Formulary
Cannabidiol: Indications, Dosing, Side Effects and Interactions
Cannabidiol clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Cannabidiol: Indications, Dosing, Side Effects and Interactions
Cannabidiol clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Seizures associated with Lennox-Gastaut syndrome [adjunctive treatment with clobazam] (specialist use only),Seizures associated with Dravet syndrome [adjunctive treatment with clobazam] (specialist use only)**
- **Adult** (By Mouth): Initially 2.5 mg/kg twice daily for 1 week, then increased to 5 mg/kg twice daily, then increased in steps of 2.5 mg/kg twice daily if required, dose to be adjusted according to response at weekly intervals, food may affect absorption (take at the same time with respect to food); maximum 20 mg/kg per day.
**Seizures associated with tuberous sclerosis complex [adjunctive treatment] (specialist use only)**
- **Adult** (By Mouth): Initially 2.5 mg/kg twice daily for 1 week, then increased to 5 mg/kg twice daily, then increased in steps of 2.5 mg/kg twice daily if required, dose to be adjusted according to response at weekly intervals, food may affect absorption (take at the same time with respect to food); maximum 25 mg/kg per day.
**Seizures associated with Lennox-Gastaut syndrome [adjunctive treatment with clobazam] (specialist use only), Seizures associated with Dravet syndrome [adjunctive treatment with clobazam] (specialist use only) for cannabidiol**
- **Child 2-17 years** (By mouth): Initially 2.5 mg/kg twice daily for 1 week, then increased to 5 mg/kg twice daily, then increased in steps of 2.5 mg/kg twice daily if required, dose to be adjusted according to response at weekly intervals, food may affect absorption (take at the same time with respect to food); maximum 20 mg/kg per day.
**Seizures associated with tuberous sclerosis complex [adjunctive treatment] (specialist use only) for cannabidiol**
- **Child 2-17 years** (By mouth): Initially 2.5 mg/kg twice daily for 1 week, then increased to 5 mg/kg twice daily, then increased in steps of 2.5 mg/kg twice daily if required, dose to be adjusted according to response at weekly intervals, food may affect absorption (take at the same time with respect to food); maximum 25 mg/kg per day.
Cautions
Elderly
Side effects
Common or very common Aggression; appetite decreased; cough; diarrhoea; drowsiness; fatigue; fever; increased risk of infection; irritability; nausea; rash; seizure; vomiting; weight decreased Frequency not known Anaemia; suicidal behaviours
Interactions
**Severe interactions:**
- If clinically significant increases of transaminases occur, cannabidiol and/or concomitant valproate should be reduced or discontinued in all patients until a recovery of transaminase elevations are...
- Co-administration of cannabidiol is also predicted to cause clinically significant interactions with CYP2C8 (repaglinide) and CYP2C9 (e.g., warfarin) substrates.
**Other interactions (40):**
- CYP3A4 or CYP2C19 inducers The strong CYP3A4/2C19 inducing agent rifampicin (600 mg administered once daily) decreased plasma concentrations of cannabidiol and of 7-hydroxy-cannabidiol (7-OH-CBD; an...
- Other strong inducers of CYP3A4 and/or CYP2C19, such as carbamazepine, enzalutamide, mitotane, St.
- John's wort, when administered concomitantly with cannabidiol, may also cause a decrease in the plasma concentrations of cannabidiol and of 7-OH-CBD by a similar amount.
- These changes may result in a decrease in the effectiveness of cannabidiol.
- UGT inhibitors Cannabidiol is a substrate for UGT1A7, UGT1A9 and UGT2B7.
- No formal drug-drug interaction studies have been conducted with cannabidiol in combination with UGT inhibitors, therefore caution should be taken when co-administering drugs that are known...
Pregnancy
Important safety information For cannabidiol MHRA/CHM advice: Antiepileptics: risk of suicidal thoughts and behaviour (August 2008) See Epilepsy . MHRA/CHM advice: Antiepileptic drugs: updated advice on switching between different manufacturers' products (November 2017) See Epilepsy . MHRA/CHM advice: Antiepileptic drugs in pregnancy: updated advice following comprehensive safety review (January 2021) See Epilepsy .
Breast feeding
Manufacturer advises avoid-limited information available.
Hepatic impairment
Manufacturer advises caution in moderate to severe impairment (risk of increased exposure). Dose adjustments Manufacturer advises dose reduction in moderate to severe impairment-consult product literature.
Medicinal forms
Solution
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
Inside MedNext for this topic
- 411 MedNext-authored chapters
- 80,000+ MCQ bank
- 15 study modes
- Growing visual cheat sheets
Study modes
- Notes
- MCQ
- Audio
- Video
- Visual
- 3D Anatomy
- Trace
- Flashcards
- Mnemonics
- Image Bank
- Clinical
- Microscopy
- Audio QBank
- Cadaver
- Book Match
Continue reading
Subject HubPharmacology Hub
All pharmacology resources in one place.
Drug SchedulesIndian Drug Schedules
Schedule H, H1, X and G classifications.
FormularyBrowse all drugs
Search 1,850+ drug profiles.
Study Cannabidiol in the MedNext app
Challenge yourself with targeted pharmacology MCQs on this drug class. Every explanation links back to the chapter that teaches the concept.
Start drug challengeExplore the full formulary

