Medical Cannabis Prescription Online: Legal & Secure

In Germany, a prescription for medical cannabis is legal, provided that a licensed physician considers cannabis therapy appropriate after a medical review. An online questionnaire, valid proof of identity, and a medical tele-consultation are required for an online cannabis prescription. The patient's identity must be verified before the prescription is issued. The issuance of a cannabis prescription occurs after a medical review of the information in the questionnaire. Dispensing takes place exclusively via pharmacies, provided a valid prescription is available. Medical cannabis in Germany can only be ordered and purchased with a valid medical prescription. For the legal acquisition of cannabis products in Germany, a valid medical prescription is always required. All licensed physicians – with the exception of dentists and veterinarians – are permitted to prescribe medical cannabis.

The legal framework for medical cannabis in Germany is determined by law. A current draft bill for further liberalization of medicinal cannabis has been approved by the Federal Cabinet but is not yet a binding law. Until final passage and entry into force, the existing legal regulations for the prescription and shipment of medical cannabis continue to apply.

The primary active ingredients from cannabis interact with the endocannabinoid system (CB1/CB2), which can influence pain modulation, inflammation, stress response, appetite, and sleep. THC acts primarily via CB1 receptors and can have analgesic, antispastic, antiemetic, and appetite-stimulating effects; CBD modulates, among others, 5-HT1A receptors and TRPV channels and can mitigate THC side effects. According to Russo, E.B. (2011), British Journal of Pharmacology 163(7), 1344-1364², terpenes can contribute to the clinical response via the so-called entourage effect, whereby standardized profiles help to use cannabis reproducibly.

Now that you know how cannabis works in the body, the next section provides an overview of the various dosage forms and products.

Choosing the right dose and form of application is a central success factor of medical cannabis therapy. The optimal dosage can vary greatly and depends on various individual and medical factors, including:

• Dried flowers for inhalation (medical vaporizers)
• Standardized extracts (THC/CBD in defined ratios)
• Magistral preparations
• Oral products – oils and capsules – for reproducible dosing with longer duration of action
• Inhalative administration for rapid onset of action for breakthrough symptoms
• Topical products such as creams or gels for peripheral pain
• Rectal preparations for special cases

Now that you have learned about the various products and dosage forms, the next section explains how the prescription process works, from the initial consultation to the prescription.

In the case of cannabis, the titration principle applies. THC-dominant preparations often start with 1–2.5 mg THC in the evening; the dose can be increased in 1–2.5 mg steps every 2–3 days until the target effect is reached, with side effects limiting the pace. CBD-rich preparations typically start at 5–10 mg two to three times daily and can be combined with THC. Oral forms require 30–120 minutes for onset of action and work longer; inhalative administration works within minutes, lasts shorter, and is suitable for as-needed situations.

For titration, target parameters (e.g., pain score, sleep duration) must be established so that cannabis can be used in a controlled and traceable manner.

In the next section, you will receive important information regarding safety, side effects, and interactions.

Choosing the right dose and form of application is a central success factor of medical cannabis therapy. Patients can choose from a variety of cannabis products and strains to find the individually suitable product for their therapy. The optimal dosage can vary greatly and depends on various individual and medical factors, including:

• Specific diagnosis or illness
• Individual sensitivity to cannabinoids
• Composition of the preparation (THC- or CBD-dominant)
• Form of application (inhalative, oral, sublingual)
• Existing comorbidities and possible drug interactions
• Time of day and desired therapeutic effect (e.g., sedating, stimulating, or analgesic)

In addition to cannabis flowers, extracts, capsules, and other dosage forms are available as cannabis products; extracts and capsules are generally more expensive than cannabis flowers. The dosage and application of each product should be individually tailored to the respective illness and the patient's personal tolerance.

Treating physicians adjust the therapy individually – taking into account the diagnosis, lifestyle, tolerance, previous experiences, allergies, etc.

Cannabinoids on online prescription are metabolized via the cytochrome P450 enzyme system – this can influence the effect of other medications. This is particularly relevant when simultaneously taking:

• Anticoagulants (e.g., warfarin, apixaban)
• Sedatives and sleep aids (e.g., benzodiazepines, zopiclone)
• Antipsychotics and antidepressants
• Beta-blockers
• Antiepileptics

A personalized questionnaire as well as regular consultations with a doctor contribute to optimizing the treatment process and developing a precise therapeutic strategy.

In the next section, you will learn more about legal aspects and documentation in cannabis therapy.

Pharmacies provide advice on vaporizer temperatures, intake times, and interactions, and support the choice between flowers, oil, and capsules. Consistently available products facilitate a constant supply; in case of shortages, equivalent strains can be recommended. For working professionals, discreet, easily titratable oils are practical, while inhalable cannabis can have advantages for acute spastic episodes. Training on device cleaning, storage, and travel suitability is part of the process if cannabis is to work reliably in everyday life.

The next section provides practical information on dispensing and product selection.