• CBD oral spray is a medication sprayed directly into the mouth. A spray, designed to be placed under the tongue, allows CBD to enter the bloodstream immediately(1).
  • CBD may have analgesic, anti-inflammatory, anticonvulsant, and neuroprotective effects(2).
  • CBD oil spray is a versatile method of administering CBD. Users can select the CBD oil spray that is most appropriate for their lifestyle, whether it is oral, topical, or nasal.
  • CBD oil is not a treatment for any disease. Before using CBD oil spray for any medical reasons, individuals must consult a healthcare professional versed in cannabis use

What Is CBD Oral Spray?

CBD spray consists of ethanol alcohol and a tincture of CBD extract. It is a versatile method of administering CBD

CBD is a nonpsychoactive compound with purported health benefits, including analgesic and anti-inflammatory properties(3). These therapeutic potentials may be good for individuals experiencing pain and inflammation. 

CBD spray is typically packaged in a discreet bottle that is convenient to carry.

Users can spray the content of CBD oral spray directly into the mouth, either under the tongue or inside the cheek. A spray, designed to be placed under the tongue,  allows CBD to enter the bloodstream immediately(4).

CBD sublingual administration is a convenient method of medication. Intake through the oral mucosal membranes results in immediate and effective absorption.

In comparison to other delivery techniques, absorption via blood vessels and microcapillaries in the mouth is one of the most effectual ways to increase cannabinoids’ bioavailability(5).

A study from the journal Pharmaceuticals mentioned that the oral route is the most preferred administration method for both patients and drug developers(6)

CBD is most frequently supplied as an oil or alcoholic formulation in soft-gel capsules, liquid solution, sublingual drops, or as an oromucosal spray due to its high lipophilicity(7), the ability of a molecule to mix with an oily phase rather than with water.

Benefits and Effectiveness of CBD Oral Spray

Oromucosal sprays work well with high-quality CBD-concentrated oil that is free of additives. The medication is effective between one to three hours(8).

To fit their needs, CBD users may choose from various CBD oil sprays, including oral, topical, and nasal sprays.  

CBD has become widely used because research suggests it may offer various health potentials(9)

CBD may show to be an effective and generally non-toxic choice for anxiety, insomnia, and chronic pain management(10).

  • In Cancer

Cancer encompasses various diseases that are defined by the growth of abnormal cells that divide uncontrollably and have the capability to invade and destroy normal human tissue(11). 

Clinical trials suggested that cannabis-based medicine (CBM) added to standard antiemetic therapy delivered via an oromucosal spray was well tolerated and provided better protection against delayed chemotherapy-induced nausea and vomiting (CINV) among individuals with cancer(12).

In addition, clinical findings hypothesized that CBD may have robust anti-proliferative and pro-apoptotic (cell death) properties(13). The nonpsychoactive compound may also prevent migration, invasion, and metastasis of cancer cells.

  • In Multiple Sclerosis

Multiple sclerosis (M.S.) is a potentially disabling disease of the central nervous system(14). M.S. is a neurodegenerative disease where the immune system attacks the protective sheath (myelin) that covers nerve fibers and causes neural communication issues between the brain and the rest of the body. 

Intranasal cannabinoid sprays may provide an opportunity to produce rapid systemic effects and long-term outcomes such as analgesia, providing relief for chronic pain(15).

Cumulative evidence from clinical trials suggests that THC:CBD oromucosal spray may have a function in inhibiting inflammation and managing chronic neuropathic pain among individuals with disabling conditions(16).

CBD spray, a cannabinoid-based treatment, has been approved as an add-on therapy for Multiple Sclerosis rigidity of muscles not controlled effectively by current anti-spasticity drugs(17)

The severity of muscle rigidity with often painful spasms in M.S. and related conditions was reduced in randomized controlled studies using oromucosal spray(18).

  • In Epilepsy

Epilepsy is a form of central nervous system (neurological) illness where aberrant brain activity leads to episodes of odd behavior, seizures, sensations, and even loss of consciousness(19).

Clinical findings have indicated how CBD may help reduce the frequency and severity of seizures among individuals with epilepsy without the negative impact of more commonly prescribed treatments(20). 

CBD, in pharmaceutical-grade CBD products, appears to have anti-seizure, antipsychotic, neuroprotective, antidepressant, and anxiolytic effects. The purported neuroprotective activity of CBD may be associated with its putative anti-inflammatory and antioxidant properties(21).

  • In Anxiety

Experiencing occasional anxiety and stress is expected in any individual’s life(22)

However, those experiencing anxiety disorders frequently have intense, excessive, and persistent worry and fear about typical daily situations. These feelings of anxiety and panic impair an individual’s performance of everyday tasks(23).

CBD may possess anxiolytic properties and seem to provide a calming effect on the central nervous system(24). 

Clinical studies also suggest that CBD may help with panic disorder, social anxiety disorder, generalized anxiety disorder, obsessive-compulsive disorder, and post-traumatic stress disorder(25).

How Does CBD Oral Spray Compare to Other CBD Products?

The sublingual method relies on the mucous membrane under the tongue and cheeks to absorb CBD. The tiny blood vessels in the connective tissue diffuse the compound, entering the bloodstream(26). 

Oral administration of cannabis has several advantages, including the availability of pharmaceutical-grade chemicals, consistent concentration, doses (low or high doses), and a simple delivery route(27).

CBD products like CBD sprays that are used sublingually or beneath the tongue are diffused through connective tissue capillaries and eventually reach the bloodstream(28)

This approach circumvents the stomach and liver which makes the bioavailability of sublingual method greater than that of ingestion(29).

Allowing CBD to be delivered successfully to the desired target sites of action relies on multiple factors. These factors include the individual’s physiology and the drug’s physicochemical properties, such as solubility, stability, dissolution, permeability, and metabolism(30).


Sativex can be an effective and safe choice for individuals with Multiple Sclerosis experiencing moderate to severe spasticity (muscle stiffness) and resistance to common antispastic medications(31).

Sativex is an oromucosal spray that modulates the endocannabinoid system. It contains the two primary active ingredients of Cannabis sativa, tetrahydrocannabinol, and cannabidiol, in a 1:1 molecular ratio(32).

Sativex, a cannabis-based mouth spray, has CBD as one of its most active ingredients. This drug has been used in treating M.S. in randomized, controlled clinical trials(33).

Sativex oromucosal spray appears to be a viable and well-received treatment alternative for Multiple Sclerosis patients with refractory spasticity(34).

Ways to Apply or Use CBD Spray?

There are several different ways to use CBD spray. The product, comfort level of the person, and the most effective solution to the problem at hand will determine the most suitable option.

In animal studies, spraying cannabis into the oral mucosa led to more extended absorption by the body(35)

Cannabidiol began to collect in the oral mucosa or the mucous membrane lining of the mouth, forming a residue that was subsequently rinsed out by saliva flow and transferred to the gastrointestinal tract(36).

As a result, cannabidiol was released slowly, allowing the chemical to stay in the bloodstream for several hours. 

CBD spray is available in an oil or a tincture and can be taken sublingually or topically, depending on the desired strength and intended use.

  • Sublingually

Experiencing the benefits of CBD more rapidly requires the use of CBD spray orally. Individuals can spray the product under the tongue and leave it there for approximately 30 to 60 seconds without swallowing and allowing it to be absorbed effectively via the sublingual gland or salivary glands located beneath the tongue(37)

The spray is rapidly absorbed through the mouth’s mucous membrane before being carried directly into the bloodstream via the capillaries.

This mode of administration is a direct route allowing the onset of effect in 15 to 30 minutes. Higher concentrations of the compound stay in the system for 2 to 4 hours(38).

  • Topically

CBD spray can be applied topically. After the substance penetrates the skin’s surface, the cannabinoid interacts with the endocannabinoid system by binding with the cannabinoid receptors and potentially imparting its pharmacological benefits(39).

 The topical application of CBD may help address inflammation symptoms(40).

CBD Spray Dosage and Preparation 

CBD is not a one-size-fits-all medicine, and its use should be carefully tailored to the needs of the individuals and the existing condition(41).

Sublingual CBD oil distribution is done by spraying or dropping CBD oil or tinctures under the tongue(42). 

This process is similar to the topical use of CBD creams, oils, salves, balms, and sprays, as the onset is around 5 to 30 minutes(43).

Vaporization involves the production of a cloud of visible vapor to inhale or vape-activate cannabis extracts. 

CBD products vaporized accelerate the onset of action by two to 15 minutes(44). It is essential to consider that vaping raises the risk of getting respiratory symptoms that could lead to lung damage(45).

Similarly, ingesting CBD-infused edibles like gummies or other CBD-infused foods and drinks produces a slower onset of action. 

After food or drink has passed through the stomach and the liver enzymes have been activated, effects usually appear between 30 and 90 minutes(46).

Likewise, CBD options are available in three different forms. A full-spectrum CBD extract contains all of the naturally occurring components in the cannabis plant, including the psychoactive THC(47).

Additionally, a broad-spectrum CBD is comparable to a full-spectrum CBD. However, it has been purified of THC, whereas CBD isolate or pure CBD includes only the cannabidiol ingredient(48).

The U.S. Food and Drug Administration (FDA) has only approved Epidiolex. A CBD oral solution for treating seizures in individuals two years of age and older who have one of two rare and severe forms of epilepsy: Lennox-Gastaut syndrome or Dravet syndrome(49). 

Epidiolex is the first FDA-approved medicine to contain a pure marijuana-derived psychoactive ingredient. 

Apart from Epidiolex, legal provisions regarding CBD vary, and research into its potential health benefits continues(50).

The dosages used in research studies differ, and there is no consensus on the specific mg of CBD indicated for specific medical conditions. If an individual decides to use CBD, one should seek medical advice from healthcare experts.

Side Effects, Risks, and Considerations

Many CBD therapies and products have few adverse side effects. Epidiolex users, for example, may develop diarrhea or other gastrointestinal issues(51). 

When consuming CBD, some may experience fatigue, dry mouth, diarrhea, decreased appetite, weariness, drowsiness, and exhaustion, all possible side effects of CBD use(52).

CBD may interact with other medications being taken. Adverse effects of CBD may result from drug-drug interactions between the CBD product and the individual’s currently prescribed medications(53).

To prevent adverse interactions, users of CBD products should get medical advice before using any CBD product, primarily if they use any medications, herbs, or supplements(54).

Uncertainty about CBD quality and dosage in supplies may be a cause of concern, such as heavy metals and pesticides in CBD oil. Recent research of 84 CBD products purchased online found that more than a quarter of the products had less CBD than the label claimed(55).

The FDA does not regulate CBD extracts and CBD products(56). Hence if an individual wants to consume products infused with CBD, it is essential to seek medical advice from healthcare professionals to prevent adverse side effects.


CBD is found in all cannabis plants, derived from either hemp or marijuana. However, CBD products are only federally legal if derived from hemp and contain less than 0.3% THC(57).

The Farm Bill removed hemp, which includes low-THC derivatives of cannabis, from the definition of marijuana(58).

According to the U.S. Food and Drug Administration, CBD is currently undergoing investigation as a new drug. Considering that a wide range of CBD products is available in different parts of the United States, CBD’s legal status has remained uncertain(59).

What Is CBD?

CBD (Cannabidiol) is an organic compound derived from the Cannabis sativa plant. Cannabis sativa is either from cannabis plants or hemp plants that contain various active cannabinoids, such as terpenes

Terpenes are responsible for cannabis’ aroma. 

CBD is a nonpsychoactive phytocannabinoid extracted straight from the hemp plant, a relative of medicinal marijuana(60)

CBD is a significant cannabinoid present in significant but variable concentrations in cannabinoid-based medicines (CBM). While CBD is structurally similar to delta-9 tetrahydrocannabinol (THC), it does not produce psychoactive effects or euphoria in humans and has a low potential for abuse. 

This favorable safety profile has resulted in the recent removal of legal and regulatory barriers to purified CBD products and a recent surge in interest in CBD treatments(61).

Clinical findings in neurology suggest that cannabidiol seems to exhibit a broad range of therapeutic effects in individuals and preclinical disease models. These potential therapeutic effects include antipsychotic, anxiolytic, immunomodulatory, anti-inflammatory, neuroprotective, and pro-cognitive properties(62).

Meanwhile, CBD’s safety and tolerability profile in humans makes it a promising candidate in various therapeutic areas like epilepsy, Alzheimer’s disease, Parkinson’s disease, and multiple sclerosis(63).

Clinical Evidence and Research for CBD Oil

CBD sprays or drops are concentrated CBD oils packaged in a pipette or spray bottle. The concentrate comprises CBD extract and a carrier oil, such as MCT (medium-chain triglycerides) oil or coconut oil(64). Combining both compounds facilitates the absorption and metabolism of CBD by the body. 

Clinical research indicates that CBD’s purported antioxidative, anti-inflammatory, and neuroprotective properties may have several beneficial pharmacological effects in managing clinical conditions such as schizophrenia, dementia, diabetes, and nausea(65).

CBD may interact with the endocannabinoid system, a signaling mechanism through the ECS receptors (CB1 and CB2 receptors) that regulate homeostasis or bodily balance

Studies examine the impact of the endocannabinoid system‘s primary receptors on energy metabolism, mood, normal immune function, and healthy inflammatory activity(66).

Published studies examine the evidence for THC: CBD oromucosal spray (nabiximols) for chronic pain relief(67).

A clinical trial examined the efficacy of a new cannabinoid combination called tetrahydrocannabinol and cannabidiol oromucosal spray(68)

THC/CBD spray appeared to produce clinically significant improvements in pain, sleep quality, and severity of the condition in a significant proportion of otherwise treatment-resistant patients(69).

The THC/CBD spray was well accepted in this study, and there were no additional safety concerns(70).

 Although more specific clinical trials are needed to draw clear findings, cumulative data suggest that add-on THC:CBD oromucosal spray (nabiximols) may be relevant in managing chronic neuropathic pain.

Moreover, case studies highlight the potential utility of THC:CBD oromucosal spray in individuals with moderate to severe spasticity who are resistant to existing therapies(71). The resulting improvements allow them to engage in physical and social activities.

Another research examined the oral side effects of oromucosal cannabis spray in patients with multiple sclerosis (MS)(72)

The main components of marijuana (sometimes called cannabis), including tetrahydrocannabinol (THC) and cannabidiol (CBD), have been combined in alcohol with a peppermint flavoring to create an oromucosal spray that can be sprayed under the tongue or on the buccal mucosa for pain relief in multiple sclerosis patients(73).

Although the existing research suggests that it is effective in this regard, some patients have mouth burning, stinging, or white lesions, which are most likely burns.

It is hypothesized that the high alcohol content of the oromucosal cannabis spray raises a basis for concern about persistent oral usage(74).

Prevention of adverse effects of CBD product use requires seeking medical advice from healthcare professionals.

  1. Cannabidiol (CBD)-what we know and what we don’t https://www.health.harvard.edu/blog/cannabidiol-cbd-what-we-know-and-what-we-dont-2018082414476
  2. Cannabidiol
  3. Ibid.
  4. Cannabidiol (CBD)-what we know and what we don’t https://www.health.harvard.edu/blog/cannabidiol-cbd-what-we-know-and-what-we-dont-2018082414476
  5. CBD A Patient’s Guide to Medicinal Cannabis. https://drive.google.com/file/d/1MILU_6ZjYkII-XMUPHLFPiPQbrz__5Sh/view regarding CBD spray.
  6. Towards Better Delivery of Cannabidiol (CBD) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7558665/
  7. ibid
  8. CBD A Patients Guide to Medicinal Cannabis https://drive.google.com/file/d/1MILU_6ZjYkII-XMUPHLFPiPQbrz__5Sh/view
  9. Cannabidiol (CBD)-what we know and what we don’t https://www.health.harvard.edu/blog/cannabidiol-cbd-what-we-know-and-what-we-dont-2018082414476
  10. ibid
  11. Cancer https://www.mayoclinic.org/diseases-conditions/cancer/symptoms-causes/syc-20370588
  12. Preliminary efficacy and safety of an oromucosal standardized cannabis extract in chemotherapy-induced nausea and vomiting https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2997305/
  13. Cannabidiol (CBD) as a Promising Anti-Cancer Drug https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7693730/
  14. Multiple Sclerosis https://www.mayoclinic.org/diseases-conditions/multiple-sclerosis/symptoms-causes/syc-20350269
  15. Cannabinoid Delivery Systems for Pain and Inflammation Treatment https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6222489/
  16. A Review of Scientific Evidence for THC:CBD Oromucosal Spray (Nabiximols) in the Management of Chronic Pain https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7027889/
  17. ibid
  18. A Review of Scientific Evidence for THC:CBD Oromucosal Spray (Nabiximols) in the Management of Chronic Pain https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7027889/
  19. Epilepsy https://www.mayoclinic.org/diseases-conditions/epilepsy/symptoms-causes/syc-20350093
  20. Use of Cannabidiol in the Treatment of Epilepsy: Efficacy and Security in Clinical Trials https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6514832/
  21. ibid
  22. Anxiety disorders https://www.mayoclinic.org/diseases-conditions/anxiety/symptoms-causes/syc-20350961
  23. ibid
  24. Cannabidiol in Anxiety and Sleep: A Large Case Series https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6326553/
  25. Cannabidiol as a Potential Treatment for Anxiety Disorders
  26. Healing with CBD page 207 https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view
  27. Oral Administration of Cannabis and Δ-9-tetrahydrocannabinol (THC) Preparations: A Systematic Review https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7353904/
  28. Healing with CBD p207 https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view
  29. ibid
  30. Towards Better Delivery of Cannabidiol (CBD) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7558665/
  31. Efficacy and safety of cannabinoid oromucosal spray for multiple sclerosis spasticity https://jnnp.bmj.com/content/87/9/944
  32. Efficacy and safety of cannabinoid oromucosal spray for multiple sclerosis spasticity https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5013116/
  33. Sativex https://www.nps.org.au/medicine-finder/sativex-oromucosal-spray
  34. Efficacy and safety of cannabinoid oromucosal spray for multiple sclerosis spasticity https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5013116/
  35. Pharmacokinetics of cannabidiol administered by 3 delivery methods at 2 different dosages to healthy dogs
  36. ibid
  37. Healing with CBD page 207 https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view
  38. ibid page 193
  39. Cannabinoid Delivery Systems for Pain and Inflammation Treatment https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6222489/
  40. ibid
  41. Healing with CBD page 185, https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view
  42. ibid page 193
  43. ibid page 193
  44. ibid page 190
  45. Can vaping damage your lungs? What we do (and don’t) know https://www.health.harvard.edu/blog/can-vaping-damage-your-lungs-what-we-do-and-dont-know-2019090417734
  46. Healing with CBD page 191 https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view
  47. Healing with CBD page 80 https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view
  48. ibid
  49. FDA Approves New Indication for Drug Containing an Active Ingredient Derived from Cannabis to Treat Seizures in Rare Genetic Disease https://www.fda.gov/news-events/press-announcements/fda-approves-new-indication-drug-containing-active-ingredient-derived-cannabis-treat-seizures-rare#:
  50. ibid
  51. Cannabidiol in Anxiety and Sleep: A Large Case Series
  52. What are the benefits of CBD — and is it safe to use? https://www.mayoclinic.org/healthy-lifestyle/consumer-health/expert-answers/is-cbd-safe-and-effective/faq-20446700
  53. World Health Organization Reports CBD Oil Is Generally Safe https://www.rtor.org/2019/07/05/who-report-on-cbd-oil/#
  54. CBD and other medications: Proceed with caution https://www.health.harvard.edu/blog/cbd-and-other-medications-proceed-with-caution-2021011121743
  55. Labeling Accuracy of Cannabidiol Extracts Sold Online https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5818782/
  56. FDA Regulation of Cannabis and Cannabis-Derived Products, Including Cannabidiol (CBD) https://www.fda.gov/news-events/public-health-focus/fda-regulation-cannabis-and-cannabis-derived-products-including-cannabidiol-cbd
  57. FDA Regulation of Cannabis and Cannabis-Derived Products, Including Cannabidiol (CBD)
  58. Hemp Production and the 2018 Farm Bill https://www.fda.gov/news-events/congressional-testimony/hemp-production-and-2018-farm-bill-07252019
  59. FDA and Cannabis: Research and Drug Approval Process https://www.fda.gov/news-events/public-health-focus/fda-and-cannabis-research-and-drug-approval-process
  60. Cannabidiol (CBD)-what we know and what we don’t
  61. Cannabidiol use and effectiveness: real-world evidence from a Canadian medical cannabis clinic https://jcannabisresearch.biomedcentral.com/articles/10.1186/s42238-021-00078-w
  62. The United Chemicals of Cannabis: Beneficial Effects of Cannabis Phytochemicals on the Brain and Cognition https://www.intechopen.com/chapters/62431
  63. A Systematic Review on the Pharmacokinetics of Cannabidiol in Humans https://www.frontiersin.org/articles/10.3389/fphar.2018.01365/full
  64. Healing with CBD page 205 https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view
  65. The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research. https://www.ncbi.nlm.nih.gov/books/NBK425767/
  66. An introduction to the endogenous cannabinoid system
  67. A Review of Scientific Evidence for THC:CBD Oromucosal Spray (Nabiximols) in the Management of Chronic Pain https://www.dovepress.com/a-review-of-scientific-evidence-for-thccbd-oromucosal-spray-nabiximols-peer-reviewed-fulltext-article-JPR
  68. A double-blind, randomized, placebo-controlled, parallel group study of THC/CBD spray in peripheral neuropathic pain treatment https://pubmed.ncbi.nlm.nih.gov/24420962/
  69. ibid
  70. ibid
  71. Who benefits most from THC:CBD spray? Learning from clinical experience https://pubmed.ncbi.nlm.nih.gov/24457847/
  72. Cannabis; adverse effects from an oromucosal spray https://www.nature.com/articles/bdj.2007.749
  73. ibid
  74. ibid
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