Significant Drug-Drug Interactions With Cannabidiol and Antiepileptics

HOUSTON – Several antiepileptic drugs (AEDs), including clobazam, rufinamide, topiramate, zonisamide, and eslicarbazepine have significant drug-drug interactions with cannabidiol (CBD), according to results from an open-label extension study presented at the 2016 American Epilepsy Society Annual Meeting.

CBD is compound isolated from the marijuana plant that, in its purest form, contains no tetrahydrocannabinol (THC), the psychoactive compound responsible for the “high” associated with marijuana use. Like many other medications, CBD is metabolized in the liver by cytochrome P-450 enzymes, sometimes resulting in drug-drug interactions. These interactions may be significant in patients with epilepsy who may be taking several concomitant AEDs to control seizures.

In this study, Tyler E. Gaston, MD, of the University of Alabama, and colleagues examined baseline serum AED levels to identify drug-drug interactions between CBD and 19 AEDS during an open-label safety study in 81 patients (39 adults, 42 children) with refractory epilepsy.


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