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Lemon, D-limonene and Compounding CBD

The Controversy Surrounding CBD: What You Need to Know

Cannabidiol, better known as CBD, is a hotly debated topic in today’s world. Do you believe that it belongs in a store alongside medical marijuana products, gummies, chocolates, and baked goods? Or that it should be behind a counter, where only a designated professional can prescribe it to an individual?

If you feel like CBD should be widely available, here’s something to consider: The dosing is critical for achieving its desired effect. Because dosing is required, this makes CBD a drug. And because it is a drug, it really should fall under the strict recommendation of a drug expert — also known as your local pharmacist. However, there are many reasons that this practice isn’t standard. To explain why we need to dig deeper into CBD and explore its effects on the body.

What is CBD?

Derived from the hemp plant, CBD is the second most prevalent active ingredient in cannabis or marijuana, but on its own, it does not give the user a “high.” It is this misconception that allows CBD to be part of the wider marijuana trade. It is often sold by self-proclaimed experts that promise miraculous healing and other benefits from using their “trusted” products. It may be the same reason many professionals prefer to steer clear of exploring the use of CBD in the healthcare setting, not wanting to be lumped in with these charlatans and snake oil merchants.

It’s an obvious predicament. Still, we can’t simply step back and ignore its popularity. Let’s instead consider CBD in terms of its biological action. From there, you can make an educated decision about its use, and, more importantly, help your patients determine the right products and dosing to achieve their desired outcomes. 

CBD and the Endocannabinoid System

CBD has been shown to exert its effects on the endocannabinoid system (ECS), a system of CB1 and CB2 receptors that are present throughout the central and peripheral nervous systems and responsible for homeostasis. 

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The ECS is made up of G protein-coupled receptors, their lipid-based retrograde receptors, and signaling enzymes. It has a regulatory role of essential functions and processes, including pain perception, sleep, mood, appetite, memory, and reproduction. Even without CBD, the ECS is active and functioning in every mammal, using endogenous endocannabinoids as neurotransmitters, which increase and decrease in response to changes in the internal and external environment.

Overall, CBD has a high safety profile, but the unpredictability of any exogenous compound needs to be considered. High doses, for example, have been shown to affect the production of liver enzymes, which may cause acute hypertension or drowsiness. It’s for this reason that the best person to educate and prescribe this drug is one who is responsible, has knowledge of the mechanisms through which it exerts its effects, has access to patient medication profile and who knows to ask the right questions in order to evaluate potential risks. In other words: a pharmacist.

A Pharmacist’s Role

A pharmacist’s role, then, is one of education before prescription. They can provide an individual with details about the differences between THC and CBD, the various products available, and dosing. They can explain the preferred mode of delivery (either topical, sublingual, buccal, or oral mucosal due to the higher rate of absorption). They can also offer insight into the adverse effects that may develop through interaction with various CYP enzymes.

Specific compounding pharmacies are now able to compound prescription CBD. CBD from VLS Pharmacy is synthetic and uses D-limonene, which comes from citrus peels of lemons and oranges. Although it is not extracted from hemp, the source is an FDA-registered manufacturer and is grown without the use of pesticides. It is a pure API with little to no taste and is a lipophilic (fat-loving) molecule. Typically, CBD must contain no more than 0.3% THC, but our version contains less than 0.1%, which is verified by assay (unlike OTC products).

It’s these standards of practice as well as a foundation of knowledge about the complex biochemical pathways of CBD that allows our team at VLS Pharmacy to truly stand out from the pretenders, bringing a drug like CBD back to where it belongs: in the trusted hands of your community drug expert.

Additional information: 

Reach out to our team to learn about best practices and to partner with our experts on dosing-specific CBD treatments for your patients. 

All medications from VLS Pharmacy and New Drug Loft are prepared in a lab that follows safety and quality standards per our status as a 503A pharmacy.

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