PRESCRIBING MEDICINAL CANNABIS

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In order to prescribe medicinal cannabis to a patient, doctors must first evaluate if their patient is eligible for medicinal cannabis and then apply for an approval through the TGA.

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There are numerous studies out there which describe the safety profiles, tolerability and potential interactions for medicinal cannabis and it is important that prescribing doctors make an informed decision to prescribe medicinal cannabis to a patient.

A practical review of cannabis safety considerations

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Practical considerations in medical cannabis administration and dosing

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PATIENT SUITABILITY

Doctors should ensure they are aware of any potential medication interactions with medicinal cannabis. It is also important to consider patient tolerance to cannabis based on their mental health or family mental health history

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Cannabinoids may interact with medications and doctors should monitor patients regularly when they are starting out on a medicinal cannabis treatment plan for any adverse effects.

Drug interactions with cannabinoids

Safety of low dose cannabidiol

Guidance for the use of medicinal cannabis in australia

DRIVING AND MEDICINAL CANNABIS

Medicinal cannabis consumption and driving is another patient consideration. It is not recommended that patients drive and consume medicinal cannabis or operate machinery due to the potential drowsiness effects of cannabis.

It is important to also check with state legislation laws regarding the presence of THC in patients whilst driving a vehicle. Currently Tasmania is the only state where a medical exemption may apply for the presence of controlled substances.

 

Medicinal cannabis and driving the intersection of health and road safety policy

ACCESSING MEDICINAL CANNABIS FOR A PATIENT

How to apply for an approval:

The easiest way to apply for an approval is using the TGA’s online portal.

TGA Online Portal

You simply have to register, log on and submit either a special access approval application or an Authorised Prescriber application.

 

For more information on using the online systems:

Special Access:

SAS Guidance

SAS Application Quick Guide

 

Authorised Prescriber:

AP Online System Guidance

AP Quick Reference Guide

STATE GOVERNMENT APPROVALS

Under some state/territory jurisdictions if you are prescribing schedule 8 cannabis products you also need a separate approval from your state health department to be allowed to do so:

State Schedule 8 Approval Required
Australian Capital Territory Yes
New South Wales No
Northern Territory No
Queensland No
South Australia Yes
Tasmania Yes
Victoria No
Western Australia Yes

 

SAS pathway: the approval application is automatically sent via the TGA portal to you state government health department.

AP pathways: the approvals must be applied for separately through your applicable health department. Below are links to the forms and information for each state:

 

Tasmania

Western Australia

South Australia

Australian Capital Territory

PATIENT ACCESS ONCE THEY ARE APPROVED

Any pharmacy Australia wide can dispense a schedule 4 or schedule 8 medicinal cannabis product. All you have to do is forward the approval and script information to your patients pharmacy for dispensing.