Question of the Month: What Are Transdermal Cannabis Patches and Gels?

We often get questions on the Leaf411 hotline about the different types of cannabis products on the market today.

The product people are most surprised to hear about? Transdermal patches or gels containing cannabis plant compounds—either cannabidiol (CBD), tetrahydrocannabinol (THC), or both CBD and THC. Transdermal products may also feature other cannabinoids like CBN or THCa (tetrahydrocannabinolic acid), which is a raw, non-psychoactive form of THC.

Transdermal products can even contain other cannabinoids, terpenes, and compounds that have therapeutic benefits.

How Transdermal Products Work

What makes transdermal patches or gels different than regular topical products you put on your skin like creams or salves?

Normally, the skin acts as a barrier. While creams and salves are absorbed by the outer layers of skin, they do not make it past all the skin layers and into the bloodstream.

However, transdermal products contain specially formulated carrier agents to help medicines, including cannabinoids, to fully penetrate the skin barrier and be absorbed directly into the bloodstream.This route of administration eliminates the need for medicines to first pass through the digestive system or respiratory system (if inhaled). It also allows for more consistent dosing over longer periods of time.

Transdermal patches and gels are not unique to cannabis. In fact, you’ve probably seen transdermal patches used to deliver other medications.

Transdermal routes of administration are used for certain birth control products, smoking cessation and motion sickness. They’re also used to deliver opioids like fentanyl that are prescribed for persistent chronic pain.

Cannabis transdermal patches use the same technology. The middle of the patch contains different cannabinoids like THC, CBD, or CBN. In some cases, terpenes and other therapeutic compounds like menthol or eucalyptus are also added. Manufacturers also add carrier agents, so that the compounds will be more readily absorbed through the skin and into the bloodstream.

The Advantages of Transdermal Cannabis Products

Transdermal cannabis patches and gels are a good option for people who want cannabis’s therapeutic benefits, but have health conditions or other restrictions that prevent them from either inhaling (smoking/vaping) or ingesting edibles or pill-based forms.

Finding an Effective Transdermal Product

Product quality is a big factor when choosing transdermal cannabis products. As we mentioned earlier, simply putting a cream or salve on your skin and letting it soak in does not make it “transdermal.” Many people—and even some budtenders—don’t understand this difference.

Look for products specifically labeled as “transdermal,” and make sure the manufacturer provides Certificates of Analysis (COAs) on their website with test results confirming the amount of THC, CBD and other cannabinoids.

CBD hemp-based transdermal patches and gels are federally legal (containing less than 0.3% THC). They can be found online or in retail outlets in most states.

Transdermal patches and gels containing higher amounts of THC are only legally sold at recreational or medical dispensaries.

How to Use Transdermal CBD Products

Transdermal CBD patches or gels are typically applied on a part of your body that has veins near the skin’s surface, like the inside of your wrist or on your ankle. The time of onset is rapid, sometimes within 20 minutes, and lasts for up to 12 hours. Remember that CBD is not intoxicating, so you won’t feel “high” from a transdermal CBD patch.

In some cases, transdermal patches can be applied elsewhere on the body for localized relief. For example, our supporting member Arcanum makes Sarco Skin, a CBD-infused kinesiology tape. Kinesiology tape is a favorite of athletes, and may help by supporting muscles and joints, while also having a positive impact on pain signals.

How to Use Transdermal THC Products

Transdermal products containing THC work in much the same way as those containing CBD, with relatively quick onset and an extended, consistent dose. Many people report that the intoxicating effects of THC are more subdued when using transdermal products containing THC or a 1:1 CBD:THC ratio.

When considering your dose, take into account that almost all of the cannabinoids contained in the patch are bioavailable. In other words, you don’t lose part of the dose through first-pass metabolism in your digestive system like you do with edibles.

We always suggest starting with one-fourth of the suggested dose or serving size. 

Transdermal gel can be dosed in smaller amounts. 

For transdermal cannabis patches, products like Mary’s Medicinals transdermal patches can be cut into smaller pieces to provide a lower dose. We suggest you check the manufacturer’s website to make sure the transdermal patch is designed so that it can be cut into smaller portions.

Need Help with Your Cannabis Questions?

The FREE anonymous Leaf411 hotline nurses can help with your questions, whether you’re a recreational cannabis user, patient, or a clinician wanting to learn more about plant-based medicine. Call us at 844-LEAF411 (844-532-3411).

The Leaf411 cannabis nurse hotline provides free, anonymous education and directional support to the general public about the safe use of legal cannabis. We partner with select business members who meet our rigorous standards to extend our education and outreach efforts.


Leaf411 Question of the Month: Does Cannabis Interact with Other Medication?

Approximately half of all Americans take at least one prescription drug every day, according to a Consumer Reports study. Many more people take non-prescription, over-the-counter painkillers, antacids and other medications.

Not surprisingly, a fair number of these people are seeking alternatives to their medications. In many cases, people are turning to cannabis—either marijuana (cannabis containing >0.3% THC, which is sold legally in dispensaries), or cannabidiol (CBD) hemp products that are sold in retail stores and online.

Smiling senior woman on phone holding prescription bottle, asking about drug interactions with cannabis.

Thinking About Adding Cannabis to Your Medicine Cabinet?

We always suggest that you talk to your healthcare provider before taking any new medication. That includes CBD hemp or marijuana. Our Leaf411 cannabis-trained nurses can provide education and guidance as well as how to discuss the possibility of adding plant medicine into your regimen with your healthcare team via our free hotline: 844-LEAF411 (844-532-3411).

Also, it’s important to talk to your healthcare provider before stopping any prescription medication. It is imperative that your prescribing physician should always be the one who guides you with stopping or weaning off any pharmaceuticals.

Understanding How Cannabis Interacts with Other Medications

Have you ever wondered why you’re told to not drink grapefruit juice with certain prescription drugs?

Prescription bottle with warning labels to not eat grapefruit while taking medication, and to take medication as prescribed.

When you take medicine by mouth, it passes through your digestive system. The digestive system’s enzymes metabolize (break down) the medicine in your liver so that some of it can enter your bloodstream. The medicine dose takes into account normal digestive processes.

However, grapefruit juice affects several digestive enzymes. It blocks the enzymes’ action, and can result in too much or too little of the drug entering your bloodstream.

What does this have to do with cannabis? Well, the cannabinoids in cannabis—especially CBD—affect your digestive enzymes in a similar way that grapefruit does. In fact, scientists have found that CBD has an even stronger effect on the cytochrome P450 enzyme than grapefruit.

Cannabis, Statins, and Blood Thinners: Use Caution

An emerging area of concern is with cardiovascular medications, including statins and blood thinners. Many of these medications are metabolized by the same liver enzymes as cannabis. As a result, people who use cannabis while also taking statins or blood thinners may end up getting a higher dose of their prescription medicine than they intended, since the liver is breaking down the drug differently than normal.

Does this mean you cannot use cannabis? Not necessarily. The key is to talk with your provider and discuss any changes that need to be made to your medication dosage, frequency or timing. You might consider sharing the link to this article from the Journal of the American College of Cardiology which provides very conservative guidance for doctors to use as a screening tool who have no experience or knowledge about cannabis. 

The Benefit of Starting Slow with Cannabis

Not all drugs are metabolized by the same liver enzymes. However, even if you’re taking medications that are not directly impacted by cannabis in your digestive system, it’s worth it to start with a low dose of marijuana or CBD, and to go slow. By starting slow, you can see how the addition of marijuana or CBD impacts your ongoing medications (after checking with a healthcare provider, of course!).

Also, Dr. David Gordon (Dr. Dave), founder of 4Pillars Health & Wellness, notes that people usually only need a small dose of cannabis for therapeutic benefits. This minimizes the risk of side effects. Dr. Dave explains that as an integrative physician, “We start with just a small amount, just to stimulate our own internal system. These are dosages that often don’t cause any intoxication or have any significant interaction.”

Dr. Dave is experienced at looking up potential interactions with medicinal cannabis. He’s found that most drug interactions don’t preclude someone from using cannabis, though he notes that drug doses may need to be adjusted. (You can read more from our recent interview with Dr. Dave here.)

Getting Answers to Your Cannabis Questions

Our Leaf411 hotline nurses have special training on cannabis-medication interactions. They also have access to a robust database of research.

We encourage you to call our free hotline at 844-LEAF411 (844-532-3411) with your questions about how CBD or marijuana may interact with other medications you are taking. 


Leaf411 Question of the Month - December 2019

By Katherine Golden, RN
Leaf411 CEO

Each month, I’ll share insights on questions we receive at the Leaf411 cannabis nurse hotline. While the hotline is anonymous, we keep track of the types of questions we get so that we can continually improve our services.

A Surprising Cannabis Question

One issue I hear all the time, including when we’re out at events like our Veteran’s Day booth, is that people think they have to inhale to get the medicinal benefits from cannabis. It’s surprising to me that this misconception is still prevalent across all age groups.

For those of us in the industry, we know that many different THC and CBD product types are out there—edibles, tinctures, transdermal patches and gels. Sometimes we assume that everyone else knows about these options as well. But when I discuss ways that cannabis can be consumed, people are surprised and have a lot of questions about which route might work best for them.

For example, I recently had a caller who wanted to try cannabis for a specific health concern but was worried how it might impact their liver issues. They had no idea that transdermal patches were an option. When I suggested a transdermal patch, they responded, “Oh, like a pain patch!” It was a medication delivery method the caller knew how to use, and it offered a safe alternative. Transdermal patches deliver THC, CBD and other cannabinoids directly to the bloodstream, bypassing the liver.

I also educated the caller about transdermal gel pens which are used on the venous areas like the inside of the wrist. They were just blown away that these types of advanced products exist in our market. Calls like this really underscore the need for education.

At Leaf411, Our Priority Is Always the Public

Our priority at Leaf411 is always the public, helping people find the best information and resources for safe cannabis use.

When I get a call, my first priority is to listen and understand why the caller wants to go down this road. I’ll ask questions about products they’re already using. If they haven’t tried cannabis yet, I’ll ask why they want to start and what their goals are.

I also spend a lot of time discussing balance. Cannabis by itself is not a magic bullet. I ask questions about callers’ activities of daily living, diet, exercise and sleep as well.

Cannabis is a plant that is shown to have benefits. However, it’s only one part of lifestyle changes that I and the other nurses encourage callers to consider.

I recently talked to someone who thought they would need to move to a different state to access legal cannabis. In fact, their home state has legalized medical cannabis, and hemp CBD products are available to be shipped to most states. They had not considered these options before our conversation.

My goal is to offer solutions that are financially sound and accessible, based on each caller’s unique situation and needs.

When it Comes to Cannabis, More is Not Always Better

We tend to think more is better. Based on my conversations with callers, that attitude has extended into cannabis and hemp CBD as well. But the latest science is showing that sometimes just a small amount  of cannabis can provide symptom relief. We don’t need to flood our systems, when it comes to what most people are trying to treat.

Also, there is a point where you can take too much marijuana, or even too much hemp CBD. I educate callers about precautions they need to take when using cannabis, just like there would be precautions with any other medications.

Launching the Leaf411 Chat Feature

We want to create the best service possible at Leaf411. It was important for us to get the phone hotline up and running, making sure it was a positive experience for people who contacted us, before adding other options to connect.

Last week, we launched the chat function on our website, providing an additional option for people to contact us.

When someone begins a chat with me, I bring the same level of attention to their concerns. I may start off chatting with someone online and then ask them to call the hotline to talk if at all possible.

People have so much to say, and tone of voice is so important to understanding someone’s needs and concerns. My hope is that the human touch that I and the other nurses provide through the phone hotline will reassure callers, even those who initially reached out to us via chat.

Call or chat our free, anonymous hotline today at 844-LEAF411 (844-532-3411) for answers to your cannabis questions!