Answer first

No standard dose of cannabis oil exists for severe muscle twitching. No US health agency has approved cannabis for this use. Trials of oral THC for muscle spasticity start at 1 to 2.5 mg THC per dose. Increase by 1 to 2.5 mg every 2 to 3 days.

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What the evidence says

Data on cannabis for muscle twitching are thin. Most data come from trials of spasticity in multiple sclerosis. A Cochrane review of oral cannabis extracts lists THC doses from 2.5 to 30 mg per day. The FDA approved Epidiolex (CBD) for three seizure conditions. It did not approve CBD for twitching.

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Starting dose

Start with 1 to 2.5 mg THC. Use a 1 mL syringe. A 10 mg/mL oil gives 1 mg in 0.1 mL. Take the dose at night. Wait 2 hours before you judge the effect. Food changes absorption. Keep the timing the same each day.

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Titration schedule

  1. Day 1 to 3: 1 to 2.5 mg THC, once at night.
  2. Day 4 to 6: 2.5 to 5 mg THC, once at night.
  3. Day 7 to 10: 5 mg THC, once or twice a day.
  4. Stop at the lowest dose that reduces twitching without side effects you cannot tolerate.

CBD and THC

CBD does not cause a high. CBD doses in trials range from 2.5 to 20 mg/kg per day. A 70 kg adult at 2.5 mg/kg takes 175 mg CBD per day. That amount costs more than low-dose THC. Oils with equal THC and CBD are another option. Nabiximols (Sativex) uses a 1:1 ratio. It is not approved in the US.

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Side effects to track

Do not drive after a THC dose until you know the effect. Keep a log. Record dose, time, twitching count, and side effects. Bring the log to your doctor.

When to get help

Severe muscle twitching can signal a nerve or brain condition. Get a diagnosis before you treat with cannabis. Stop cannabis oil if twitching gets worse. Get help for chest pain, fainting, or new weakness.