Possible Interaction: Cannabidiol and Clobazam

“In the present study, we tested whether the presence of concomitant clobazam affected seizure frequency and severity (treatment response) 12 weeks after initiation of therapy with CBD in patients with treatment-resistant epilepsy (TRE).”

“OBJECTIVE We have previously shown that cannabidiol (CBD; Epidiolex®) significantly affects levels of clobazam/N-desmethylclobazam , rufinamide, topiramate, zonisamide, and eslicarbazepine.”

“A bi-directional drug interaction occurred with cannabidiol and clobazam.”

“There is potential for pharmacokinetic interactions between CBD and brivaracetam, clobazam , eslicarbazepine, lacosamide, gabapentin, oxcarbazepine, phenobarbital, potassium bromide, pregabalin, rufinamide, sirolimus/everolimus, stiripentol, tiagabine, topiramate and zonisamide.”

“However, the intrinsic anticonvulsant activity of CBD has been questioned due to a pharmacokinetic interaction between CBD and a first‐line medication, clobazam.”

“This recognized interaction has led to speculation that the anticonvulsant efficacy of CBD may simply reflect CBD augmenting clobazam exposure.”

“The open question remains whether and, mainly, to what extent CBD efficacy is enhanced by concomitant CLB administration.6,7”

“During the process, the European Medicines Agency (EMA) licence granted marketing authorisation for CBD only in conjunction with clobazam.”

“Reduction of CLB dose may be considered if adverse reactions known to occur with CLB are experienced when it is coadministered with CBD.”

“Evaluation of the results of individual trials clearly showed that improvement in seizure control over placebo was greater when CBD was added on to CLB than when it was added on to other medications.”

“Greater antiseizure effects, and a greater burden of adverse effects, are observed when CBD is combined with CLB.”

“There was a significantly greater responder rate for subjects taking CBD and CLB than those taking CBD without CLB only at the point of best seizure control within the first year of CBD treatment (p = 0.0240).”

“The results show that the effect of cannabidiol on the median reduction in drop-seizure frequency in patients with Lennox-Gastaut syndrome may be explained by a drug-drug interaction with clobazam.”

“With this study we aim to test the hypothesis that the effect of cannabidiol on drop-seizure frequency in patients with Lennox-Gastaut syndrome and Dravet syndrome could be attributed to a drug-drug interaction with clobazam.”