“Over-the-counter” cannabidiol (CBD) sold in the community pharmacy setting in Colorado

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Introduction: The use of cannabidiol is becoming so popular that even pharmacies now carry over-the-counter (OTC) cannabidiol products in Colorado, USA. Objective: The primary goal of this study was to evaluate cannabidiol products sold in the community pharmacy setting to determine the content of cannabidiol and other active ingredients and the safety information that may be provided to individuals considering the use of these products. Methods: Documentation of cannabidiol products available for purchase in pharmacies was compiled by visiting chain and independent pharmacies within the state of Colorado. Cannabidiol products were documented for claims of use, dose, route, administration, additional ingredients, and cost. Results: In total, 60 cannabidiol products (15 oral, 44 topical, and one transdermal) were found in 35 pharmacies. The concentrations of oral cannabidiol varied from 10 to 60 mg/mL. In total, 13 (87%) of the oral products were labeled as “full spectrum.” Six (40%) of the oral cannabidiol products listed medium-chain triglycerides, a compound with evidence of increasing oral bioavailability. The amount of cannabidiol labeled on topical products varied from 30 mg cannabidiol/15 mL to 1000 mg cannabidiol. Some products did not indicate any quantity of cannabidiol or did provide the amount of hemp extract/oil but did not specify how much cannabidiol was present. In total, 29 (66%) of the topical products contained additional active ingredients: arnica, camphor, capsaicin, menthol, peppermint oil, white willow bark (salicylic acid), tea tree oil, and trolamine salicylate. Only one type of transdermal product for cannabidiol delivery was found, which provided a dose of 20 mg cannabidiol/24 h. Conclusion: The findings of this study illustrate the extensive variability of cannabidiol products and the importance of communication with people considering their use. Counseling those utilizing these products may help to avoid drug–drug or drug–supplement interactions and adverse events.

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