Desarrollo de Formulaciones Magistrales de Cannabidiol (CBD): Estrategia personalizada para el manejo del dolor crónico refractario y síntomas asociados a enfermedades neurológicas y oncológicas en el ambiente hospitalario privado

Keisha Aolani Blanco Arias
Departamento de Atención Farmacéutica, Hospital Clínica Bíblica, San José, Costa Rica.

Jeaustin Mora Jiménez
Departamento de Investigación, Hospital Clínica Bíblica, San José, Costa Rica.

Jonathan Jesús García Montero
Profesor Universitario, Universidad de Ciencias Médicas (UCIMED), San José, Costa Rica.
Coordinador del Servicio de Preparaciones Magistrales, Hospital Clínica Bíblica, San José, Costa Rica.

Resumen

Antecedentes: El dolor crónico refractario, los trastornos neurológicos y las complicaciones asociadas a patologías oncológicas representan un desafío clínico significativo debido a la eficacia limitada y al perfil de toxicidad de los tratamientos convencionales, especialmente los opioides. El cannabidiol (CBD), fitocannabinoide no psicotrópico derivado de Cannabis sativa, ha mostrado propiedades analgésicas, anticonvulsivas, ansiolíticas y antiinflamato-analgésicas, anticonvulsivas, ansiolíticas y antiinflamatorias que lo posicionan como alternativa coadyuvante potencial. En Costa Rica, el reciente marco regulatorio permite su preparación magistral, aunque persiste la necesidad de estandarización en el ámbito hospitalario privado. Métodos: Se realizó una revisión estructurada de la literatura farmacotécnica y clínica publicada entre 2017 y 2025, con el fin de evaluar la viabilidad técnica y clínica del desarrollo de formulaciones magistrales de CBD. A partir del análisis comparativo de formulaciones reportadas, se diseñaron cuatro formas farmacéuticas adaptadas al contexto hospitalario: solución oral, gomitas, cápsulas y crema tópica. Resultados: Las formulaciones propuestas demostraron factibilidad técnica en términos de estabilidad, selección de excipientes y compatibilidad con la normativa farmacéutica costarricense. Cada forma farmacéutica permite ajustes posológicos individualizados y responde a necesidades terapéuticas específicas según vía de administración y perfil clínico del paciente. Conclusiones: Las formulaciones magistrales de CBD constituyen una estrategia viable para la individualización farmacoterapéutica en pacientes con patologías complejas, ofreciendo una alternativa complementaria cuando las opciones comerciales son limitadas. Se recomienda la realización de estudios experimentales locales para validar estabilidad y desempeño clínico.

Palabras claves

Cannabidiol (CBD), sistema endocannabinoide, formulaciones magistrales, dolor crónico refractario, patologías neurológicas, síntomas asociados terapias oncológicas, individualización farmacoterapéutica.

Abstract

Background: Refractory chronic pain, neurological disorders, and complications associated with oncological diseases represent significant clinical challenges due to the limited efficacy and safety concerns of conventional treatments, particularly opioids. Cannabidiol (CBD), a non-psychotropic phytocannabinoid derived from Cannabis sativa, has demonstrated analgesic, anticonvulsant, anxiolytic, and anti-inflammatory properties, positioning it as a potential adjuvant therapeutic alternative. In Costa Rica, recent regulatory developments authorize magistral CBD preparations; however, standardization within private hospital settings remains limited. Methods: A structured literature review of pharmacotechnical and clinical studies published between 2017 and 2025 was conducted to assess the technical and clinical feasibility of developing CBD-based magistral formulations. Based on comparative analysis of reported formulations, four dosage forms adapted to the hospital context were designed: oral solution, gummies, capsules, and topical cream. Results: The proposed formulations demonstrated technical feasibility in terms of stability considerations, excipient selection, and compliance with Costa Rican pharmaceutical regulations. Each dosage form allows individualized dose adjustment and addresses specific therapeutic needs according to route of administration and patient profile. Conclusions: CBD magistral formulations represent a feasible strategy for pharmacotherapeutic individualization in patients with complex conditions, offering a complementary alternative when commercial options are insufficient. Further local experimental studies are recommended to validate stability parameters and clinical performance.

Keywords

Cannabidiol (CBD), endocannabinoid system; drug compounding; chronic pain; nervous system diseases; neoplasms therapy; personalized medicine.

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