Cannabidiol

Cannabidiol is used to control seizures in adults and children 1 year of age and older with Lennox-Gastaut syndrome (a disorder that begins in early childhood and causes seizures, developmental delays, and behavioral issues), Dravet syndrome (a disorder that begins in early childhood and causes seizures and later may lead to developmental delays and changes in eating, balance, and walking), or tuberous sclerosis complex (TSC; a genetic condition that causes tumors to grow in many organs). Cannabidiol is in a class of medications called cannabinoids. It is not known exactly how cannabidiol works to prevent seizure activity.

🔔 How should this medicine be used?

Cannabidiol comes as a solution (liquid) to take by mouth. It is usually taken twice daily. You may take cannabidiol either with or without food, but be sure to take it the same way each time. Take cannabidiol at around the same times every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take cannabidiol exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Use the oral syringe that came with the medication for measuring the solution. Do not use a household spoon to measure your dose.

Use a dry oral syringe each time that you take the medication. The solution may turn cloudy if water enters the medication bottle or is inside the syringe, but this will not change the safety or how well the medication works.

The oral solution can be given through a feeding tube. If you have a feeding tube, ask your doctor how you should take the medication. Follow these directions carefully.

Your doctor will start you on a low dose of cannabidiol and gradually increase your dose, usually not more than once every week.

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Cannabidiol helps to control your condition, but does not cure it. Continue to take cannabidiol even if you feel well. Do not stop taking cannabidiol without talking to your doctor. If you suddenly stop taking cannabidiol, you may experience withdrawal symptoms such as new or worsening seizures. Your doctor will probably decrease your dose gradually.

Your doctor or pharmacist will give you the manufacturer’s patient information sheet (Medication Guide) when you begin treatment with cannabidiol and each time you refill your prescription. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website (http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm) or the manufacturer’s website to obtain the Medication Guide.

🔔 Other uses for this medicine

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

🔔 What special precautions should I follow?

Before taking cannabidiol,

• tell your doctor and pharmacist if you are allergic to cannabidiol, any other medications, sesame seed oil, or any of the ingredients in cannabidiol solution. Ask your pharmacist or check the Medication Guide for a list of the ingredients.
• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: antidepressants; medications for anxiety; bupropion (Aplenzin, Zyban); caffeine; carbamazepine (Carbatrol, Equetro, Tegretol, Teril); cimetidine (Tagamet); clarithromycin (in Biaxin); clobazam (Onfi); diazepam (Diastat, Valium); diflunisal; diltiazem (Cardizem, Cartia, Taztia, others); efavirenz (Sustiva); erythromycin (E.E.S, Eryped, Ery-tab); esomeprazole (Nexium); felbamate (Felbatol); fenofibrate (Antara); fluoxetine (Prozac); fluvoxamine (Luvox); gemfibrozil (Lopid); indinavir (Crixivan); isoniazid (Laniazid, in Rifater); itraconazole (Onmel, Sporanox); ketoconazole; lamotrigine (Lamictal); lansoprazole (Prevacid); lorazepam (Ativan); medications for mental illness; morphine (Astramorph, Kadian); nefazodone; nelfinavir (Viracept); nevirapine (Viramune); omeprazole (Prilosec); oral contraceptives; pantoprazole (Protonix); phenobarbital; phenytoin (Dilantin, Phenytek); rifabutin (Mycobutin); rifampin (Rifadin, in Rifamate, in Rifater); ritonavir (Norvir, in Kaletra); sedatives; sleeping pills; medications for seizures; theophylline (Elixophyllin, Theo-24); ticlopidine; tranquilizers; valproate (Depacon); verapamil (Verelan); and voriconazole (Vfend). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Many other medications may also interact with cannabidiol, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list.
• tell your doctor what herbal products you are taking, especially St. John’s Wort.
• tell your doctor if you drink or have ever drunk large amounts of alcohol or use or have ever used street drugs or excessive amounts of prescription medications. Also tell your doctor if you have or have ever had depression, mood problems, suicidal thoughts or behavior, or liver disease.
• tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking cannabidiol, call your doctor.
• you should know that cannabidiol may make you drowsy or unable to concentrate. Do not drive a car or operate machinery until you know how this medication affects you.
• ask your doctor about the safe use of alcoholic beverages while you are taking cannabidiol. Alcohol can make certain side effects from cannabidiol worse.
• you should know that your mental health may change in unexpected ways and you may become suicidal (thinking about harming or killing yourself or planning or trying to do so) while you are taking cannabidiol. A small number of adults and children 5 years of age and older (about 1 in 500 people) who took anticonvulsants to treat various conditions during clinical studies became suicidal during their treatment. There is a risk that you may experience changes in your mental health if you take an anticonvulsant medication such as cannabidiol, but there may also be a risk that you will experience changes in your mental health if your condition is not treated. You and your doctor will decide whether the risks of taking an anticonvulsant medication are greater than the risks of not taking the medication. You, your family, or your caregiver should call your doctor right away if you experience any of the following symptoms: panic attacks; agitation or restlessness; new or worsening irritability, anxiety, or depression; acting on dangerous impulses; difficulty falling or staying asleep; aggressive, angry, or violent behavior; mania (frenzied, abnormally excited mood); talking or thinking about wanting to hurt yourself or end your life; withdrawing from friends and family; preoccupation with death and dying; giving away prized possessions; or any other unusual changes in behavior or mood. Be sure that your family or caregiver knows which symptoms may be serious so they can call the doctor if you are unable to seek treatment on your own.

🔔 What special dietary instructions should I follow?

Talk to your doctor about eating grapefruit and drinking grapefruit juice while taking this medication.