[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Antiseizure medicines](https://durgical.com/en/pharmacology/classes/antiseizure-medicines/) › Cannabidiol

# Cannabidiol

## Antiseizure medicines?

Antiseizure medicines

A purified, non-intoxicating compound from the cannabis plant, given as an oral solution for rare severe childhood epilepsies.

Updated Nov 1, 2026

Also called: CBD

## Quick facts

**Group**
[Antiseizure medicines](https://durgical.com/en/pharmacology/classes/antiseizure-medicines/)

**Target**
Several possible targets (antiseizure mechanism not established)

**Used for**
Seizures of Lennox-Gastaut syndrome

**Key effects**
Diarrhoea · Sleepiness and tiredness

**Monitor**
Liver enzymes and bilirubin before · Drowsiness

**ATC**
N03AX24

No doses: the clinician sets them by the current guideline.

On this page

- The basics Mechanism of action
- Indications
- Adverse effects
- Pharmacokinetics
- Memory aid

- Safety Contraindications
- Key interactions
- What is monitored
- Administration and safety
- Pregnancy and breastfeeding
- Nursing care

- Study Test yourself

- Connections Connections

## Mechanism of action

◆**Several possible targets (antiseizure mechanism not established)**Cannabidiol

ⓘ The figure shows cannabidiol bound to the human sodium channel Nav1.7, one of its many proposed targets; how it reduces seizures is still unknown.

**Target in 3D:** Several possible targets (antiseizure mechanism not established). PDB structure 8G1A (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/8G1A) · Drag to rotate · pinch to zoom

Cannabidiol (CBD) is a phytocannabinoid without the psychoactive effect of THC and with little affinity for the CB1 and CB2 receptors. How it reduces seizures is unknown. Proposed actions include activating TRPV1, blocking the orphan receptor GPR55, activating 5-HT1A receptors and inhibiting adenosine reuptake (ENT-1), which together could lower neuronal excitability.

- CBD acts on several non-cannabinoid targets
- Neuronal excitability falls by an unclear route
- Fewer seizures in Dravet, Lennox-Gastaut and TSC

## Indications

- Seizures of Lennox-Gastaut syndrome [Epilepsy and seizures →](https://durgical.com/en/conditions/epilepsy-and-seizures/)
- Seizures of Dravet syndrome [Epilepsy and seizures →](https://durgical.com/en/conditions/epilepsy-and-seizures/)
- Seizures of tuberous sclerosis complex [Tuberous sclerosis complex →](https://durgical.com/en/conditions/tuberous-sclerosis-complex/)

## Adverse effects

### Common

- Diarrhoea
- Sleepiness and tiredness
- Loss of appetite and weight loss
- Trouble sleeping
- Drooling and problems with walking

### Serious (rare, important)

- Liver injury: raised enzymes, jaundice, dark urine, right upper abdominal pain
- Infections (fever, cough)
- Rash or hives
- Suicidal thoughts or behaviour, as with other antiseizure medicines

## Contraindications

- Allergy to cannabidiol or to any component of the solution

## Key interactions

**Clobazam**
CBD raises the active metabolite of clobazam (N-desmethylclobazam): more sedation

**Valproate**
Higher risk of raised liver enzymes

**St John's wort and caffeine supplements**
May interact with CBD; they are reviewed before starting

**Alcohol**
Worse drowsiness

## What is monitored

- Liver enzymes and bilirubin before and during treatment
- Weight and appetite
- Drowsiness, especially with clobazam
- Mood and suicidal thoughts

## Administration and safety

- Oral solution measured with the oral syringe supplied; a dry syringe is used each time
- Given the same way each time with respect to food
- Can be given through a feeding tube
- Raised gradually and never stopped suddenly

## Pregnancy and breastfeeding

There is little information in pregnancy; it is a decision for the treating team.

## Nursing care

- Check liver tests before starting and during follow-up
- Watch for jaundice, dark urine and abdominal pain
- Weigh the child at visits
- Teach the family that pharmaceutical CBD is not the same as unregulated cannabis products

## Pharmacokinetics

**Absorption**
Oral solution; poorly soluble in water, and a high-fat meal raises absorption

**Distribution**
Very lipophilic; stored in brain and fat, which prolongs its elimination

**Metabolism**
In the liver and gut by several CYPs; it also inhibits CYP2C and CYP3A4

## Memory aid

«CBD calms Dravet, LGS and TSC»: three rare epilepsies, and a watch on the liver.

## Test yourself

Think of the answer, then tap the question to see it.

## Which three conditions is pharmaceutical cannabidiol approved for?

Seizures of Lennox-Gastaut syndrome, Dravet syndrome and tuberous sclerosis complex.

## Why can cannabidiol increase sedation when given with clobazam?

It raises levels of clobazam's active metabolite, N-desmethylclobazam.

## Which laboratory tests are followed during cannabidiol treatment?

Liver tests (transaminases and bilirubin).

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/cannabidiol/)

[More Pharmacology questions →](https://durgical.com/en/practice/?f=pharmacology)

## Connections

## Related drugs 4

- [Clobazam](https://durgical.com/en/pharmacology/clobazam/)
- [Valproic acid](https://durgical.com/en/pharmacology/valproic-acid/)
- [Stiripentol](https://durgical.com/en/pharmacology/stiripentol/)
- [Fenfluramine](https://durgical.com/en/pharmacology/fenfluramine/)

## Related conditions 2

- [Epilepsy and seizures](https://durgical.com/en/conditions/epilepsy-and-seizures/)
- [Tuberous sclerosis complex](https://durgical.com/en/conditions/tuberous-sclerosis-complex/)

[← Back to the class: Antiseizure medicines](https://durgical.com/en/pharmacology/classes/antiseizure-medicines/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [Cannabidiol: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a618051.html) (MedlinePlus (U.S. National Library of Medicine), 2026); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=N03AX24) (WHO Collaborating Centre for Drug Statistics Methodology, 2026); [RCSB PDB - 8G1A: Cryo-EM structure of Nav1.7 with CBD](https://www.rcsb.org/structure/8G1A) (RCSB Protein Data Bank, 2026).

## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake

Representative model, for educational purposes only.

---
Source: https://durgical.com/en/pharmacology/cannabidiol/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/cannabidiol/