What is medical cannabis, really?
“Medical cannabis” is not a single product. It is an umbrella term for very different medicines with quite different active-substance profiles and dosage forms. This article sorts things out, along the lines of the Swiss regulatory framework: what is actually dispensed by pharmacies, and where the line runs between an authorised finished product and a magistral preparation.
Two worlds: finished product vs. formula magistralis
In Switzerland, cannabis medicines reach patients by two legally distinct routes:
- Finished products with Swissmedic authorisation. Industrially manufactured, with an authorisation dossier, professional information and patient information leaflet.
- Magistral preparations (formula magistralis under Art. 9 para. 2 lit. a TPA). These are prepared “in a public pharmacy or hospital pharmacy in the execution of a medical prescription for a specific person”. They do not require Swissmedic authorisation, but they are subject to strict pharmacopoeia and compounding requirements.
Since 1 August 2022 both routes can be prescribed without an FOPH exemption permit.
The authorised finished products
Authorised cannabis-based finished products are rare in Switzerland. Swissmedic confirms: “Aktuell besteht mit Sativex® nur ein in der Schweiz zugelassenes Arzneimittel auf Cannabis-Extrakt Basis” (Sativex® is currently the only authorised cannabis-extract medicine in Switzerland).
Beyond that, imported or synthetic cannabinoid finished products exist:
- Sativex® (oromucosal spray, 27 mg THC and 25 mg CBD per ml), authorised as add-on therapy for moderate to severe spasticity in multiple sclerosis
- Marinol® (synthetic dronabinol capsules, 2.5 / 5 / 10 mg), imported
- Canemes® (nabilone, 1 mg capsules), imported
- Epidyolex® (pure CBD syrup, 100 mg/ml), authorised for rare epilepsy forms (Dravet, Lennox-Gastaut)
The typical magistral preparations
Most Swiss prescriptions run through magistral preparations, individually compounded by a pharmacy according to a prescription. A representative selection from Swiss practice (Bahnhof Apotheke Langnau, 2021 Pharmacopoeia expert meeting):
- Dronabinol solution 2.5 % as oral drops
- Dronabinol solution 5 % as an ethanolic inhalation solution
- Cannabis tincture, standardised (e.g. 10 mg THC / 20 mg CBD per ml)
- Cannabis oil 1 % and 2.7 %, oily drops with defined THC/CBD ratio
- CBD solutions at 2.5 / 5 / 10 / 20 %, oily drops
- Cannabis flowers for vaporiser inhalation or tea preparation (NRF 22.12 ff.)
- Suppositories, ointments and creams for specific indications
The galenic forms are not arbitrary. They largely follow the Neues Rezeptur Formularium (NRF), the German-Swiss reference for pharmacy compounding. Examples:
- NRF 22.7, dronabinol capsules 2.5 / 5 / 10 mg
- NRF 22.8, oily dronabinol drops 25 mg/ml
- NRF 22.10, oily cannabidiol solution 50 / 100 mg/ml
- NRF 22.12, cannabis flowers for inhalation after vaporisation
Cannabis flowers: raw material or medicine?
Cannabis flowers are a special case. Swissmedic notes that cannabis for medical purposes “can be a raw material (API), a non-use-ready intermediate or a use-ready medicine”.
In practice this means:
- The pharmacy may dispense flowers, provided they are tested to pharmacopoeia standards (the Ph. Eur. cannabis flowers monograph has been in force since 1 July 2024).
- Use is typically by vaporiser. Combustion in a “joint”-style consumption form is not medically recommended.
Overview: what the pharmacy dispenses
| Category | Examples | Authorisation | Typical use |
|---|---|---|---|
| Finished product | Sativex®, Epidyolex® | Swissmedic | Oromucosal spray, syrup |
| Imported finished product | Marinol®, Canemes® | Swissmedic + import permit | Capsules |
| Magistral, drops | Dronabinol solution, cannabis oil | no authorisation, FM | oral, sublingual |
| Magistral, inhalation | Inhalation solution, cannabis flowers | no authorisation, FM / pharmacopoeia | vaporiser |
| Magistral, topical | Suppositories, creams | no authorisation, FM | local |
What patients can take from this
- The dosage form is not a matter of preference but a medical decision: drops act differently from a vaporiser; a capsule acts differently from a cream.
- Magistral preparations are not “cannabis light”: they are subject to the same requirements of identity, purity and content as an authorised medicine, simply without an industrial authorisation dossier.
- Which form is appropriate is decided jointly by physician and pharmacy, depending on indication, tolerability and life situation.
This article summarises publicly available Swiss regulation. It does not replace medical advice. For the individual choice of dosage form, please speak with a physician from our directory.
Sources
- Information sheet, Cannabis for medical purposes · Swissmedic
- FAQ on the cannabis information sheet (May 2025) · Swissmedic
- Cannabis on prescription, situation in Switzerland (Pharmacopoeia expert meeting 2021) · Swissmedic, M. Fankhauser
- Sativex, oromucosal spray (authorisation information) · Swissmedic
- FAQ cannabis medicines · Federal Office of Public Health FOPH
- Therapeutic Products Act (TPA), Art. 9 para. 2 · Federal Chancellery, Fedlex