramadol, certain selective serotonin reuptake inhibitors, fibromyalgia medications.
• Patients experiencing adverse effects should immediately discontinue use and contact their clinician.

Key points

• Guidance was driven by a recent survey among ~3000 patients with osteoarthritis, RA, 79% of whom reported past or current CBD use or considering trying.
• Caution patients using liquid CBD to learn both dosing and CBD amount in each dose.
• Sublingual CBD: start with a few milligrams twice daily; increase by the same amount after several weeks if relief is inadequate or continue use as-is if inadequate.
• Do not add tetrahydrocannabinol to CBD product without speaking to the clinician.