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Dvora Namdar - Institute of Plant Science, Agriculture Research Organization, Volcani Center, Rishon LeZion 7528809, Israel. 
Omer Anis - Department of Urology, Sheba Medical Center, Ramat Gan 5262000, Israel.
 
Patrick Poulin - Consultant Patrick Poulin Inc., Québec City, QC G1V 0A6, Canada; School of Public Health, Université de Montréal, Montréal, QC H3T 1J4, Canada.
 
Hinanit Koltai - Institute of Plant Science, Agriculture Research Organization, Volcani Center, Rishon LeZion 7528809, Israel.

Despite the surge in cannabis chemistry research and its biological and medical activity, only a few cannabis-based pharmaceutical-grade drugs have been developed and marketed to date. Not many of these drugs are Food and Drug Administration (FDA)-approved, and some are still going through regulation processes. Active compounds including cannabinergic compounds (i.e., molecules targeted to modulate the endocannabinoid system) or phytocannabinoid analogues (cannabinoids produced by the plant) may be developed into single-molecule drugs. However, since in many cases treatment with whole-plant extract (whether as a solvent extraction, galenic preparation, or crude oil) is preferred over treatment with a single purified molecule, some more recently developed cannabis-derived drugs contain several molecules. Different combinations of active plant ingredients (API) from cannabis with proven synergies may be identified and developed as drugs to treat different medical conditions. However, possible negative effects between cannabis compounds should also be considered, as well as the effect of the cannabis treatment on the endocannabinoid system. FDA registration of single, few, or multiple molecules as drugs is a challenging process, and certain considerations that should be reviewed in this process, including issues of drug-drug interactions, are also discussed here.

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Chronological Review and Rational and Future Prospects of Cannabis-Based Drug Development

Dvora Namdar - Institute of Plant Science, Agriculture Research Organization, Volcani Center, Rishon LeZion 7528809, Israel. 
Omer Anis - Department of Urology, Sheba Medical Center, Ramat Gan 5262000, Israel.
 
Patrick Poulin - Consultant Patrick Poulin Inc., Québec City, QC G1V 0A6, Canada; School of Public Health, Université de Montréal, Montréal, QC H3T 1J4, Canada.
 
Hinanit Koltai - Institute of Plant Science, Agriculture Research Organization, Volcani Center, Rishon LeZion 7528809, Israel.

Chronological Review and Rational and Future Prospects of Cannabis-Based Drug Development

Despite the surge in cannabis chemistry research and its biological and medical activity, only a few cannabis-based pharmaceutical-grade drugs have been developed and marketed to date. Not many of these drugs are Food and Drug Administration (FDA)-approved, and some are still going through regulation processes. Active compounds including cannabinergic compounds (i.e., molecules targeted to modulate the endocannabinoid system) or phytocannabinoid analogues (cannabinoids produced by the plant) may be developed into single-molecule drugs. However, since in many cases treatment with whole-plant extract (whether as a solvent extraction, galenic preparation, or crude oil) is preferred over treatment with a single purified molecule, some more recently developed cannabis-derived drugs contain several molecules. Different combinations of active plant ingredients (API) from cannabis with proven synergies may be identified and developed as drugs to treat different medical conditions. However, possible negative effects between cannabis compounds should also be considered, as well as the effect of the cannabis treatment on the endocannabinoid system. FDA registration of single, few, or multiple molecules as drugs is a challenging process, and certain considerations that should be reviewed in this process, including issues of drug-drug interactions, are also discussed here.

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