cannabidiol at a glance
Medicine class
Antiseizure treatment
Licensed uses
Seizures associated with Lennox–Gastaut syndrome, Dravet syndrome or tuberous sclerosis complex
Treatment role
Used alongside other antiseizure treatments; clobazam is required for the licensed Lennox–Gastaut and Dravet indications
Administration
Oral liquid measured with the supplied syringe and taken consistently in relation to food
What is cannabidiol used for?
Licensed as an add-on treatment for:
Seizures associated with Lennox–Gastaut syndrome, with clobazam, in people aged 2 years and over.
Seizures associated with Dravet syndrome, with clobazam, in people aged 2 years and over.
Seizures associated with tuberous sclerosis complex, alongside other antiseizure treatment, in people aged 2 years and over.
How does cannabidiol work?
The exact antiseizure mechanism is not fully understood and does not appear to depend on direct cannabinoid-receptor activation. It may reduce excessive neuronal activity through several signalling pathways.
cannabidiol preparations and strengths
Oral solution
Route: Oral
Strengths: 100 mg/mL
How to take cannabidiol
Use the supplied oral syringe and follow the prescriber’s volume instructions carefully.
Take it consistently either with or without food. If taken with food, keep the type of meal reasonably similar because food can substantially alter absorption.
This consistency also applies to a ketogenic diet.
Place the syringe tip inside the cheek and press the plunger gently. Clean and air-dry the syringe afterwards.
Certain nasogastric or gastrostomy tubes may be used when directed by the clinical team.
Do not stop suddenly unless instructed by the prescriber.
cannabidiol side effects
Common or expected effects
- Sleepiness or sedation
- Reduced appetite
- Diarrhoea, vomiting or nausea
- Fever or fatigue
- Weight loss or reduced weight gain
- Irritability or aggression
- Rash
- Raised liver enzymes
Get urgent medical advice
- Severe allergic reaction
- Severe or increasing seizures
- Thoughts of self-harm or suicide
- Clinically important liver injury, which may first be detected through blood tests
cannabidiol in pregnancy
Human pregnancy data are limited, and animal studies found reproductive toxicity. Cannabidiol should generally be avoided during pregnancy unless a specialist judges that the expected maternal benefit clearly outweighs the potential fetal risk. Do not stop epilepsy treatment without medical advice.
cannabidiol while breastfeeding
There are no adequate human data on transfer into breast milk or effects on the infant. The product information advises stopping breastfeeding during treatment; discuss feeding options with the specialist team.
cannabidiol interactions
Cannabidiol has clinically important interactions. The prescriber should review all medicines, supplements and herbal products.
Clobazam
Increases exposure to clobazam’s active metabolite, raising the likelihood of sleepiness and sedation.
Valproate
Combined use increases the risk of raised liver enzymes and may increase diarrhoea and reduced appetite.
Everolimus and other sensitive oral P-glycoprotein substrates
Cannabidiol may substantially increase exposure, making therapeutic drug monitoring and specialist review important.
Common questions about cannabidiol
Answers are fully visible for fast scanning and source review.
Is cannabidiol the same as shop-bought CBD oil?
No. The licensed product is standardised, with defined indications and manufacturing controls; retail CBD supplements are not interchangeable.
Will cannabidiol make me high?
It is not expected to cause a cannabis high. The licensed product is highly purified and contains only a tightly limited amount of THC as an impurity.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.