PLANTOGRAM · DOCTORS’ EDUCATION
Paediatric Medicinal Cannabis Access in Australia
Understand Australian paediatric medicinal cannabis access, specialist involvement, evidence boundaries, consent and monitoring considerations.
Access for children requires a separate assessment
Paediatric medicinal cannabis decisions require a condition-specific assessment and careful consideration of the child’s development, existing care and treatment risks. Adult prescribing assumptions should not be carried across to children.
This resource explains access and assessment principles. It does not promote routine cannabinoid treatment for children or provide a product-selection or dosing algorithm.
Specialist support for SAS-B
For unapproved Category 2–5 products in patients under 18, the TGA requires relevant specialist support for an application by a GP. The specialist must be a non-GP medical practitioner whose specialty is relevant to the indication. A relevant specialist making their own application does not need a separate support letter.
The supporting letter must be patient-specific, directed to the applying practitioner and dated within the preceding 12 months. Renewal requires a new application and new support letter. These safeguards also matter where a formulation contains another Schedule 8 cannabinoid rather than appreciable THC.
AP access is not the adult pathway
For paediatric Category 2–5 AP access, the practitioner must be a relevant non-GP specialist and hold HREC approval specific to under-18 patients. The adult established-history-of-use route should not be presented as a shortcut for children.
The TGA sets different provisions for Category 1 products and nurse practitioners. GPs may seek paediatric Category 1 AP access with relevant HREC approval. Nurse practitioners are not eligible for AP status; their paediatric SAS-B access is limited to Category 1 with the stated support or scope evidence. Check the current TGA table for the intended practitioner and product.
Evidence is condition- and product-specific
A registered cannabidiol medicine is indicated as adjunctive therapy for seizures associated with Dravet syndrome or Lennox–Gastaut syndrome from two years of age. That registration does not establish equivalent benefit for other CBD preparations or other childhood conditions.
Autism, other neurological conditions, chronic pain and palliative care require condition-specific assessment. These conditions should not be read as approved indications or a uniform level of evidence. Non-epilepsy use needs the relevant specialist’s judgement, current research and consideration of established care.
What should be documented?
A useful paediatric record explains the condition, specialist involvement, previous treatment, proposed outcome, alternatives and reasons for considering the intervention. Consent should involve the appropriate parent or guardian and the child’s participation or assent where suitable.
Agree on how benefit, adverse effects and development will be followed. Depending on the situation, review may include seizure records, function, behaviour, sleep, cognition, appetite, school participation, medicine interactions and relevant investigations. The monitoring plan should match the actual medicine and clinical risks.
Clinical positioning
Paediatric assessment should begin with the child’s condition and established treatment options. A popular format, an adult regimen or a “CBD-dominant” label is not enough to establish appropriateness. The decision and review plan belong within coordinated clinical care.
References and further reading
- TGA: Clarification of paediatric access requirements, 3 April 2025
- TGA: Accessing medicinal cannabis for a patient
- TGA: Cannabidiol registration indication
- TGA: Guidance on epilepsy in paediatric and young adult patients
