Antiepileptic (cannabinoid)

Cannabidiol

Brand names: Epidyolex

Adult dose

Dose: Start 2.5mg/kg BD; increase to 5mg/kg BD (max 10mg/kg BD)

Route: Oral

Frequency: BD

Clinical pearls

NICE TA614 / TA615 / TA681: Lennox-Gastaut, Dravet, tuberous sclerosis epilepsy
ABN / RCPCH paediatric epilepsy guidance
Specialist paediatric neurology — schedule 5 controlled drug

Contraindications

Severe hepatic impairment
Concurrent or recent severe drug-induced liver injury
Pregnancy
Hypersensitivity

Side effects

Somnolence
Diarrhoea
Decreased appetite
Hepatotoxicity (transaminase elevations)
Pneumonia
Rash

Interactions

Clobazam (markedly increases N-desmethylclobazam — additive sedation)
Valproate (additive hepatotoxicity)
Strong CYP3A4/2C19 inhibitors/inducers

Monitoring

LFTs (baseline, 1, 3, 6 months)
Seizure diary
Mood
Drug interactions

Reference: BNF; NICE TA614/TA615/TA681; ABN; RCPCH; https://bnf.nice.org.uk/drugs/cannabidiol/. Verify against your local formulary and the latest BNF before prescribing.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Rome IV Diagnostic Criteria for Cyclic Vomiting Syndrome (CVS) · Functional GI Disorders

Pathways