Epidiolex (cannabidiol) is a prescription drug used to manage seizures caused by certain disorders. Epidiolex comes as a liquid that you swallow.

Specifically, Epidiolex is used to help manage seizures caused by:

For more information about the specific uses of Epidiolex, see the “What is Epidiolex used for?” section.

Epidiolex basics

The active ingredient in Epidiolex is cannabidiol (CBD). An active ingredient is what makes a drug work.

It’s available as a liquid solution that you swallow.

Epidiolex is only available in brand-name form. Currently, there are no generic forms of Epidiolex available.

Read on to learn more about Epidiolex and its uses, side effects, and other information.

Epidiolex is used to help manage seizures caused by the following conditions:

  • Lennox-Gastaut syndrome, a severe form of epilepsy
  • Dravet syndrome, a rare type of epilepsy that begins in infancy and can cause developmental delays in children
  • tuberous sclerosis complex, a genetic condition that causes noncancerous tumors in the brain and other areas of the body

For managing seizures from these conditions, Epidiolex can be used in adults and children ages 12 months and older.

Seizures may occur from unusual signaling in the electrical activity of the brain. They can cause confusion, uncontrollable movements, and loss of consciousness.

Epidiolex’s mechanism of action for managing seizures is unknown. “Mechanism of action” refers to how a drug works to treat a condition.

Like most drugs, Epidiolex may cause mild or serious side effects. The following lists describe some of the more common side effects Epidiolex may cause. These lists don’t include all possible side effects.

Keep in mind that side effects of a drug can depend on:

  • your age
  • other health conditions you have
  • other medications you take

Your doctor or pharmacist can tell you more about the potential side effects of Epidiolex. They can also suggest ways to help reduce side effects.

Mild side effects

Here’s a list of some of the mild side effects that Epidiolex can cause. To learn about its other mild side effects, talk with your doctor or pharmacist, or read Epidiolex’s prescribing information.

Mild side effects of Epidiolex that have been reported include:

  • sleepiness
  • decreased appetite
  • diarrhea
  • fatigue (low energy)
  • weakness
  • skin rash
  • insomnia (trouble sleeping) and other sleeping disorders
  • infections
  • fever
  • vomiting

Mild side effects of drugs may go away within a few days to a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Epidiolex can occur, but they aren’t common. If you have serious side effects from Epidiolex, call your doctor right away. But if you think you’re having a medical emergency, you should call 911 or your local emergency number.

Serious side effects of Epidiolex that have been reported include:

Allergic reaction

Be sure to tell your doctor if you have a sesame allergy before you start taking Epidiolex. Some allergic reactions have been reported with Epidiolex, which contains sesame seed oil.

Allergic reactions to cannabidiol or other ingredients in Epidiolex are also possible.

Symptoms of a mild allergic reaction can include:

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include swelling under your skin, usually in your eyelids, lips, hands, or feet. They can also include swelling of your tongue, mouth, or throat, which can cause trouble breathing.

Call your doctor right away if you have an allergic reaction to Epidiolex. But if you think you’re having a medical emergency, call 911 or your local emergency number.

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms and can determine whether you should keep taking Epidiolex.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you’ve had a serious allergic reaction to Epidiolex, they may have you switch to a different treatment.

Your doctor will recommend the dosage of Epidiolex that’s right for you. Here are commonly used dosages, but always take the dosage your doctor prescribes.

Form and concentration

Epidiolex is available as a liquid solution that you swallow.

Epidiolex comes in one concentration: 100 milligrams per milliliter of solution (mg/mL).

Recommended dosage

You’ll take a dose of Epidiolex twice per day. Your doctor will calculate your dose based on your body weight in kilograms (kg). One kilogram is equal to about 2.2 pounds (lb).

Epidiolex’s manufacturer offers a dosing calculator, which you can use to check the dosage your doctor prescribed.

Dosage for Dravet syndrome or Lennox-Gastaut syndrome

Doctors may prescribe Epidiolex to help manage seizures caused by Dravet syndrome or Lennox-Gastaut syndrome. The recommended starting dose for this condition is 2.5 mg per kg of body weight (mg/kg). You’ll take this twice per day, for a total daily dose of 5 mg/kg.

The typical recommended maintenance dosage of Epidiolex for these conditions is 5 mg/kg twice daily (10 mg/kg total).

Depending on how your condition responds to Epidiolex, your doctor can increase your dosage to a maximum of 10 mg/kg twice per day (20 mg/kg total).

Dosage for tuberous sclerosis complex

Epidiolex can be used to help treat seizures caused by tuberous sclerosis complex. When prescribed this way, the recommended starting dose is 2.5 mg/kg twice per day (5 mg/kg total).

Each week, your doctor will likely increase your dose by 2.5 mg/kg twice daily (5 mg total). They’ll increase your dose until you reach the recommended maintenance dose of 12.5 mg/kg twice per day, for a total daily dose of 25 mg/kg.

How to take

Epidiolex is available as a liquid solution that you swallow. You should always use the measuring syringes that come with Epidiolex. This is the best way to make sure that your dose is accurate.

It’s recommended that you discard any Epidiolex that you don’t use within 12 weeks after opening the bottle.

You should not suddenly stop taking Epidiolex. It’s possible that suddenly stopping treatment can increase your risk of seizures. If you need to stop taking Epidiolex, talk with your doctor. They’ll lower your dosage gradually to help decrease your risk of seizures.

Taking Epidiolex with other drugs

In many cases, people who have a seizure disorder take multiple medications to treat their condition. So your doctor may recommend taking Epidiolex along with other seizure medications. Examples include levetiracetam (Keppra) and topiramate (Topamax).

Before you start taking Epidiolex, your doctor will determine the best treatment options for you.

Questions about taking Epidiolex

Here are some common questions about Epidiolex’s dosing.

  • Should I take Epidiolex with food? You can take this drug with or without food. But food can affect how your body absorbs Epidiolex. So it’s important to be consistent about when you take the drug. If you take it with a meal, try always to take it with a meal. If you take it on an empty stomach, try always to take it on an empty stomach.
  • Is there a best time of day to take Epidiolex? You should take Epidiolex twice per day. Taking this drug around the same time each day helps maintain a steady level in your body. This helps the drug work effectively.
  • What if I miss a dose of Epidiolex? If you miss your dose of Epidiolex, talk with your doctor or pharmacist. In some cases, they may recommend taking your dose as soon as you remember. But if it’s almost time for your next dose, your doctor or pharmacist may recommend skipping your missed dose and taking your next dose when you usually would.
  • Will I need to use Epidiolex long term? Yes, you’ll likely take Epidiolex long term if you and your doctor feel that this medication is safe and effective for your condition. This medication works to prevent seizures and is usually used as a long-term treatment.
  • How long does Epidiolex take to work? Epidiolex will start working after you take your first dose of medication. But it may take weeks before you notice that you’re having fewer seizures than usual. In studies of Epidiolex, people taking the drug reported fewer seizures within 4 weeks of starting treatment.

Overdose

Do not take more Epidiolex than your doctor prescribes. Using more than this can lead to serious side effects.

What to do in case you take too much Epidiolex

Call your doctor if you think you’ve taken too much Epidiolex. You can also call 800-222-1222 to reach America’s Poison Centers or use its online resource. But if you have severe symptoms, immediately call 911 or your local emergency number. Or go to the nearest emergency room.

Certain factors can affect whether Epidiolex is a good treatment option. These include:

  • any medications you take
  • any medical conditions you have
  • your overall health

These factors and others are discussed here in more detail.

Interactions

Taking a medication with certain vaccines, foods, and other things can affect how the medication works. These effects are called interactions.

Before taking Epidiolex, be sure to tell your doctor about all medications you take, including prescription and over-the-counter types. Also, describe any vitamins, herbs, or supplements you use. Your doctor or pharmacist can tell you about any interactions these items may cause with Epidiolex.

For information about drug-condition interactions, see the “Warnings” section.

Interactions with drugs or supplements

Epidiolex can interact with certain kinds of drugs or specific drugs. These include:

This list does not contain all the drugs that may interact with Epidiolex. Your doctor or pharmacist can tell you more about these interactions and any others that may occur when using Epidiolex.

Other interactions

In addition, Epidiolex can interact with certain supplements, such as St. John’s wort and caffeine.

This medication can also interact with alcohol. For more information, see the “Epidiolex and alcohol” section.

Before you start taking Epidiolex, tell your doctor about any supplements that you take. They will let you know whether your supplements are safe to take with this medication.

Warnings

Epidiolex may not be right for you if you have certain medical conditions. These are known as drug-condition interactions. Other factors may also affect whether Epidiolex is a good treatment option for you.

Talk with your doctor about your health history before you take Epidiolex. Factors to consider include those in the following list.

Depression, other mood disorders, or suicidal thoughts or behaviors: Epidiolex can increase the risk of suicidal thoughts or behaviors. People who have depression, mood problems, or suicidal thoughts or behaviors have an even higher risk of this side effect.

If you have a personal or family history of any of these mental health conditions, tell your doctor before you take Epidiolex. This will help them determine whether Epidiolex is safe for you to take. In some cases, they may recommend a different treatment option for you.

Liver problems: Epidiolex may cause liver damage. If you already have liver problems, taking Epidiolex can worsen your condition. Tell your doctor about any liver problems you have before starting Epidiolex treatment. They can check your liver before and during treatment. Depending on the condition of your liver, your doctor may recommend a different treatment option for you.

Allergic reaction: If you’ve had an allergic reaction to Epidiolex or any of its ingredients, including sesame seed oil, your doctor will likely not prescribe Epidiolex. Ask them what other medications are better options for you.

Help is out there

If you or someone you know is in crisis and considering suicide or self-harm, please seek support:

  • Call or text the 988 Suicide and Crisis Lifeline at 988 or chat at 988lifeline.org. Caring counselors are available to listen and provide free and confidential support 24/7.
  • Text HOME to the Crisis Text Line at 741741 to connect with a volunteer crisis counselor for free and confidential support 24/7.
  • Not in the United States? Find a helpline in your country with Befrienders Worldwide.
  • Call 911 or your local emergency services number if you feel safe to do so.

If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.

If you’re not in the same household, stay on the phone with them until help arrives.

Epidiolex and alcohol

Your doctor may recommend avoiding alcohol while you’re taking Epidiolex. This medication may cause you to feel sleepy or less alert, and so can alcohol. As a result, drinking alcohol during treatment may increase your risk of such side effects.

If you drink alcohol, ask your doctor about how much may be safe for you to consume while taking Epidiolex.

Pregnancy and breastfeeding

It’s not known whether Epidiolex may be safe to take during pregnancy or while breastfeeding.

At this time, there haven’t been studies of the drug during pregnancy. It’s also not known whether Epidiolex may pass into breast milk or its effects on a breastfeeding child.

If you’re pregnant or breastfeeding or planning to become pregnant or breastfeed, talk with your doctor before taking Epidiolex. They’ll discuss with you the potential risks and benefits of taking this drug during pregnancy or while breastfeeding.

A pregnancy registry collects information about the effects of a drug when taken during pregnancy. This can help determine the drug’s effects on a developing fetus or someone who is pregnant. If you take Epidiolex while pregnant, consider enrolling in the pregnancy registry for antiseizure drugs. For information, call 888-233-2334 or visit the registry website.

Find answers to some commonly asked questions about Epidiolex.

Is Epidiolex a controlled substance?

No, Epidiolex currently isn’t a controlled substance. Controlled substances are drugs regulated by the United States government because they may cause dependence or misuse. With dependence, a person’s body becomes used to a drug and needs it to function as usual. Misuse is using a medication in a different way than prescribed, such as taking more than recommended.

Epidiolex contains CBD as its active ingredient, and some people may try to misuse it. This is because they may think the drug causes a “high,” which isn’t the case. So it’s important to store the drug in a secure place.

In addition, be sure to keep the prescription label on your bottle of Epidiolex, especially when traveling. In the U.S., it’s legal to have prescription Epidiolex. But in some states, using CBD without a prescription is illegal.

Can Epidiolex treat anxiety or schizophrenia?

At this time, Epidiolex isn’t approved by the Food and Drug Administration (FDA) to treat anxiety or schizophrenia. This drug is currently only approved to manage seizures caused by Lennox-Gastaut syndrome, Dravet syndrome, or tuberous sclerosis complex.

One study suggests that CBD, the active ingredient in Epidiolex, may ease anxiety symptoms. But there isn’t enough information yet to determine whether the drug may be safe or effective in people with anxiety.

In a study of CBD for treating schizophrenia, people taking the drug had a decrease in symptoms. But another study found that CBD didn’t affect schizophrenia symptoms. More studies or clinical trials are needed to determine whether Epidiolex may be a safe or effective treatment for people with schizophrenia.

If you’re interested in using Epidiolex to treat anxiety or schizophrenia, talk with your doctor. They can work with you to devise the best treatment plan for your condition. For more information about Epidiolex’s approved uses, see the “What is Epidiolex used for?” section.

Is Epidiolex used for pain, migraine episodes, or autism spectrum disorder?

Currently, Epidiolex is only approved by the FDA to manage seizures caused by Lennox-Gastaut syndrome, Dravet syndrome, or tuberous sclerosis complex. It’s not currently approved to treat pain, migraine episodes, or autism spectrum disorder (ASD).

Studies of CBD, the active ingredient in Epidiolex, suggest the drug may work for treating symptoms of migraine headaches and ASD. Results from studies of CBD as a treatment for pain have been mixed. At this time, more studies are needed to determine whether Epidiolex may be a safe and effective treatment for these conditions.

If you’re interested in using Epidiolex to treat any of these conditions, talk with your doctor. They can work with you to develop the best treatment plan for your condition.

Is Epidiolex the same as CBD?

Yes and no. Epidiolex contains CBD as its active ingredient. But Epidiolex is FDA approved to manage seizures in some people. Over-the-counter CBD products aren’t regulated by the FDA, so they aren’t approved to treat specific medical conditions.

It’s also important to note that nonprescription CBD products may contain other active ingredients, including small amounts of tetrahydrocannabinol (THC). Epidiolex contains CBD as its only active ingredient.

Epidiolex and nonprescription CBD products may also differ in other ways, including cost and dosage. For more detailed information about which treatment option is right for you, talk with your doctor or pharmacist.

People may take Epidiolex or Charlotte’s Web supplements to help manage certain seizure disorders. However, only Epidiolex is approved for this use.

Charlotte’s Web supplements and products contain hemp, so they aren’t regulated by the FDA. This means the manufacturer of Charlotte’s Web can’t make claims about medical uses for this product.

Another difference between Epidiolex and Charlotte’s Web is the dosage form. Epidiolex is only available as a liquid solution that you swallow. Charlotte’s Web comes as creams, capsules, and oils.

To learn more about how Epidiolex compares with Charlotte’s Web, see the “Epidiolex vs. Charlotte’s Web” section of this Epidiolex overview.

The price of prescription drugs can vary depending on many factors. These factors include what your insurance plan covers (if you have insurance) and which pharmacy you use.

If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. You may also be eligible for an Epidiolex copay savings program from the drug’s manufacturer.

Learn more about saving money on prescriptions.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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