All the Therapeutic System Drugs
Cannabinoids. THC 0.3, 0.9, 1.5, 3, 4.5 mg/drop, CBD 0.6, 0.9, 3, 4.5, 6 mg/drop. *This product requires a license for medical cannabis.
BOTTLE. (sublingual drop.): 10gr (330 drops). Dosage should be adjust. individual.
The Israel MOH has outlined in Guidance 106 the 12 indicat. for which med. cannabis is indicated. Accord. to this guidance, the 11 indicat. for this product are:
Chemother-induc. nausea and vomit. (CINV)/ chemother induc. pain.
Metastat. cancer pain.
Spastic. of MS.
Pain in Parkinson's dis.
Cachexia in AIDS.
Recalcitrant epilep. in adult. (Note: Accord. to Guidance 106, med. cannab. is also indic. for recalcitrant epilep. in ped. pts. but this is not an indicat. for this product)
Palliative care for termin. ill pts.
Post- traum. stress disord.
In general, the use of med. cannabis is indicated in pts. who have adequate. tried and failed convent. ther.
Please refer to Guidance 106 for details.
In addition, for an individ. pt. with a clinical. signific. med. condit. that cannot be adequate. managed by convent. ther. and which is not includ. as one of the 12 approved indicat. (eg autism, fibromyalgia), the physician can appeal to the MOH Committee for Med. Cannabis to ask for approval on an individ. exception. basis.
C/I: Prior, current/ family history (1st degr. relative) of psychos. or schizophr. or schizoaffective disord., a hist. of addict. or substance abuse (include. cannabis use disord.or addict. to alcohol), use in preg.or lact., use in pts. <18 yrs. old, bipol.disord., hypersens. to cannabis, coconut oil, palm kernel oil.
In pts. with hepat. cancer, it is recommend. not to use med. cannab. that contains THC.
SNRI. Duloxetine HCl 30 mg, 60 mg. CAPS: 7,14,28 x 30 mg, 60 mg.
intial: 30 mg dly. maint: 60 mg dly.
Ther. response: 2-4 wks aft. tmt. To
discont: Taper by 1/2 dose (30 mg) dly
or on alt. days. See lit.
Major depress. episodes., Generalized
anxiety dis., Neuropath. pain assoc.
with diabet. periph. neuropathy.,
fibromyalg., chron. muscoskeletal pain.
C/I: Concom. use with MAOI,
uncontrolled narrow-angle glaucoma.
SNRI. Duloxetine (as HCl) 20, 30, 60 mg. DR CAPS: 30 ×20mg, 30mg, 60mg.
Major depres.disor. 60 mg/d.
GAD: init. reccom. dose 30 mg ×1/d for
1 week, may be incr. to 60 mg ×1/d.
Max until: 120mg x 1/d.
Diab. periph. neurop. pain: 60 mg x
1/d; lower init., dose, grad. incr. in pts.
with ren. impair.
Fibromyal.: init. 30 mg x 1/d; for 1
week, may be incr. to 60 mg ×1/d.
Chron. musculoskel. pain: init. 30 mg
start at 30 mg ×1/d for 1 week, may be
incr. to 60 mg ×1/d.
Tmt. of Major. depress. epis.; manag. of
neurop. pain assoc. with diab. periph.
neurop. Tmt. of GAD; Fibromyal.; Manag.
of chron. muscoskel. pain when other ther.
have fail.or are contra-ind.
C/I: Hypersens. , Liver dis. result. in hep.
impair., Sev. ren. impair., Pts. und. other
medic. contain. duloxetine.
Concom. use with MAOIs or within 14 d.
after use MAOIs Init. of tmt. with MAOIs
should be start. only on a 5th day elapse
from stop. tmt. with Duloxetine.
Concom. use with fluvoxamine,
thioridazine, cimetidine, quinolone.
Concom. use with ciprofloxacin or
enoxacin Pts. with uncontr. narr.-ang.
GABA Analog. Gabapentin 300 mg, 400 mg. CAPS: 100 x 300 mg, 400 mg. With/out
food with full glass water. Titrate over a
few days to max. dose of 1,800 mg dly
in 3 div. doses. Discont. grad. over min.
of 1 wk. See lit.
Adjunct. tmt. partial seizures with/out
second. generalizat. in adults with epilepsy. Tmt. neuropath. pain in diabet.
neuropathy, post-herpetic neuropathy
C/I: Hypersens. See lit.
GABA Analog. Gabapentin 300, 400, 600, 800 mg. CAPS: 100 x 300 mg, 400 mg.
TABS: 60 x 600 mg, 800 mg. Titrate. to
max. 900-1,800 mg dly in 3 div. doses
with/without food. To minimize S/E.
Day 1: 300 mg at bedt. Day 2: 300 mg 2
xdly; Day 3: 300 mg 3 x dly, not more
than 12 hrs apart. Can incr. by 300 mg/
dly in 3 div. doses to max. 1800 mg/ day.
To discont.,decr. orsubstit: Grad.
over min. 1 wk. Elderly: Adjust as reqd.
As adjunct.ther. in the tmt. of part. seizures
with and without second. generaliz. in
adults with epilepsy. – Tmt. of neuropath.
pain in diab. neuropat.
Anticonvulsant. Pregabalin 25, 50, 75, 100, 150, 200, 225, 300 mg. CAPS: 14, 56 x 25 mg, 50 mg, 75 mg, 100 mg, 150 mg, 200 mg, 225 mg, 300 mg.
The dose range is 150-600 mg/d in 2-3 divid. doses.
Neuropathic pain 150 mg/d in 2-3 divid. doses. Based on individ. pt. response and tolerab. the dosage dose may be incr. to 300 mg/d after an interv. of 3-7 d., and if needed, to a max. dose of 600 mg/d after an addit. 7-day interv.
Fibromyalgia: 300-450 mg/d in 2 divid. doses. Some pts. may derive addit. benefit at 600 mg/d. Dosing should begin at 75 mg×2/d (150 mg/d) and may be incr. to 150 mg×2/d (300 mg/d) within 1 wk. based on efficacy & tolerabil.
Generalis. anxiety disord. (GAD): The dose range is 150-600 mg/d given as two/three divid. doses. The need for tmt. should be reassessed regularly.
Pregabalin tmt. can be started with a dose of 150 mg/d. Based on individ. pt. response and tolerab., the dose may be incr. to 300 mg/d after 1 wk. Follow. an addit. week the dose may be incr. to 450 mg/d. The max. dose of 600 mg/d may be achieved after an addit. wk.
Discont. of pregabalin: In accordance with current clinical practice, if pregabalin has to be discont. it is recomm. this should be done gradually over a minimum of 1 wk. independ. of the indication.
Tmt. of peripher. & central neuropath. pain in adult.
Managem. of fibromyalgia.
Tmt. of (GAD) in adult.