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cbd oil dosage for seizures

If you feel you need a higher dosage as a starting point we have created the following chart to assist you. This chart is submitted as a suggestive guide only and is not meant to take the place of a qualified physician.

The anti-convulsant effects of CBD are not confined to these rare forms of epilepsy, however. Generally speaking, cannabinoids are anticonvulsant and have been referred to as “circuit breakers” because of their ability to reduce seizures and corresponding neurodegeneration. 2,3 ( https://www.ncbi.nlm.nih.gov/pubmed/18776886 , https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4189640 /)

1. Press Announcements – FDA approves first drug comprised of an active ingredient derived from marijuana to treat rare, severe forms of epilepsy [press release]. Office of the Commissioner2018.


4. How To Determine Dosage Based On A Specific Product

3. Katona I, Freund TF. Endocannabinoid signaling as a synaptic circuit breaker in neurological disease. Nat Med. 2008;14(9):923-930.

7. Devinsky O, Cross JH, Laux L, et al. Trial of Cannabidiol for Drug-Resistant Seizures in the Dravet Syndrome. N Engl J Med. 2017.

The evidence base supporting the anti-convulsant effects of CBD is diverse and increasingly compelling. It ranges from anecdotal reports by patient and healthcare providers 4 ( https://www.ncbi.nlm.nih.gov/pubmed/25845492 ) to pre-clinical studies involving animals to randomized controlled trials involving humans. 5 ( https://www.ncbi.nlm.nih.gov/pubmed/24854329 ) Two open-label studies and one double-blind, placebo-controlled trial showed meaningful reductions in seizure frequency and severity, specifically seizures associated with Dravet and Lennox-Gastaut syndromes (Median seizure frequency decreased by 40% in one of the open-label studies 6 ( https://www.ncbi.nlm.nih.gov/pubmed/26724101 ) and 53% in the placebo-controlled trial). 7 ( https://www.ncbi.nlm.nih.gov/pubmed/28538134 ) A 2018 systematic review and meta-analysis including four trials involving 550 patients with Lennox-Gastaut syndrome (LGS) and Dravet syndrome (DS) concluded that CBD contributed to a greater reduction in seizure frequency than conventional treatment alone. 8 ( https://www.ncbi.nlm.nih.gov/pubmed/30390221 )

for the treatment of two rare and severe forms of epilepsy, Lennox-Gastaut syndrome and Dravet syndrome. 1 ( https://www.fda.gov/newsevents/newsroom/pressannouncements/ucm611046.htm )

*The Agriculture and Nutrition Act of 2018 (H.R. 2) legalizes hemp and hemp-derived CBD. The bill changes the definition of hemp to encompass any plant or product derived from the plant that contain less than 0.3% THC by dry weight and classifies them as exempt from the controlled substance restrictions applied to marijuana. The law further amends the Controlled Substances Act to exempt hemp from Schedule I drugs.

The FDA approval and Drug Enforcement Administration (DEA) scheduling of Epidiolex brings to market the first plant-based drug derived from the cannabis plant in the U.S.

What do I need to know about hemp?

On June 25, 2018, the U.S. Food & Drug Administration (FDA) approved EPIDIOLEX ® (cannabidiol, CBD) oral solution for the treatment of seizures associated with two epilepsy syndromes – Lennox-Gastaut syndrome and Dravet syndrome – in people two years of age or older. Epidiolex represents a new medication option for children with these types of epilepsy. It is also the first ever FDA approved medication to treat seizures in Dravet syndrome.

Hemp traditionally contains lower concentrations of THC and higher levels of CBD. Cannabinoids extracted from hemp plants, including CBD, have until recently been classified as marijuana and considered Schedule I substances. Per the DEA, Schedule I substances currently have no accepted medical use and have a high potential for abuse. A federal law* enacted in December 2018, however, reclassifies hemp and hemp-derived CBD as an agricultural commodity and exempts it from the list of Schedule I Drugs.

In this episode of Hallway Conversations, epilepsy.com Editor-In-Chief Dr. Joseph Sirven interviews Dr. Jose Cavazos MD, PhD, professor of neurology at the University of Texas Health Science Center in San Antonio. They discuss Dr. Cavazos’ experience serving as a panelist on the recent U.S. Food and Drug Administration (FDA) Peripheral and Central Nervous System Drug Advisory Committee review of Epidiolex ® for the treatment of Dravet and Lennox-Gastaut syndromes.

enzalutamide will decrease the level or effect of cannabidiol by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Consider an increase in cannabidiol dosage (based on clinical response and tolerability) when coadministered with a strong CYP2C19 inducer.

metronidazole will increase the level or effect of cannabidiol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Consider reducing the cannabidiol dose when coadministered with a moderate CYP3A4 inhibitor.

cannabidiol, riluzole. affecting hepatic enzyme CYP1A2 metabolism. Modify Therapy/Monitor Closely. Owing to the potential for both CYP1A2 induction and inhibition with the coadministration of CYP1A2 substrates and cannabidiol, consider reducing dosage adjustment of CYP1A2 substrates as clinically appropriate.

Minor

cannabidiol, olanzapine. affecting hepatic enzyme CYP1A2 metabolism. Modify Therapy/Monitor Closely. Owing to the potential for both CYP1A2 induction and inhibition with the coadministration of CYP1A2 substrates and cannabidiol, consider reducing dosage adjustment of CYP1A2 substrates as clinically appropriate.

Monitor Closely (1) cannabidiol, conjugated estrogens, vaginal. affecting hepatic enzyme CYP1A2 metabolism. Modify Therapy/Monitor Closely. Owing to the potential for both CYP1A2 induction and inhibition with the coadministration of CYP1A2 substrates and cannabidiol, consider reducing dosage adjustment of CYP1A2 substrates as clinically appropriate.

Monitor Closely (1) metronidazole will increase the level or effect of cannabidiol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Consider reducing the cannabidiol dose when coadministered with a moderate CYP3A4 inhibitor.

Monitor Closely (1) clotrimazole will increase the level or effect of cannabidiol by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Consider reducing the cannabidiol dose when coadministered with a moderate CYP3A4 inhibitor.