Cannabidiol

Cannabidiol Brand Name– EPIDIOLEX

What is Cannabidiol

Cannabidiol is an oral cannabinoid indicated for the treatment of seizures associated with Lennox-Gastaut syndrome and Dravet syndrome.

Cannabidiol is a marijuana derivative; however, it lacks the psychoactive properties that are commonly associated with delta-9-tetrahydrocannabinol (THC).

Cannabidiol significantly reduced seizure frequency in patients with Dravet syndrome and Lennox-Gastaut syndrome when added to other antiepileptic therapies during clinical trials. A reduction in seizures was observed within 4 weeks of treatment initiation for both forms of epilepsy.

In patients with Dravet syndrome, the median percentage reduction in monthly convulsive seizures from baseline was 39% for those receiving cannabidiol 20 mg/kg/day vs. 13% for those receiving placebo.

During the maintenance period, 6.7% of cannabidiol-treated patients were seizure free.

In patients with Lennox-Gastaut syndrome, the median percentage reduction in monthly drop seizure frequency from baseline was 37% for those receiving cannabidiol 10 mg/kg/day, 42% to 44% for those receiving 20 mg/kg/day, and 17% to 22% for those receiving placebo.

Somnolence, decreased appetite, and diarrhea are among the most common adverse reactions of cannabidiol. Dose-related elevations in liver transaminases can occur, and routine monitoring of hepatic enzymes is necessary

Indications

  • Dravet syndrome
  • Lennox-Gastaut syndrome

Side Effects

  1. abdominal pain
  2. agitation
  3. anemia
  4. angioedema
  5. anorexia
  6. asthenia
  7. depression
  8. diarrhea
  9. drowsiness
  10. elevated hepatic enzymes
  11. erythema
  12. fatigue
  13. hypersalivation
  14. hypoxia
  15. infection
  16. insomnia
  17. irritability
  18. lethargy
  19. malaise
  20. pruritus
  21. rash
  22. suicidal ideation
  23. weight loss

Monitoring Parameters

  • LFTs

Contraindications

  • abrupt discontinuation
  • breast-feeding
  • depression
  • driving or operating machinery
  • hepatic disease
  • pregnancy
  • sesame oil hypersensitivity
  • suicidal ideation

Interactions

  • Acetaminophen; Aspirin, ASA; Caffeine
  • Acetaminophen; Butalbital
  • Acetaminophen; Butalbital; Caffeine
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
  • Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
  • Acetaminophen; Codeine
  • Acetaminophen; Dextromethorphan; Doxylamine
  • Acetaminophen; Diphenhydramine
  • Acetaminophen; Hydrocodone
  • Acetaminophen; Oxycodone
  • Acetaminophen; Pentazocine
  • Acetaminophen; Tramadol
  • Acrivastine; Pseudoephedrine
  • Alfentanil
  • Alogliptin; Pioglitazone
  • Alosetron
  • Alprazolam
  • Amiodarone
  • Amitriptyline
  • Amitriptyline; Chlordiazepoxide
  • Amlodipine; Celecoxib
  • Amobarbital
  • Amoxapine
  • Amoxicillin; Clarithromycin; Lansoprazole
  • Amoxicillin; Clarithromycin; Omeprazole
  • Anxiolytics; Sedatives; and Hypnotics
  • Apalutamide
  • Apomorphine
  • Aprepitant, Fosaprepitant
  • Aripiprazole
  • Armodafinil
  • Asenapine
  • Aspirin, ASA; Butalbital; Caffeine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Caffeine; Orphenadrine
  • Aspirin, ASA; Carisoprodol
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Omeprazole
  • Aspirin, ASA; Oxycodone
  • Atazanavir
  • Atazanavir; Cobicistat
  • Atropine
  • Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Atropine; Difenoxin
  • Atropine; Diphenoxylate
  • Atropine; Edrophonium
  • Atropine; Hyoscyamine; Phenobarbital; Scopolamine
  • atypical antipsychotic
  • Azelastine
  • Azelastine; Fluticasone
  • Baclofen
  • Belladonna Alkaloids; Ergotamine; Phenobarbital
  • Belladonna; Opium
  • Benzhydrocodone; Acetaminophen
  • Bosentan
  • Brexpiprazole
  • Brompheniramine
  • Brompheniramine; Carbetapentane; Phenylephrine
  • Brompheniramine; Dextromethorphan; Guaifenesin
  • Brompheniramine; Guaifenesin; Hydrocodone
  • Brompheniramine; Hydrocodone; Pseudoephedrine
  • Brompheniramine; Pseudoephedrine
  • Buprenorphine
  • Buprenorphine; Naloxone
  • Bupropion
  • Bupropion; Naltrexone
  • Butabarbital
  • Butorphanol
  • Caffeine
  • Caffeine; Ergotamine
  • Capsaicin; Metaxalone
  • Carbamazepine
  • Carbetapentane; Chlorpheniramine
  • Carbetapentane; Chlorpheniramine; Phenylephrine
  • Carbetapentane; Diphenhydramine; Phenylephrine
  • Carbetapentane; Phenylephrine; Pyrilamine
  • Carbetapentane; Pyrilamine
  • Carbidopa; Levodopa; Entacapone
  • Carbinoxamine
  • Carbinoxamine; Dextromethorphan; Pseudoephedrine
  • Carbinoxamine; Hydrocodone; Phenylephrine
  • Carbinoxamine; Hydrocodone; Pseudoephedrine
  • Carbinoxamine; Phenylephrine
  • Carbinoxamine; Pseudoephedrine
  • Cariprazine
  • Carisoprodol
  • Carvedilol
  • Celecoxib
  • Cenobamate
  • Central-acting adrenergic agents
  • Ceritinib
  • Cetirizine
  • Cetirizine; Pseudoephedrine
  • Chlophedianol; Dexbrompheniramine
  • Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
  • Chloral Hydrate
  • Chloramphenicol
  • Chlorcyclizine
  • Chlordiazepoxide
  • Chlordiazepoxide; Clidinium
  • Chlorpheniramine
  • Chlorpheniramine; Codeine
  • Chlorpheniramine; Dextromethorphan
  • Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Phenylephrine
  • Chlorpheniramine; Pseudoephedrine
  • Chlorpromazine
  • Chlorthalidone; Clonidine
  • Chlorzoxazone
  • Cimetidine
  • Ciprofloxacin
  • Clarithromycin
  • Clemastine
  • Clobazam
  • Clomipramine
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  • Clonidine
  • Clopidogrel
  • Clorazepate
  • Clozapine
  • Cobicistat
  • Codeine
  • Codeine; Guaifenesin
  • Codeine; Phenylephrine; Promethazine
  • Codeine; Promethazine
  • Conivaptan
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  • Cyclosporine
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  • Danazol
  • Dantrolene
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  • Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
  • Delavirdine
  • Desflurane
  • Desipramine
  • Deutetrabenazine
  • Dexchlorpheniramine
  • Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Dexmedetomidine
  • Dextromethorphan; Diphenhydramine; Phenylephrine
  • Dextromethorphan; Promethazine
  • Diazepam
  • Diclofenac
  • Diclofenac; Misoprostol
  • Diflunisal
  • Dihydrocodeine; Guaifenesin; Pseudoephedrine
  • Diltiazem
  • Dimenhydrinate
  • Diphenhydramine
  • Diphenhydramine; Hydrocodone; Phenylephrine
  • Diphenhydramine; Ibuprofen
  • Diphenhydramine; Naproxen
  • Diphenhydramine; Phenylephrine
  • Doxepin
  • Doxylamine
  • Doxylamine; Pyridoxine
  • Dronabinol
  • Dronedarone
  • Droperidol
  • Duloxetine
  • Duvelisib
  • Efavirenz
  • Efavirenz; Emtricitabine; Tenofovir
  • Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
  • Enflurane
  • Entacapone
  • Enzalutamide
  • Erythromycin
  • Erythromycin; Sulfisoxazole
  • Esketamine
  • Esomeprazole
  • Esomeprazole; Naproxen
  • Estazolam
  • Eszopiclone
  • Ethanol
  • Etomidate
  • Etravirine
  • Famotidine; Ibuprofen
  • Fedratinib
  • Felbamate
  • Fenofibrate
  • Fentanyl
  • Flibanserin
  • Fluconazole
  • Fluoxetine
  • Fluoxetine; Olanzapine
  • Fluphenazine
  • Flurazepam
  • Flurbiprofen
  • Fluvoxamine
  • Fosamprenavir
  • Fosphenytoin
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  • Gemfibrozil
  • Glimepiride
  • Glimepiride; Pioglitazone
  • Glimepiride; Rosiglitazone
  • Glipizide
  • Glipizide; Metformin
  • Glyburide
  • Glyburide; Metformin
  • grapefruit juice
  • Guaifenesin; Hydrocodone
  • Guaifenesin; Hydrocodone; Pseudoephedrine
  • Guanabenz
  • Guanfacine
  • Halogenated Anesthetics
  • Haloperidol
  • Halothane
  • Homatropine; Hydrocodone
  • Hydrochlorothiazide, HCTZ; Methyldopa
  • Hydrocodone
  • Hydrocodone; Ibuprofen
  • Hydrocodone; Phenylephrine
  • Hydrocodone; Potassium Guaiacolsulfonate
  • Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
  • Hydrocodone; Pseudoephedrine
  • Hydromorphone
  • Hydroxyzine
  • Ibuprofen
  • Ibuprofen; Oxycodone
  • Ibuprofen; Pseudoephedrine
  • Idelalisib
  • Iloperidone
  • Imatinib
  • Imipramine
  • Indinavir
  • Indomethacin
  • Isavuconazonium
  • Isoflurane
  • Isoniazid, INH
  • Isoniazid, INH; Pyrazinamide, PZA; Rifampin
  • Isoniazid, INH; Rifampin
  • Itraconazole
  • Ketamine
  • Ketoconazole
  • Lamotrigine
  • Lansoprazole
  • Lansoprazole; Naproxen
  • Lasmiditan
  • Lefamulin
  • Lemborexant
  • Lesinurad
  • Lesinurad; Allopurinol
  • Letermovir
  • Levocetirizine
  • Levorphanol
  • Lofexidine
  • Loperamide
  • Loperamide; Simethicone
  • Lopinavir; Ritonavir
  • Lorazepam
  • Loxapine
  • Lumacaftor; Ivacaftor
  • Lumacaftor; Ivacaftor
  • Lumateperone
  • Lurasidone
  • Maprotiline
  • Meclizine
  • Melatonin
  • Meloxicam
  • Meperidine
  • Meperidine; Promethazine
  • Meprobamate
  • Mesoridazine
  • Metaxalone
  • Metformin; Pioglitazone
  • Metformin; Repaglinide
  • Metformin; Rosiglitazone
  • Methadone
  • Methocarbamol
  • Methohexital
  • Methyldopa
  • Metoclopramide
  • Midazolam
  • Mifepristone
  • Mirtazapine
  • Mitotane
  • Modafinil
  • Molindone
  • Morphine
  • Morphine; Naltrexone
  • Nabilone
  • Nalbuphine
  • Nanoparticle Albumin-Bound Paclitaxel
  • Naproxen
  • Naproxen; Pseudoephedrine
  • Naproxen; Sumatriptan
  • Nateglinide
  • Nefazodone
  • Nelfinavir
  • Netupitant, Fosnetupitant; Palonosetron
  • Nilotinib
  • Nortriptyline
  • Olanzapine
  • Ombitasvir; Paritaprevir; Ritonavir
  • Omeprazole
  • Omeprazole; Amoxicillin; Rifabutin
  • Omeprazole; Sodium Bicarbonate
  • Opiate Agonists-Antagonists
  • Orphenadrine
  • Oxazepam
  • Oxycodone
  • Oxymorphone
  • Paliperidone
  • Pentazocine
  • Pentazocine; Naloxone
  • Pentobarbital
  • Perampanel
  • Perphenazine
  • Perphenazine; Amitriptyline
  • Pexidartinib
  • Phenobarbital
  • Phenothiazines
  • Phenylephrine; Promethazine
  • Phenytoin
  • Pimavanserin
  • Pimozide
  • Pioglitazone
  • Piroxicam
  • Posaconazole
  • Pramipexole
  • Pregabalin
  • Primidone
  • Prochlorperazine
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  • Propofol
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  • Quazepam
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  • Quinine
  • Rabeprazole
  • Ramelteon
  • Rasagiline
  • Remifentanil
  • Repaglinide
  • Ribociclib
  • Ribociclib; Letrozole
  • Rifampin
  • Riluzole
  • Risperidone
  • Ritonavir
  • Ropinirole
  • Rosiglitazone
  • Rotigotine
  • Rufinamide
  • Saquinavir
  • Scopolamine
  • Secobarbital
  • Sedating H1-blockers
  • Selexipag
  • Sevoflurane
  • Sodium Oxybate
  • St. John’s Wort, Hypericum perforatum
  • Sufentanil
  • Suvorexant
  • Tapentadol
  • Tasimelteon
  • Telithromycin
  • Temazepam
  • Tetrabenazine
  • Thalidomide
  • Theophylline, Aminophylline
  • Thiethylperazine
  • Thioridazine
  • Thiothixene
  • Ticlopidine
  • Tipranavir
  • Tizanidine
  • Tolbutamide
  • Tolcapone
  • Torsemide
  • Tramadol
  • Trandolapril; Verapamil
  • Trazodone
  • Treprostinil
  • Triazolam
  • Tricyclic antidepressants
  • Trifluoperazine
  • Trimipramine
  • Triprolidine
  • Tucatinib
  • Valerian, Valeriana officinalis
  • Valproic Acid, Divalproex Sodium
  • Verapamil
  • Vigabatrin
  • Voriconazole
  • Warfarin
  • Zafirlukast
  • Zaleplon
  • Ziprasidone
  • Zolpidem
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