Table 3 Course of treatment with FM2, with clinical outcomes
From: The use of medical cannabis in pediatric palliative care: a case series
Dose (mg/kg/day) | Titration (mg/ml) | Duration (days) | Seizure n (daily frequency); features | Days free from seizures | Pain | Days free from pain (%) | Adverse events | |
|---|---|---|---|---|---|---|---|---|
Patient 1 | ||||||||
Starting dose | 0.11 | THC 5.2%; CDB 6.2% | 9 | 1 (0.11) Tonic-clonic, no O2 desaturation | 8/9 | No | 9 (100) | No |
Change 1 | 0.21 | Continued | 15 | 9 (0.6); tonic-clonic, with O2 desaturation in 8/9 | 12 | No | 15 (100) | No |
Change 2 | 0.41 | Continued | 9 | 3 (0.33); with O2 desaturation | 7 | No | 9 (100) | |
Change 3 | 0.52 | THC 5.2%; CBD 12.5% | 70 | 42 (0.6); O2 desaturation in 37/42 | Yes | 67 (96); analgesiscs 5-tims | No | |
Change 4 | 0.59 | THC 5.2%; CDB 8% | 24 | 9 (0.38); with O2 desaturation | Yes | 21 (87.5) | ||
Change 5 | 0.55 | THC 5.1%; CDB 8.3% | 69 | 36 (0.52); O2 desaturation in 34/36 | Yes | 65 (94.2) | ||
Change 6 | continued | THC 5.2%; CDB 8.4% | 36 | 18 (0.5); O2 desaturation in 18/18 | no | 36 (100) | ||
Change 7 | continued | THC 4.7%; CDB 7.6% | 43 | 11 (0.26) | Yes | 37 (86) | ||
Change 8 | 0.42 | THC 4.5%; CDB 7.4% | 37 | 12 (0.32) | No | 37 (100) | ||
Change 9 | 0.56 | THC 4.5%; CDB 7.3% | 29 | 10 (0.34) | No | 29 (100) | ||
Change 10 | 0.57 | THC 4.6%; CDB 7.4% | 19 | 13 (0.68) | 17 | No | 19 (100) | |
Change 11 | 0.55 | THC 4.4%; CDB 7.1% | 22 | 10 (0.45) | 19 | No | 22 (100) | |
Patient 2 | ||||||||
Starting dose | 0.11 | THC 6.5%; CDB 8.5% | 33 | 266 (8) | 0 | Yes, moderate | 1 (3) | |
Change 1 | 0.2 | Continued | 33 | 191 (5.79) | 0 | Moderate | 1 (3) | |
Change 2 | 0.31 | Continued | 30 | 125 (4.17) | 0 | Mild | 3 (10) | |
Change 3 | 0.34 | THC 5.8%; CDB 7.2% | 26 | 157 (6.04) | 0 | Moderate | 0 | |
Change 4 | 0.23 | THC 2.7%; CDB 9.3% | 31 | 100 (3.23) | 0 | Mild | 2 (6.5) | |
Change 5 | 0.21 | THC 1.2%; CDB 1.6% | 14 | 43 (3.07) | 0 | Moderate | 0 | |
Change 6 | 0.51 | THC 5.9%; CDB 8.3% | 30 | 80 (2.66) | 0 | Mild | 14 (48.3) | |
Change 7 | 0.52 | THC 6.1%; CDB 8.2% | 38 | 116 (3.05) | 0 | Mild | 20 (52.6) | Drowsiness |
Change 8 | 0.34 | THC 4%; CDB 6.2% | 31 | 83 (2.68) | 0 | Mild | 16 (51.6) | |
Change 9 | 0.39 | THC 4.6%; CDB 6.5% | 29 | 73 (2.52) | 0 | Mild | 18 (62) | |
Change 10 | 0.4 | THC 4.9%; CDB 6.6% | 27 | 68 (2.52) | 0 | Very mild | 18 (66.7) | |
Change 11 | 0.38 | THC 4.6%; CDB 6.3% | 35 | 81 (2.31) | Very mild | 20 (82.8) | ||
Patient 3 | ||||||||
Starting dose | 0.1 | na | 50 | 150 (3.57); 50 with O2 desaturation | 0 | NRS = 1 | 14 (28) | Euphoria |
Change 1 | 0.2 | 30 | 90 (3); tonic-clonic, 20 with O2 desaturation | 0 | NRS = 1 | 20 (67) | Euphoria | |
Change 2 | 0.31 | THC 4.1%; CBD 2.9% | 42 | 84 (2); with O2 desaturation | 12 (29) | No | 42 (100) | |
Change 3 | 0.28 | THC 3.7%; CBD 3.1% | 60 | 120 (2); 22 with O2 desaturation | 20 (33) | No | 60 (100) | |
Change 4 | 0.48 | THC 5.4%; CBD 3.5% | 90 | 374 (2) | 60 (32.1) | No | 90 (100) | |
Patient 4 | ||||||||
Starting dose | 0.1 | THC 5%; CBD 6.7% | 14 | 11 (0.79); no O2 desaturation | 8 (57) | NRS = 4 | NA | |
Change 1 | 0.17 | Continued | 9 | 15 (1.67) | 4 (44) | NA | NA | |
Change 2 | 0.22 | Continued | 53 | 60 (1.13 | 33 (62) | NA | NA | Drowsiness Resolution with schedule change from 0.4 ml × 3 to 0.3 + 0.4 + 0.8 ml each day |
Change 3 | Continued (0.3 + 0.4 + 0.8 ml/day) | THC 4.7%; CBD 9.9% | 60 | 79 (1.23) | 38 (59.4) | NA | NA | |
Change 4 | 0.1 (0.4 ml × 3 daily) | THC 2%; CBD 8.9% | 84 | 85 (1) | 49 (58.3) | NA | NA | |
Change 5 | 0.14 (0.4 + 0.5 + 0.9 ml/day) | THC 2.3%; CBD 2.9% | 27 | 34 (1.26) | 14 (52) | NA | NA | |
Change 6 | 0.22 | THC 4.7%; CBD 5.5% | 30 | 30 (1) | 22 (73) | NA | NA | |
Change 7 | 0.17 | Continued | 30 | 30 (1) | 17 (58) | NA | NA | |
Change 8 | 0.22 | Continued | 60 | 81 (1.37) | NA | NA | NA | |
Patient 5 | ||||||||
Starting dose | 0.12 | THC 6%; CBD 8% | 8 | 40 (5) | 0 | 3 | 2 (25) | |
Change 1 | 0.23 | Continued | 7 | 28 (4); absence and tonic-clonic | 2 | 2 (29) | ||
Change 2 | 0.4 | Continued | 15 | 60 (4) | 2 | 7 (47) | ||
Change 3 | 0.62 | THC 6.4%; CBD 8.9% | 26 | 78 (3) | 0 | 2 | 15 (58) | Drowsiness: remission with schedule change from 0.65 ml three-times/day to 0.5 + 0.5 + 0.9 ml/day |
Change 4 | 0.42 | Continued | 77 | 231 (3) | 2 | 44 (57) | Euphoria | |
Change 5 | 0.38 | THC 5.9%; CBD 10% | 240 | 720 (3) | 2 | Euphoria: remission with dose reduction to 0.2, schedule 0.2 + 0.3 + 0.9 ml/day | ||
Patient 6 | ||||||||
Starting dose | 0.71 | THC 6.74% | 39 | 9 (0.23) | Analgesics 12-times | |||
Change 1 | 1.2 | THC 11.5%; CBD 14.1% | 27 | 6 (0.22) | NA | Analgesics 9-times | Irritability: dose reduction to 0.85 mg/kg/day | |
Change 2 | 0.4 | THC 5.42%; CBD 7.87% | 86 | 13 (0.15) | Analgesics 13-times | NA | ||
Change 3 | 0.6 | THC 10.5%; CBD 9.1% | 56 | 8 (0.14) | NA | Analgesics 13-times | NA | Euphoria: spontaneous resolution |
Change 4 | 0.4 | THC 4.8%; CBD 7.4% | 38 | 6 (0.16) | NA | Analgesics 10-times | NA | |
Change 5 | 0.44 | THC 4.14%; CBD 5.61% | 84 | 28 (0.33) | NA | Analgesics 64-times | 20 (23) | Reduced appetite |
Change 6 | 0.49 | THC 4.6%; CBD 6.16% | 28 | NA | NA | No pain | 0 (100) | Restlessness and tachycardia |