Cannabidiol

Parent or patient Information Leaflet

Dr. C. P. Ravi Kumar

Consultant Paediatric Neurologist
MRCPCH, CCT in Paediatrics (U.K.)
Fellow in Paediatric Epilepsy &
Neurology (London)

Cannabidiol is a medicine used in treatment of epilepsy; it is usually reserved to individuals with a severe form of epilepsy, which is not responding to standard line of medications.

This drug has been found to be effective in certain syndromic epilepsy such as Dravet Syndrome and Lennox Gastaut Syndrome.

This drug is currently not sold in India when this leaflet was published.

Why is it important for my child to take this medicine?

It is important that your child takes Cannabidiol regularly so that they have no Seizures or fewer seizures.

Do not stop giving Cannabidiol suddenly, as your child may have more seizures.

What is Cannabidiol available as?

Liquid medicine

When should I give Cannabidiol ?

Twice a day; morning and evening. Ideally, 10-12 hours apart.

For example, anytime between 7 to 8 am and right after 12 hours between 7 to 8 pm. You can adjust the time slot according to your schedule.

However, there are some exceptions when your doctor may advise to give it thrice a day. Please follow your doctor’s instructions in such case.

It should ideally be given at the samE time every day to establish a routine as it minimizes the chances of missing a dose.

What if I miss a dose?

Liquids: The missed dosage can be given, if you remember to give it within a lapse of 6 hours. If you fail to give the missed dose within 6 hours, then might as well leave it. It is advisable to wait until the time of next routine dose.

Never give a double dose of Cannabidiol .

If your child vomits out the content within 30 minutes of taking the medicine dosage then you can give the dose again; but if your child vomits after 30 minutes of taking the dose, then just leave it be and do not give it again.

How much of the drug should be given?

Your doctor will advise the correct dosage that is required for your child in the prescription.

When Cannabidiol is first given to your child, it will be started with a small amount, and then will be increased, little by little, over the course of a few days or weeks, in order to allow the child’s to get use to the medication. Your doctor will clarify what steps to take.

It is mandatory to follow the instructions given by your doctor about the dosage of medication.

Ultimately, when your child is free of seizures or convulsions (fits) and has no obvious side effects, you will know that the dosage is just correct.

How should I give the medicine? “Giving Medicines”

Liquid or syrup: Use an oral syringe or a medicine spoon to measure the adequate amount. You can easily get these from any pharmacy nearby.

Do not use a kitchen teaspoon as it will not give the accurate amount of the drug.

Are there any possible side effects? “Side effects”

Although medicines are given to make children feel better, they may sometimes cause unwanted side effects.

Side-effects that you must do something about

Diarrhea is a common side effect, it is found to be due to the oil used as preservative rather than the drug. Newer preparations are being introduced to avoid the above side effect.

Liver disease: It is mandatory to monitor liver enzymes regularly. If your doctor catches any evidence of liver dysfunction, it must be taken care of immediately. If your child’s health deteriorates and falls sick every few hours, suffers from stomachache, skin and eyes are pale yellow in color, feels lethargic and sleepy or increased number of seizures take them to your doctor straight away.

Other side-effects you need to know about

Your child may experience these side-effects when they first start taking Cannabidiol. They will be able to settle down within a week or so as their body gets used to the medicine. Continue to give Cannabidiol to your child as your doctor has directed you to.

• Increased sleepiness or being drowsy.
• Reduced appetite.
• Fatigue, malaise.
• Insomnia and other sleep problems.

If your child starts developing skin Rash, Stop Medications right there and SEEK IMMEDIATE MEDICAL ADVICE from your DOCTOR

Sometimes your child may experience other side-effects that are not listed above. If you notice any abnormalities with your child’s body or behavior, do not hesitate and immediately contact your doctor.

Can other common medicines be given at the same time as Cannabidiol ?

• Medications like ibuprofen, paracetamol, antibiotics or any of the other over the counter medicines can be given when necessary, except the ones your doctor has prohibited you from.

• Consult with your doctor before giving any other medicines to your child. This includes herbal or complementary medicines.
• Some other medicines used to treat epilepsy may affect how well Cannabidiol works or may cause side effects. If your child is experiencing more fits or seizures, or any other side effects after using other medications, talk to your doctor immediately.

Where should I keep this medicine?

• Keep the medicine in a cupboard, secured away from heat and direct sunlight. It is not a must to keep the medicine in the refrigerator though.

• Make sure the medicine is out of your child’s reach.
• Store the medication in the same box it was packed in.

For more information please take a look at the manufacturer’s information leaflet.

References :

1. IAP Drug Formulary Web Update 2020(3) Edition 58, https://www.iapdrugformulary.com/Home
2. Consumer Medicines Information (CMI), https://www.tga.gov.au/consumer-medicines-information-cmi
3. British National Formulary for Children (BNFC)
4. Food and Drug Administration, USA https://www.fda.gov