Quick answer
Start with 1 mg to 2.5 mg of THC. Hold the liquid under your tongue for 60 to 90 seconds, then swallow. Wait 2 hours before taking more. Add 1 mg to 2.5 mg at a time. Most people find a working dose within 2 to 4 weeks.
Read the label before you measure
US cannabis tincture labels list THC and CBD in milligrams per milliliter (mg/mL) and the total bottle volume. A 30 mL bottle at 10 mg/mL holds 300 mg of THC. Products sold in state-licensed dispensaries run from 1 mg/mL to 20 mg/mL. Each batch carries a lab test from the state program. Check that test for the actual THC and CBD numbers. The label number and the test number can differ.
Convert drops to milligrams
A standard 1 mL dropper delivers about 20 drops of an alcohol tincture or a thin oil. Thick oils make smaller drops, so a dropper can deliver 30 drops or more. Measure in milliliters when the dropper has a mL mark.
- 10 mg/mL: 1 drop = 0.5 mg THC. 1 mL = 10 mg THC.
- 5 mg/mL: 1 drop = 0.25 mg THC. 1 mL = 5 mg THC.
- 20 mg/mL: 1 drop = 1 mg THC. 1 mL = 20 mg THC.
Use the dropper that came with the bottle. Kitchen spoons do not measure milliliters. If the label gives only total milligrams for the bottle, divide by the volume. A 15 mL bottle with 150 mg THC is 10 mg/mL.
medical cannabis tincture dosage mg
Titration schedule
Titration means raising the dose in steps until symptoms ease or side effects start. One common schedule:
- Days 1 to 3: 1 mg to 2.5 mg THC, taken once in the evening.
- Days 4 to 7: the same dose, or add 1 mg to 2.5 mg if you feel nothing.
- Week 2: hold at the lowest dose that helps. Raise by 1 mg to 2.5 mg no more than once every 3 to 7 days.
Stop raising the dose when you get relief, or when side effects appear. Side effects include dry mouth, drowsiness, a fast heartbeat, and anxiety. A 2015 meta-analysis in JAMA pooled 79 trials and 6,462 participants. It found moderate evidence for THC-based medicines in chronic pain and spasticity. THC doses in those trials ranged from 2.5 mg to 30 mg per day.
Onset and duration
Held under the tongue, a tincture starts working in 15 to 45 minutes. Swallowed, it starts in 30 to 120 minutes. Peak effects arrive at 1 to 3 hours. Effects last 4 to 8 hours. THC taken by mouth reaches the blood at a small share of the dose. Published estimates run from about 4% to 20%. This is why a swallowed tincture feels stronger than the same milligrams inhaled.
CBD tinctures
CBD doses in clinical trials run higher than THC doses. The FDA-approved CBD drug Epidiolex is dosed at 5 mg/kg per day to 20 mg/kg per day for seizures. For a 70 kg adult that is 350 mg to 1,400 mg per day. CBD tinctures sold outside dispensaries are not the same product and are not FDA-approved.
What changes your dose
- Liver enzymes CYP3A4 and CYP2C9 break down THC and CBD. Liver function and genetics shift blood levels.
- CBD blocks some of the same enzymes. It can raise blood levels of clobazam, warfarin, and tacrolimus. Tell your prescriber about every tincture you take.
- Prior cannabis use raises tolerance. People who use often need more milligrams for the same effect.
- Alcohol and sedatives add to drowsiness.
Storage and safety
Keep the bottle capped, upright, and out of sunlight. Alcohol tinctures hold potency for 1 to 2 years. Oil tinctures hold for about 1 year. Store away from children and pets. A 30 mL bottle at 20 mg/mL holds 600 mg of THC. Do not drive for at least 4 hours after a dose, or longer if you feel impaired. Call a clinician for chest pain, fainting, or severe confusion. Cannabis raises heart rate for 2 to 3 hours after a dose.