CBD Dosage Chart for Pain: mg Ranges and Titration Steps

CBD dosage chart for pain: the short answer

No health agency has approved CBD for pain. The FDA approved one CBD drug, Epidiolex, and only for seizures. There is no standard dose for pain. Trials that measured CBD against pain used 25 mg per day to 1,000 mg per day. Most people start at 5 mg to 10 mg per dose and add 5 mg to 10 mg every 5 to 7 days.

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General dose tiers

These ranges come from trial data and drug labels. They are not a prescription.

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• Low: 5 mg to 25 mg per dose, 1 to 2 times per day. Total 10 mg to 50 mg per day.
• Medium: 25 mg to 75 mg per dose, 1 to 2 times per day. Total 50 mg to 150 mg per day.
• High: 75 mg to 150 mg per dose, 2 times per day. Total 150 mg to 300 mg per day.
• Very high: 150 mg to 500 mg per dose. This range shows up in trials, not in home use.

Weight-based dosing

The Epidiolex label doses in milligrams per kilogram of body weight (mg/kg). A 70 kg adult at 1 mg/kg takes 70 mg. At 5 mg/kg the dose is 350 mg. Weight changes the dose in children more than in adults. Weight also matters when CBD is taken with other drugs.

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What the trials used

• Chronic pain studies: 25 mg per day and higher, for 2 to 12 weeks.
• Anxiety studies: 150 mg to 600 mg per day. One public speaking test used a single 300 mg dose.
• Schizophrenia trials: 1,000 mg per day.
• Epidiolex label: 2.5 mg/kg twice daily at the start, up to 20 mg/kg per day.

Pain trials are smaller and shorter than epilepsy trials. Few pain trials run past 12 weeks.

Bioavailability changes the number

The Epidiolex label lists oral bioavailability near 6 percent. Other studies report 4 percent to 20 percent for oral CBD products. A high-fat meal raises absorption. Inhaled CBD reaches the blood at about 31 percent. Sublingual drops sit under the tongue for 1 to 2 minutes, and the rest is swallowed. The Epidiolex label lists a half-life of 56 to 61 hours after 7 days of twice daily dosing.

Steps to find a dose

1. Record a pain score from 0 to 10 each day for 3 days.
2. Start at 5 mg to 10 mg, once per day, in the evening.
3. Hold that dose for 5 to 7 days.
4. Add 5 mg to 10 mg every 5 to 7 days until pain scores drop or side effects start.
5. Cut back by 5 mg if side effects start.
6. Log the mg amount, the time, and the product batch number.

Side effects and limits

Common side effects: diarrhea, sleepiness, fatigue, and appetite loss. The Epidiolex label reports liver enzyme rises in some patients at 20 mg/kg per day and requires liver monitoring during the first weeks. CBD blocks the CYP3A4 and CYP2C19 enzymes. It raises blood levels of clobazam, warfarin, and some seizure drugs.

Where a chart does not apply

Topical CBD acts at the site. A topical dose is not comparable to an oral dose. Vaped CBD reaches the blood in minutes. Edibles take 30 to 90 minutes. Hemp products in the US are not reviewed by the FDA for content. A 2017 study of 84 online CBD products found 26 percent contained less CBD than the label stated and 43 percent contained more.

Bottom line

Start at 5 mg to 10 mg. Raise by 5 mg to 10 mg every 5 to 7 days. Most over-the-counter use lands between 10 mg and 50 mg per day. Trial doses go higher and carry more side effects. Check with a doctor if you take warfarin, clobazam, or other seizure drugs, or if you have liver disease.