Cannabidiol

Mechanism :

The exact anticonvulsant mechanism of action of cannabidiol is unknown; however, it does not appear to involve its effects on cannabinoid receptors.

Indication :

Lennox-Gastaut syndrome (LGS) or Dravet syndrome (DS) in patients ≥.2 years of age.

Contraindications :

Hypersensitivity to cannabidiol or any component of the formulation.

Dosing :

≥2 years and Adolescents:

Oral: Initial: 2.5 mg/kg twice daily; increase in weekly. increments of 2.5 mg/kg twice daily to a maximum dosage of 10 mg/kg twice daily.

Adverse Effect :

Drowsiness, lethargy, sedation, sleep disorder, skin rash, weight loss, anorexia, diarrhea, anemia, increased serum AST & ALT, infection, viral infections, asthenia.

Interaction :

CYP2C19 Inducers: May decrease the serum concentration of Cannabidiol.
CYP2C19 Inhibitors: May increase the serum concentration of Cannabidiol.
CYP3A4 Inducers: May decrease the serum concentration of Cannabidiol.
CYP3A4 Inhibitors: May increase the serum concentration of Cannabidiol.
Valproate Products: May enhance the hepatotoxic effect of Cannabidiol.

Hepatic Dose :

Mild hepatic impairment: No dose adjustment required.
Moderate hepatic impairment: Start with 1.25 mg/kg/dose PO BD. Increase dose gradually to 2.5 mg/kg PO BD. Max: 10 mg/kg/day PO.
Severe hepatic impairment: Start with 0.5 mg/kg PO BD. Increase dose gradually to 1 mg/kg PO BD. Max: 4 mg/kg/day PO.