cannabidiol, theophylline. 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.
Significant – Monitor Closely
cannabidiol, efavirenz. affecting hepatic enzyme CYP2B6 metabolism. Modify Therapy/Monitor Closely. Owing to the potential for both CYP2B6 induction and inhibition with the coadministration of CYP2B6 substrates and cannabidiol, consider reducing dosage adjustment of CYP2B6 substrates as clinically appropriate.
cannabidiol will increase the level or effect of chlorpropamide by decreasing metabolism. Modify Therapy/Monitor Closely. Cannabidiol may potentially inhibit CYP2C9 activity. Consider reducing the dose when concomitantly using CYP2C9 substrates.
Serious – Use Alternative (1)
cannabidiol will increase the level or effect of fosphenytoin by affecting hepatic enzyme CYP2C19 metabolism. Modify Therapy/Monitor Closely. Consider reducing the dose of sensitive CYP2C19 substrates, as clinically appropriate, when coadministered with cannabidiol.
Purpose: There is uncertainty regarding the appropriate dose of Cannabidiol (CBD) for childhood epilepsy. We present the preliminary data of seven participants from the Cannabidiol in Children with Refractory Epileptic Encephalopathy (CARE-E) study.
An improvement in the total QOLCE-55 scores was observed in all participants with the greatest improvements were found on the Cognitive, Social and Emotional Functioning subscales ( Figure 2 ). While the improvements in the QOLCE scores decreased during the weaning period following Visit 6 the scores remained improved over the baseline scores.
Efficacy Outcome Measures
Participant A-04 had slight elevations of AST at Visits 3 and 6 (48 U/L and 44 U/L, respectively -reference: 10–40 U/L). GGT was elevated prior to, and remained elevated throughout, the study, reaching a peak of 88 U/L at Visit 4. Participant A-04’s serum lipase at 173 U/L (normal: 22–51 U/L) was significantly elevated at Visit 5. As he was asymptomatic and an abdominal ultrasound was normal, he continued to receive CHE. By Visit 6, lipase levels decreased to 83 U/L and returned to normal following the study after valproic acid dosing was decreased and CHE was continued at 10–12 mg/kg/day.