Epidiolex (Cannabidiol) is used for the treatment of seizures associated with Dravet syndrome, Lennox-Gastaut syndrome, or tuberous sclerosis complex in people one year of age and older.
Dosage: The starting cannabidiol dosage is 2.5 mg/kg twice a day. Following one week, the dosage can be increased to a maintenance dosage of 5 mg/kg twice a day. Patients who are tolerating cannabidiol at 5 mg/kg twice a day and need further reduction of seizures may benefit from the increase of dose up to a maximum standard maintenance dose of 10 mg per kg twice a day, in weekly increments of 2.5 mg per kg twice a day, as tolerated. For patients in whom a quick titration from 10 to to 20 mg/kg/day is warranted, the dosage can be increased no more frequently than every other day. Use of 20 mg per kg per day dose of epidiolex resulted in more reductions in the rate of seizures in comparison to the standard maintenance dose of 10 mg per kg per day, but with more side effects.
Side Effects: The most commonly reported epidiolex side effects include:
- Decreased appetite
- Sleep problems
- Increase in liver enzymes
- Feeling very tired and weak
Warnings and Precautions:
- The cannabidiol uses are contraindicated in patients with a history of hypersensitivity to this medication.
- Assess serum transaminases (ALT/AST) and total bilirubin levels in all patients with epidiolex dosage before initiating therapy.
- Patients are advised to notify their healthcare professional if they become pregnant or intend to become pregnant while on cannabidiol 100 mg therapy.
- Caution patients regarding operating hazardous machinery until they are certain that epidiolex use does not affect them adversely.
- Patients are advised that this drug may cause them to feel sleepy, which may get better over time. Other drugs (e.g. clobazam) or alcohol with cannabidiol doses may increase sleepiness.