Current Nepalese Legislative Framework, Pharmacology and Chemistry of Medicinal Cannabis: A Comprehensive Review

Cannabis sativa is an annual, dioecious plant belonging to the family Cannabaceae, with origins traced to equatorial and subtropical regions, particularly Central Asia. In Nepal, cannabis has long held cultural and medicinal significance within Ayurvedic and traditional healing systems, where it is associated with restoring balance between the body, mind and spirit. This review aims to provide a comprehensive overview of medicinal cannabis, with a particular focus on the current Nepalese legislative framework, its botanical and geographical characteristics, pharmacological properties, chemical composition, formulations and future perspectives.A systematic literature search was conducted using PubMed, MEDLINE, Europe PMC and Google Scholar. Relevant studies were identified using thematically aligned keyword combinations, refined iteratively and linked using Boolean operators to ensure broad and inclusive coverage of available evidence. After years of prohibition, Nepal is set to legalize the cultivation and consumption of Cannabis for medicinal purposes. It contains a variety of phytochemicals, including alkaloids, flavonoids, terpenoids and cannabinoids, which are its main bioactive compounds. Cannabinoids are classified into phytocannabinoids, endocannabinoids and synthetic cannabinomimetics, primarily interacting with CB1 and CB2 receptors. Traditionally, cannabis has been used to address digestive issues, pain relief, rheumatism and gout. In contemporary medicine, it treats conditions such as HIV/AIDS, cancer, PTSD, glaucoma and chronic pain. Medicinal cannabis presents significant therapeutic potential supported by traditional knowledge and emerging scientific evidence. A clear and robust regulatory framework, combined with further pharmacological and clinical research, is essential to ensure its safe, effective and ethical integration into Nepal’s healthcare system.