How THC and CBD from an oral spray move through the body

A THC/CBD mouth spray produced blood levels well below those seen with smoking, with no drug buildup after nine days of repeated use.

Stott, C G et al.·European journal of clinical pharmacology·2013·Moderate EvidenceRandomized Controlled Trial
RTHC-00739Randomized Controlled TrialModerate Evidence2013RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Randomized Controlled Trial
Evidence
Moderate Evidence
Sample
Not reported

What This Study Found

In this Phase I pharmacokinetic trial, healthy male volunteers received a THC/CBD oral spray at three dose levels (2, 4, or 8 sprays) either as single doses or daily for nine days. Both THC and CBD were rapidly absorbed after spraying.

Peak blood concentrations stayed below 12 ng/mL across all dose levels, well below the levels typically reported in people who smoke or inhale cannabis. THC showed greater bioavailability than CBD at every dose tested.

Importantly, there was no evidence of accumulation with repeated daily dosing for any of the compounds measured. Variability between individuals ranged from moderate to high for all pharmacokinetic measures. The spray was well tolerated, with no serious adverse events reported.

Key Numbers

Peak THC blood concentrations stayed below 12 ng/mL across all dose levels. Three dose tiers were tested: 2 sprays (5.4 mg THC, 5.0 mg CBD), 4 sprays (10.8 mg THC, 10.0 mg CBD), and 8 sprays (21.6 mg THC, 20.0 mg CBD). Nine consecutive days of dosing showed no accumulation.

How They Did This

This was a Phase I, within-subject crossover study in healthy male volunteers. Participants received single or multiple doses of THC/CBD oromucosal spray (containing 2.7 mg THC and 2.5 mg CBD per spray) after overnight fasting. Plasma samples were analyzed using gas chromatography-mass spectrometry for THC, CBD, and the THC metabolite 11-hydroxy-THC.

Why This Research Matters

Understanding how quickly cannabinoids are absorbed and whether they accumulate with repeated use is essential for medical formulation development. The finding that peak blood levels stayed far below those from smoking suggests oral spray delivery may carry a lower risk of the acute psychoactive effects associated with high-peak THC exposure.

The Bigger Picture

Pharmaceutical cannabinoid products need reliable pharmacokinetic profiles to gain regulatory approval. This study helped establish the dosing framework for THC/CBD oral spray (later marketed as Sativex), demonstrating predictable absorption patterns and a safety margin compared to inhaled cannabis.

What This Study Doesn't Tell Us

The study included only healthy male participants, so results may not generalize to females or people with medical conditions. Fasting conditions may not reflect real-world use. The controlled clinical setting differs from typical patient use patterns.

Questions This Raises

  • ?How do these pharmacokinetic profiles change in patients with multiple sclerosis or other conditions for which the spray is indicated?
  • ?Does food intake meaningfully alter absorption?
  • ?Would longer-term dosing beyond nine days reveal any accumulation effects?

Trust & Context

Key Stat:
Peak THC levels stayed below 12 ng/mL, well under levels seen with smoking
Evidence Grade:
Controlled Phase I trial with systematic pharmacokinetic measurements, though limited to healthy male volunteers.
Study Age:
Published in 2013, this study informed the regulatory pathway for THC/CBD oral spray products.
Original Title:
A phase I study to assess the single and multiple dose pharmacokinetics of THC/CBD oromucosal spray.
Published In:
European journal of clinical pharmacology, 69(5), 1135-47 (2013)
Database ID:
RTHC-00739

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled TrialGold standard for testing treatments
This study
Cohort / Case-Control
Cross-Sectional / Observational
Case Report / Animal Study

Participants are randomly assigned to treatment or placebo groups to test cause and effect.

What do these levels mean? →

Frequently Asked Questions

Does THC build up in the body with daily oral spray use?

In this nine-day study, there was no evidence of THC, CBD, or THC metabolite accumulation with once-daily dosing at any of the three dose levels tested.

How do THC blood levels from oral spray compare to smoking?

Peak concentrations from the spray stayed below 12 ng/mL, which researchers noted was well below levels typically reported in people who smoke or inhale cannabis.

Read More on RethinkTHC

Cite This Study

RTHC-00739·https://rethinkthc.com/research/RTHC-00739

APA

Stott, C G; White, L; Wright, S; Wilbraham, D; Guy, G W. (2013). A phase I study to assess the single and multiple dose pharmacokinetics of THC/CBD oromucosal spray.. European journal of clinical pharmacology, 69(5), 1135-47. https://doi.org/10.1007/s00228-012-1441-0

MLA

Stott, C G, et al. "A phase I study to assess the single and multiple dose pharmacokinetics of THC/CBD oromucosal spray.." European journal of clinical pharmacology, 2013. https://doi.org/10.1007/s00228-012-1441-0

RethinkTHC

RethinkTHC Research Database. "A phase I study to assess the single and multiple dose pharm..." RTHC-00739. Retrieved from https://rethinkthc.com/research/stott-2013-a-phase-i-study

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.