Titrated cannabis-based extracts, the indications of the Lombardy Region

On Tuesday 16 April 2024, the General Directorate for Pharmaceutical Welfare and Medical Devices of the Lombardy Region, in a note signed by the manager Ida Fortino, specified that «the marketing of titrated cannabis-based extracts makes it necessary to integrate the indications regarding Cannabis already in place in order to give homogeneity to the Ssr prescriptions across the territory”. In particular, as highlighted «without prejudice to the other prescriptive methods, it is specified that even for titrated extracts it is advisable for the doctor to draw up a prescription indicating the quantity of titrated extract by volume, since these extracts are supplied to the pharmacy in liquid form and loaded on the register of entry-exit of drugs in ml (milliliters)”.

Dosage in mg of THC and/or CBD and ATC code

In addition to this, the Lombardy Region has underlined that «the doctor must indicate on the prescription the dosage in mg of THC and/or CBD and the ATC code», furthermore that «the dispensing of a minimum volume equal to 50 ml (milliliters )”. The Region then highlighted that «both for the oleolite prepared by the pharmacist and for the diluted titrated extract, when the indicated dosage involves a consumption greater than 50ml (milliliters) in the 30 days of therapy, the pharmacist must prepare multiple volumes of 50ml (milliliters)”. Finally, «with the aim of standardizing the concentration in the two different preparation techniques, also for the purposes of patient protection, and in consideration that the minimum dispensable volume expected is equal to 50ml (milliliters), the titrated extract must be diluted at least 1:1 with suitable vehicle”.