What is Titration?
Titration is a medical term that you might see throughout your journey with eCS Clinic, in our education materials, when speaking with your practitioner or at the pharmacy. But it’s not a term that is used in normal life. So, we’re here to help you better understand, what titration is, the jargon and abbreviations you might see and how to titrate your medications.
Caffrey & Borrelli (2020) explain titration really well, as “[giving] the patient adequate and effective treatment, at the lowest dose possible, with the aim of minimizing unnecessary medication use and side effects”. This is the key with titration, to get the best effect with the least medication. Increasing the dose of a medication above where we see therapeutic effect opens increased opportunity for adverse side effects, with cannabinoid medications and any medication for that matter. The benefits of titration are echoed by many other research articles Kristensen (2022) calling it “a powerful approach to achieve precision dosing”.
Common Terms Relating to Titration
Dose relates to the amount of medication you should take. Dose may be represented as a number with or without units. For example, 0.15 may be written, if the medication is an oil, this means the dose is 0.15 ml.
PRN stands for pro re nata and means ‘as needed’. Gordon et al. (2008) discusses this common practice, especially in acute pain management. PRN provides the patient more control over their own titration; increasing, maintaining, or decreasing dose as needed, within the bounds set by the prescribing practitioner for your safety.
Latin Shorthand for Frequency
Mane, Nocte, BD, TDS and QID are all common terms that describe the dose frequency or how often you should take the medication. All of these terms are derived from Latin, but we’ve translated them for you here. If you’re interested, Lees, Castellaro & Youngman (2005) describe these terms and their use in further detail.
- Mane translates to “morning” and is used to mean ‘once per day in the morning’
- Nocte translates to “night” and is used to mean ‘once per day and night’
- BD/BID (bis in die) translates to “twice daily” and is used to mean ‘at morning and night’
- TDS (ter die sumendus) is used to mean ‘three times per day’ or ‘every 8 hours’
- TID (ter in die) is also used to mean ‘three times per day’ or ‘every 8 hours’
- QID (quater in die) is used to mean ‘four times per day’ or ‘every 6 hours’
We also have an article: Cannabinoids, Cannabis and Marijuana which clarifies the many terms used in the Medicinal Cannabis industry.
Everything Else While You're Titrating Your Cannabinoid Medications
Other Medications and Treatments
For many patients when they begin titrating cannabinoid medications, they have other concurrent medications and treatments.
It’s important to always speak with your healthcare professional before changing any current treatments, weaning off or stopping any medications, including your cannabinoid medications.