What is the appropriate cannabidiol (CBD) dosing for epilepsy?

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Last updated: March 2, 2025View editorial policy

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From the Research

CBD dosing for epilepsy should start at 2-10 mg/kg/day, increasing to a maximum dose of 25-50 mg/kg/day, as evidenced by the most recent study 1. The dosing regimen for cannabidiol (CBD) in the treatment of epilepsy is crucial for maximizing its efficacy while minimizing potential side effects.

  • The initial dose should be low, typically in the range of 2-10 mg/kg/day, as reported in the study 1.
  • This dose can be gradually increased every 1-2 weeks to a target dose, with the maximum recommended dose being 25-50 mg/kg/day, as seen in the study 1.
  • It is essential to monitor patients closely for side effects, such as diarrhea, somnolence, and elevated liver enzymes, especially when CBD is used alongside other anti-seizure medications like valproate or clobazam, due to potential drug interactions 2.
  • The FDA-approved medication Epidiolex (pharmaceutical-grade CBD) is commonly used for this purpose, with specific dosing recommendations for different types of epilepsy, including Lennox-Gastaut syndrome and Dravet syndrome 1.
  • Treatment should always be supervised by a neurologist or epileptologist who can adjust dosing based on seizure control and side effects, and medication should never be stopped abruptly as this could trigger seizures 1.
  • Regular monitoring of liver function is also crucial, especially when CBD is used in combination with other medications that may affect liver function, such as valproate 2.
  • The most recent and highest quality study 1 provides the best evidence for the dosing regimen of CBD in epilepsy, showing sustained seizure reduction up to 192 weeks with an acceptable safety profile.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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