Prescription & processDoc series
First medical cannabis prescription in Germany: what patients should know
Your first prescription for medical cannabis is the start of a treatment with medical supervision. What is checked beforehand, which documents help, how the private prescription works in Germany and why the first weeks are a settling-in phase.
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Prescription & process
Contents of this article
For a first prescription (Erstrezept), a doctor checks whether medical cannabis is an option for you. This requires an honest medical history, realistic expectations and the willingness to follow the first weeks closely. You are not entitled to a prescription.
In Germany, medical cannabis is a prescription medicine. With telemedicine providers such as 420doc it is prescribed on a private prescription (Privatrezept): you pay the doctor's fee and the pharmacy (Apotheke) yourself. Since 30 July 2026, statutory health insurance (GKV, the Krankenkasse) no longer pays for cannabis flowers. What still applies to extracts and private insurance (PKV) is explained in Health insurance and medical cannabis.
What is checked before a first prescription?
Which symptoms do you have, since when and how severe are they? Which treatments have already been tried and with what result? Which previous illnesses do you have, which medicines do you take? Is there a history of mental illness in you or your family, a pregnancy or breastfeeding?
Your life situation also counts: your job, driving, responsibility for others. These questions are not a formality; they decide whether a prescription is medically justifiable.
The first prescription is the start of ongoing care, not a one-off transaction.
Which documents help?
Doctor's letters (Arztbriefe), test results (Befunde), an up-to-date medication plan (Medikationsplan) or reports from earlier treatments make the assessment more precise. They are not mandatory, but they improve the basis for the decision.
If your records come from another country, the guide Medical records from abroad explains how translation and upload work. How a request runs step by step is described under How it works.
The settling-in phase
The first weeks are a phase of finding the right setting. Treatment usually starts with a low amount that is adjusted slowly. How this works is explained in the article Medical cannabis dosage.
During this time your ability to react may be changed. Do not drive as long as you do not know the effect reliably. The rules on German roads are explained in the guide Driving with a cannabis prescription.
What can you realistically expect?
Not everyone responds equally well. Some report a noticeable change, others little effect or bothersome side effects. Treatment with medical cannabis is not a promise of a cure but one option in a treatment plan that is reviewed regularly. An overview of possible side effects is given in Medical cannabis side effects.
A treatment diary helps you and the practice assess effects and side effects objectively.
Frequently asked questions
What are the requirements for a first prescription?
A serious or chronic illness for which other treatments have not helped enough or were not tolerated, and a medical judgement that a treatment trial is justifiable. The minimum age at 420doc is 18.
Do I need medical records?
Not necessarily, but they help with the assessment.
What happens if my request is declined?
You receive feedback. At 420doc the fee is refunded if the request is declined; details are under Prices & reimbursement.
Does my Krankenkasse pay for the first prescription?
Not for cannabis flowers: statutory health insurance has not covered them since 30 July 2026. With a private prescription you pay the doctor and the pharmacy yourself; privately insured people can submit the bills to their insurer, depending on their tariff.
Sources
420doc editorial team · Published on 26 October 2026 · Updated on 26 October 2026
This article is for general information only and does not replace individual medical advice. How we review our content
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Medical cannabis dosage: how treatment is started and adjusted
Medical cannabis is not dosed by a fixed scheme but adjusted by a doctor: start low, increase slowly, watch effects and side effects. How this titration works, why patience matters and what you can contribute. No dosing recommendations.
Repeat cannabis prescription in Germany: process and requirements
A repeat prescription (Folgerezept) continues an ongoing treatment if it is well tolerated and still makes medical sense. What you are asked, when a consultation is needed and how often you need a new prescription.
Does German health insurance cover medical cannabis? The rules since July 2026
Since 30 July 2026, statutory health insurance in Germany no longer pays for cannabis flowers. Standardised extracts and certain finished medicines can still be covered under conditions and with prior approval, and a private prescription remains possible.
Well informed. Now get a medical review.
If medical cannabis may be an option for you, start your request online. A doctor reviews it individually; a prescription is only issued if it is medically justifiable.
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