Epidiolex

Overview

cannabidiol

cannabinoid

• CYP2C19 substrate
• CYP3A4 substrate
• CYP1A2 inhibitor, weak
• CYP2C8 inhibitor, weak
• CYP2C19 inhibitor, moderate
• UGT1A9 inhibitor
• P-gp inhibitor, strong
• CYP2B6 inducer, weak
• affected by altered fat absorption
• antiepileptic agent
• CNS depression

Contraindicated

• amifampridine
Epidiolex (cannabidiol (CBD))

+

amifampridine

1 interaction

Contraindicated

cannabidiol + amifampridine

contraindicated if seizure disorder use; otherwise, caution advised: combo may alter seizure control (antagonistic effects, amifampridine may decr. seizure threshold)

• bupropion
Epidiolex (cannabidiol (CBD))

+

bupropion

1 interaction

Contraindicated

cannabidiol + bupropion

contraindicated: combo may decr. bupropion and metabolite levels, efficacy; may alter seizure control (hepatic metabolism induced; antagonistic effects, bupropion may decr. seizure threshold)

• colchicine
Epidiolex (cannabidiol (CBD))

+

colchicine

1 interaction

Contraindicated

cannabidiol + colchicine

CV RISK REDUCTION: contraindicated; GOUT or FMF: contraindicated in pts w/ renal or hepatic impairment; otherwise, decr. colchicine dose based on indication during and x14 days after cannabidiol use as follows: GOUT PROPHYLAXIS: give colchicine 0.3 mg qod-qd; ACUTE GOUT TX: give colchicine 0.6 mg x1 only; FMF: decr. max colchicine dose to 0.6 mg/day divided qd-bid: combo may incr. colchicine levels, risk of myopathy, rhabdomyolysis, other life-threatening toxicity (gut P-gp-mediated transport inhibited)

• dalfampridine
Epidiolex (cannabidiol (CBD))

+

dalfampridine

1 interaction

Contraindicated

cannabidiol + dalfampridine

contraindicated: combo may alter seizure control (antagonistic effects, dalfampridine may decr. seizure threshold)

• fezolinetant
Epidiolex (cannabidiol (CBD))

+

fezolinetant

1 interaction

Contraindicated

cannabidiol + fezolinetant

contraindicated: combo may incr. fezolinetant levels, risk of adverse effects (hepatic metabolism inhibited)

Avoid/Use Alternative

• abrocitinib
Epidiolex (cannabidiol (CBD))

+

abrocitinib

1 interaction

Avoid/Use Alternative

cannabidiol + abrocitinib

avoid combo if also combined w/ moderate or strong CYP2C9 inhibitor; otherwise, caution advised: combo may incr. abrocitinib and active metabolite levels, risk of serious infection, other adverse effects (hepatic metabolism inhibited)

• apixaban
Epidiolex (cannabidiol (CBD))

+

apixaban

1 interaction

Avoid/Use Alternative

cannabidiol + apixaban

ADULT PTS: monitor bleeding s/sx; if also combined w/ strong CYP3A4 inhibitor, decr. apixaban 5 mg bid or 10 mg bid dose by 50% or avoid combo if already on 2.5 mg bid; PEDS PTS: monitor bleeding s/sx; if also combined w/ strong CYP3A4 inhibitor, consider decr. apixaban dose: combo may incr. apixaban levels, risk of bleeding, other adverse effects (gut P-gp-mediated transport inhibited)

• butalbital
Epidiolex (cannabidiol (CBD))

+

butalbital

1 interaction

Avoid/Use Alternative

cannabidiol + butalbital

avoid combo: combo may decr. cannabidiol levels, efficacy; may incr. risk of CNS and respiratory depression, psychomotor impairment (hepatic metabolism induced; additive effects)

• cannabis
Epidiolex (cannabidiol (CBD))

+

cannabis

1 interaction

Avoid/Use Alternative

cannabidiol + cannabis

avoid combo: combo may incr. risk of CNS depression, psychomotor impairment, other adverse effects; may alter seizure control (additive effects, duplicate therapy; antagonistic effects, cannabis may decr. seizure threshold)

• clonidine
Epidiolex (cannabidiol (CBD))

+

clonidine

1 interaction

Avoid/Use Alternative

cannabidiol + clonidine

if ADHD use, avoid combo; otherwise, caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• clopidogrel
Epidiolex (cannabidiol (CBD))

+

clopidogrel

1 interaction

Avoid/Use Alternative

cannabidiol + clopidogrel

avoid combo: combo may decr. clopidogrel active metabolite levels, efficacy (hepatic metabolism inhibited, decr. conversion of clopidogrel to active metabolite)

• codeine
Epidiolex (cannabidiol (CBD))

+

codeine

1 interaction

Avoid/Use Alternative

cannabidiol + codeine

avoid combo if antitussive use; otherwise, monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, codeine may decr. seizure threshold)

• dabigatran
Epidiolex (cannabidiol (CBD))

+

dabigatran

1 interaction

Avoid/Use Alternative

cannabidiol + dabigatran

ATRIAL FIBRILLATION: avoid combo if CrCl <30 mL/min; OTHER INDICATIONS: avoid combo if CrCl <50 mL/min; if dabigatran use for DVT/PE prophylaxis post-hip replacement and CrCl >50 mL/min, consider separating admin. at least 2h apart: combo may incr. dabigatran levels, risk of bleeding (including life-threatening), other adverse effects (gut P-gp-mediated transport inhibited)

• doxylamine
Epidiolex (cannabidiol (CBD))

+

doxylamine

1 interaction

Avoid/Use Alternative

cannabidiol + doxylamine

avoid combo if doxylamine use for pregnancy-related nausea/vomiting; otherwise, caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• ensartinib
Epidiolex (cannabidiol (CBD))

+

ensartinib

1 interaction

Avoid/Use Alternative

cannabidiol + ensartinib

avoid combo: combo may incr. ensartinib levels, risk of bradycardia, hyperglycemia, other adverse effects (gut P-gp-mediated transport possibly inhibited)

• ethanol (alcoholic beverage)
Epidiolex (cannabidiol (CBD))

+

ethanol (alcoholic beverage)

1 interaction

Avoid/Use Alternative

cannabidiol + ethanol (alcoholic beverage)

avoid combo: combo may incr. cannabidiol levels, risk of profound CNS and respiratory depression, psychomotor impairment, other adverse effects (mechanism unknown, additive effects)

• ethanol injection
Epidiolex (cannabidiol (CBD))

+

ethanol injection

1 interaction

Avoid/Use Alternative

cannabidiol + ethanol injection

use alternative or monitor respiratory rate: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• ginkgo
Epidiolex (cannabidiol (CBD))

+

ginkgo

1 interaction

Avoid/Use Alternative

cannabidiol + ginkgo

avoid consumption of ginkgo seeds; otherwise, caution advised: combo may alter seizure control (antagonistic effects, ginkgotoxin may decr. seizure threshold)

• haloperidol
Epidiolex (cannabidiol (CBD))

+

haloperidol

1 interaction

Avoid/Use Alternative

cannabidiol + haloperidol

avoid combo: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, haloperidol may decr. seizure threshold)

• hydrocodone
Epidiolex (cannabidiol (CBD))

+

hydrocodone

1 interaction

Avoid/Use Alternative

cannabidiol + hydrocodone

avoid combo if antitussive use; otherwise, monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, hydrocodone may decr. seizure threshold)

• isocarboxazid
Epidiolex (cannabidiol (CBD))

+

isocarboxazid

1 interaction

Avoid/Use Alternative

cannabidiol + isocarboxazid

use alternative during and x10 days after isocarboxazid use: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, isocarboxazid may decr. seizure threshold)

• kava
Epidiolex (cannabidiol (CBD))

+

kava

1 interaction

Avoid/Use Alternative

cannabidiol + kava

avoid combo: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• kratom
Epidiolex (cannabidiol (CBD))

+

kratom

1 interaction

Avoid/Use Alternative

cannabidiol + kratom

use alternative or monitor respiratory rate: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, kratom may decr. seizure threshold)

• lefamulin
Epidiolex (cannabidiol (CBD))

+

lefamulin

1 interaction

Avoid/Use Alternative

cannabidiol + lefamulin

ORAL LEFAMULIN: avoid combo; IV lefamulin use OK: combo may incr. lefamulin levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (gut P-gp-mediated transport inhibited)

• lenacapavir
Epidiolex (cannabidiol (CBD))

+

lenacapavir

1 interaction

Avoid/Use Alternative

cannabidiol + lenacapavir

avoid combo w/ oral lenacapavir if also combined w/ strong CYP3A4 and UGT1A1 inhibitors; otherwise, caution advised: combo may incr. lenacapavir levels, risk of adverse effects (gut P-gp-mediated transport inhibited)

• meperidine
Epidiolex (cannabidiol (CBD))

+

meperidine

1 interaction

Avoid/Use Alternative

cannabidiol + meperidine

use alternative or monitor respiratory rate, withdrawal sx, especially w/ cannabidiol doses greater than 7.5 mg/kg/dose bid; consider decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may decr. meperidine levels, efficacy; may incr. normeperidine levels, risk of neurotoxicity; may incr. risk of profound CNS and respiratory depression, psychomotor impairment; may alter seizure control (hepatic metabolism induced, incr. toxic metabolite formation; additive effects; antagonistic effects, meperidine may decr. seizure threshold)

• metaxalone
Epidiolex (cannabidiol (CBD))

+

metaxalone

1 interaction

Avoid/Use Alternative

cannabidiol + metaxalone

use alternative or monitor respiratory rate: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• methadone
Epidiolex (cannabidiol (CBD))

+

methadone

1 interaction

Avoid/Use Alternative

cannabidiol + methadone

use alternative or monitor respiratory rate, ECG, withdrawal sx, especially w/ cannabidiol doses greater than 7.5 mg/kg/dose bid; consider decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. or decr. methadone levels, incr. risk of profound CNS and respiratory depression, psychomotor impairment, QT prolongation, cardiac arrhythmias, other adverse effects or decr. efficacy; may alter seizure control (hepatic metabolism inhibited, hepatic metabolism induced; additive effects; antagonistic effects, methadone may decr. seizure threshold)

• metoclopramide
Epidiolex (cannabidiol (CBD))

+

metoclopramide

1 interaction

Avoid/Use Alternative

cannabidiol + metoclopramide

use alternative: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, metoclopramide may decr. seizure threshold)

• midazolam
Epidiolex (cannabidiol (CBD))

+

midazolam

1 interaction

Avoid/Use Alternative

cannabidiol + midazolam

use alternative or monitor respiratory rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• neratinib
Epidiolex (cannabidiol (CBD))

+

neratinib

1 interaction

Avoid/Use Alternative

cannabidiol + neratinib

avoid combo if also combined w/ strong-mod CYP3A4 inhibitor; otherwise, caution advised: combo may incr. neratinib levels, risk of adverse effects (gut P-gp-mediated transport inhibited)

• norgestimate (contraceptive)
Epidiolex (cannabidiol (CBD))

+

norgestimate (contraceptive)

1 interaction

Avoid/Use Alternative

cannabidiol + norgestimate (contraceptive)

use additional non-hormonal or alternative contraception during and x28 days after cannabidiol tx, especially w/ cannabidiol doses greater than 7.5 mg/kg/dose bid: combo may decr. norgestimate and active metabolites levels, contraceptive efficacy (hepatic metabolism induced)

• oxybate
Epidiolex (cannabidiol (CBD))

+

oxybate

1 interaction

Avoid/Use Alternative

cannabidiol + oxybate

use alternative or monitor respiratory rate; decr. dose of one or both drugs: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, hypotension, syncope (additive effects)

• pazopanib
Epidiolex (cannabidiol (CBD))

+

pazopanib

1 interaction

Avoid/Use Alternative

cannabidiol + pazopanib

avoid combo: combo may incr. pazopanib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (gut P-gp-mediated transport inhibited)

• phenelzine
Epidiolex (cannabidiol (CBD))

+

phenelzine

1 interaction

Avoid/Use Alternative

cannabidiol + phenelzine

use alternative: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, phenelzine may decr. seizure threshold)

• pirfenidone
Epidiolex (cannabidiol (CBD))

+

pirfenidone

1 interaction

Avoid/Use Alternative

cannabidiol + pirfenidone

avoid combo if also combined w/ mod-strong CYP1A2 inhibitor; otherwise, caution advised: combo may incr. pirfenidone levels, risk of adverse effects (hepatic metabolism inhibited)

• pralsetinib
Epidiolex (cannabidiol (CBD))

+

pralsetinib

1 interaction

Avoid/Use Alternative

cannabidiol + pralsetinib

use alternative or consider monitoring ECG, electrolytes and decr. pralsetinib dose as follows: if on pralsetinib 400 mg qd, decr. to 300 mg qd; if on pralsetinib 400 mg qd and also combined w/ strong CYP3A4 inhibitor: decr. to 200 mg qd; if on pralsetinib 300 mg qd, decr. to 200 mg qd; if on pralsetinib 200 mg qd, decr. to 100 mg qd: combo may incr. pralsetinib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (gut P-gp-mediated transport inhibited)

• promethazine
Epidiolex (cannabidiol (CBD))

+

promethazine

1 interaction

Avoid/Use Alternative

cannabidiol + promethazine

use alternative or monitor respiratory rate; decr. dose of one or both drugs: combo may incr. risk of CNS and respiratory depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, promethazine may decr. seizure threshold)

• relugolix
Epidiolex (cannabidiol (CBD))

+

relugolix

1 interaction

Avoid/Use Alternative

cannabidiol + relugolix

PROSTATE CANCER: may hold relugolix if oral cannabidiol tx up to 2wk; otherwise, use alternative or monitor ECG, electrolytes and admin. relugolix at least 6h before oral cannabidiol; FIBROID-ASSOC. BLEEDING: use alternative or admin. relugolix at least 6h before oral cannabidiol: combo may incr. relugolix levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (gut P-gp-mediated transport inhibited)

• repotrectinib
Epidiolex (cannabidiol (CBD))

+

repotrectinib

1 interaction

Avoid/Use Alternative

cannabidiol + repotrectinib

avoid combo: combo may incr. repotrectinib levels, risk of CNS depression, psychomotor impairment, other adverse effects (gut P-gp-mediated transport inhibited, additive effects)

• rivaroxaban
Epidiolex (cannabidiol (CBD))

+

rivaroxaban

1 interaction

Avoid/Use Alternative

cannabidiol + rivaroxaban

avoid combo if also combined w/ strong CYP3A4 inhibitor; use alternative if CrCl <80 and combined w/ moderate CYP3A4 inhibitor; otherwise, monitor bleeding s/sx: combo may incr. rivaroxaban levels, risk of bleeding, other adverse effects (gut P-gp-mediated transport inhibited)

• ropeginterferon alfa-2b
Epidiolex (cannabidiol (CBD))

+

ropeginterferon alfa-2b

1 interaction

Avoid/Use Alternative

cannabidiol + ropeginterferon alfa-2b

use alternative: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• scopolamine
Epidiolex (cannabidiol (CBD))

+

scopolamine

1 interaction

Avoid/Use Alternative

cannabidiol + scopolamine

use alternative: combo may increase risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, scopolamine may decrease seizure threshold)

• silodosin
Epidiolex (cannabidiol (CBD))

+

silodosin

1 interaction

Avoid/Use Alternative

cannabidiol + silodosin

avoid combo: combo may incr. silodosin levels, risk of adverse effects (gut P-gp-mediated transport inhibited)

• thalidomide
Epidiolex (cannabidiol (CBD))

+

thalidomide

1 interaction

Avoid/Use Alternative

cannabidiol + thalidomide

use alternative or consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, thalidomide may decr. seizure threshold)

• tizanidine
Epidiolex (cannabidiol (CBD))

+

tizanidine

1 interaction

Avoid/Use Alternative

cannabidiol + tizanidine

use alternative or monitor BP, HR: combo may incr. tizanidine levels, risk of hypotension (including orthostasis, syncope), bradycardia, CNS depression, psychomotor impairment, other adverse effects (hepatic metabolism inhibited, additive effects)

• topotecan
Epidiolex (cannabidiol (CBD))

+

topotecan

1 interaction

Avoid/Use Alternative

cannabidiol + topotecan

avoid combo w/ oral topotecan: combo may incr. topotecan levels, risk of serious infection, myelosuppression, other adverse effects (gut P-gp-mediated transport inhibited)

• tradipitant
Epidiolex (cannabidiol (CBD))

+

tradipitant

1 interaction

Avoid/Use Alternative

cannabidiol + tradipitant

use alternative: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• tranylcypromine
Epidiolex (cannabidiol (CBD))

+

tranylcypromine

1 interaction

Avoid/Use Alternative

cannabidiol + tranylcypromine

use alternative: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, tranylcypromine may decr. seizure threshold)

• trimethobenzamide
Epidiolex (cannabidiol (CBD))

+

trimethobenzamide

1 interaction

Avoid/Use Alternative

cannabidiol + trimethobenzamide

use alternative or consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• venetoclax
Epidiolex (cannabidiol (CBD))

+

venetoclax

1 interaction

Avoid/Use Alternative

cannabidiol + venetoclax

monitor CBC, tumor lysis syndrome s/sx; CLL/SLL: consider alternative or decr. venetoclax dose by at least 50%; AML: decr. venetoclax dose by at least 50%: combo may incr. venetoclax levels, risk of serious infection, myelosuppression, tumor lysis syndrome, other adverse effects (gut P-gp-mediated transport inhibited)

• zuranolone
Epidiolex (cannabidiol (CBD))

+

zuranolone

1 interaction

Avoid/Use Alternative

cannabidiol + zuranolone

use alternative or consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

Monitor/Modify Tx

• afatinib
Epidiolex (cannabidiol (CBD))

+

afatinib

1 interaction

Monitor/Modify Tx

cannabidiol + afatinib

decr. afatinib dose by 10 mg/day if not tolerated: combo may incr. afatinib levels, risk of adverse effects (gut P-gp-mediated transport inhibited)

• aldesleukin
Epidiolex (cannabidiol (CBD))

+

aldesleukin

1 interaction

Monitor/Modify Tx

cannabidiol + aldesleukin

withhold aldesleukin if mod-severe somnolence occurs; otherwise, caution advised: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, aldesleukin may decr. seizure threshold)

• alfentanil
Epidiolex (cannabidiol (CBD))

+

alfentanil

1 interaction

Monitor/Modify Tx

cannabidiol + alfentanil

monitor BP, respiratory rate; decr. dose of one or both drugs: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, hypotension; may alter seizure control (additive effects; antagonistic effects, alfentanil may decr. seizure threshold)

• alprazolam
Epidiolex (cannabidiol (CBD))

+

alprazolam

1 interaction

Monitor/Modify Tx

cannabidiol + alprazolam

monitor respiratory rate: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• aminophylline
Epidiolex (cannabidiol (CBD))

+

aminophylline

1 interaction

Monitor/Modify Tx

cannabidiol + aminophylline

monitor theophylline levels: combo may incr. theophylline levels, risk of cardiac arrhythmias, seizures, other toxicities; may alter seizure control (hepatic metabolism inhibited; aminophylline converted to theophylline; antagonistic effects, theophylline may decr. seizure threshold)

• amiodarone
Epidiolex (cannabidiol (CBD))

+

amiodarone

1 interaction

Monitor/Modify Tx

cannabidiol + amiodarone

monitor ECG: combo may incr. amiodarone levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism possibly inhibited)

• apalutamide
Epidiolex (cannabidiol (CBD))

+

apalutamide

1 interaction

Monitor/Modify Tx

cannabidiol + apalutamide

consider cannabidiol dose adjustment: combo may decr. cannabidiol and active metabolite levels, efficacy; may alter seizure control (hepatic metabolism induced; antagonistic effects, apalutamide may decr. seizure threshold)

• atorvastatin
Epidiolex (cannabidiol (CBD))

+

atorvastatin

1 interaction

Monitor/Modify Tx

cannabidiol + atorvastatin

monitor CK, myopathy sx: combo may incr. atorvastatin levels, risk of myopathy, rhabdomyolysis, other adverse effects (gut P-gp-mediated transport inhibited)

• avatrombopag
Epidiolex (cannabidiol (CBD))

+

avatrombopag

1 interaction

Monitor/Modify Tx

cannabidiol + avatrombopag

monitor platelets, thrombosis s/sx: combo may incr. avatrombopag levels, risk of thromboembolism, other adverse effects (gut P-gp-mediated transport inhibited)

• baclofen intrathecal
Epidiolex (cannabidiol (CBD))

+

baclofen intrathecal

1 interaction

Monitor/Modify Tx

cannabidiol + baclofen intrathecal

monitor respiratory rate: combo may incr. risk of CNS and respiratory depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, baclofen may decr. seizure threshold)

• belzutifan
Epidiolex (cannabidiol (CBD))

+

belzutifan

1 interaction

Monitor/Modify Tx

cannabidiol + belzutifan

monitor Hgb, hypoxia s/sx: combo may incr. belzutifan levels, risk of anemia, hypoxia, other adverse effects (hepatic metabolism inhibited)

• bendamustine
Epidiolex (cannabidiol (CBD))

+

bendamustine

1 interaction

Monitor/Modify Tx

cannabidiol + bendamustine

monitor CBC: combo may incr. bendamustine levels, risk of serious infection, myelosuppression, other adverse effects (hepatic metabolism inhibited)

• buprenorphine
Epidiolex (cannabidiol (CBD))

+

buprenorphine

1 interaction

Monitor/Modify Tx

cannabidiol + buprenorphine

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, buprenorphine may decr. seizure threshold)

• butorphanol
Epidiolex (cannabidiol (CBD))

+

butorphanol

1 interaction

Monitor/Modify Tx

cannabidiol + butorphanol

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, butorphanol may decr. seizure threshold)

• caffeine citrate
Epidiolex (cannabidiol (CBD))

+

caffeine citrate

1 interaction

Monitor/Modify Tx

cannabidiol + caffeine citrate

monitor caffeine levels: combo may incr. caffeine levels, risk of adverse effects (hepatic metabolism inhibited)

• carbamazepine
Epidiolex (cannabidiol (CBD))

+

carbamazepine

1 interaction

Monitor/Modify Tx

cannabidiol + carbamazepine

consider cannabidiol dose adjustment: combo may decr. cannabidiol levels, efficacy; may incr. risk of CNS depression, psychomotor impairment (hepatic metabolism induced; additive effects)

• carvedilol
Epidiolex (cannabidiol (CBD))

+

carvedilol

1 interaction

Monitor/Modify Tx

cannabidiol + carvedilol

monitor BP, HR: combo may incr. carvedilol levels, risk of hypotension, bradycardia, AV block, other adverse effects (gut P-gp-mediated transport inhibited)

• ceritinib
Epidiolex (cannabidiol (CBD))

+

ceritinib

1 interaction

Monitor/Modify Tx

cannabidiol + ceritinib

monitor ECG, electrolytes: combo may incr. ceritinib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (gut P-gp-mediated transport inhibited)

• chlordiazepoxide
Epidiolex (cannabidiol (CBD))

+

chlordiazepoxide

1 interaction

Monitor/Modify Tx

cannabidiol + chlordiazepoxide

monitor respiratory rate: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• chlorpromazine
Epidiolex (cannabidiol (CBD))

+

chlorpromazine

1 interaction

Monitor/Modify Tx

cannabidiol + chlorpromazine

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, chlorpromazine may decr. seizure threshold)

• cilostazol
Epidiolex (cannabidiol (CBD))

+

cilostazol

1 interaction

Monitor/Modify Tx

cannabidiol + cilostazol

decr. cilostazol dose to 50 mg bid: combo may incr. cilostazol levels, risk of adverse effects (hepatic metabolism inhibited)

• citalopram
Epidiolex (cannabidiol (CBD))

+

citalopram

1 interaction

Monitor/Modify Tx

cannabidiol + citalopram

adjust max citalopram dose to 20 mg/day: combo may incr. citalopram levels, risk of QT prolongation, cardiac arrhythmias, CNS depression, psychomotor impairment, other adverse effects; may alter seizure control (hepatic metabolism inhibited, additive effects; antagonistic effects, citalopram may decr. seizure threshold)

• clobazam
Epidiolex (cannabidiol (CBD))

+

clobazam

1 interaction

Monitor/Modify Tx

cannabidiol + clobazam

monitor respiratory rate, ALT, AST, total bilirubin, ammonia levels, s/sx infection, D/C clobazam if liver enzyme elevations occur; consider decr. dose of one or both drugs: combo may incr. levels of both drugs, risk of CNS and respiratory depression, psychomotor impairment, hepatocellular injury, hyperammonemia, pneumonia, other adverse effects (hepatic metabolism inhibited, additive effects)

• clonazepam
Epidiolex (cannabidiol (CBD))

+

clonazepam

1 interaction

Monitor/Modify Tx

cannabidiol + clonazepam

monitor respiratory rate: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• clorazepate
Epidiolex (cannabidiol (CBD))

+

clorazepate

1 interaction

Monitor/Modify Tx

cannabidiol + clorazepate

monitor respiratory rate: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• clozapine
Epidiolex (cannabidiol (CBD))

+

clozapine

1 interaction

Monitor/Modify Tx

cannabidiol + clozapine

monitor ECG, BP, HR; consider decr. clozapine dose: combo may incr. clozapine levels, risk of QT prolongation, cardiac arrhythmias, hypotension, bradycardia, CNS depression, psychomotor impairment, other adverse effects; may alter seizure control (hepatic metabolism inhibited, additive effects; antagonistic effects, clozapine may decr. seizure threshold)

• cyclophosphamide
Epidiolex (cannabidiol (CBD))

+

cyclophosphamide

1 interaction

Monitor/Modify Tx

cannabidiol + cyclophosphamide

monitor CBC, renal, cardiac fxn, especially w/ cannabidiol doses greater than 7.5 mg/kg/dose bid: combo may incr. cyclophosphamide active metabolite levels, risk of serious infection, myelosuppression, nephrotoxicity, cardiotoxicity, other adverse effects (hepatic metabolism possibly induced, incr. active metabolite formation)

• cyclosporine
Epidiolex (cannabidiol (CBD))

+

cyclosporine

1 interaction

Monitor/Modify Tx

cannabidiol + cyclosporine

monitor oral cyclosporine levels, renal fxn: combo may incr. cyclosporine levels, risk of serious infection, nephrotoxicity, other adverse effects; may alter seizure control (gut P-gp-mediated transport inhibited; antagonistic effects, cyclosporine may decr. seizure threshold)

• daridorexant
Epidiolex (cannabidiol (CBD))

+

daridorexant

1 interaction

Monitor/Modify Tx

cannabidiol + daridorexant

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• desflurane
Epidiolex (cannabidiol (CBD))

+

desflurane

1 interaction

Monitor/Modify Tx

cannabidiol + desflurane

monitor respiratory rate; consider decr. dose of one or both drugs: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• dexmedetomidine
Epidiolex (cannabidiol (CBD))

+

dexmedetomidine

1 interaction

Monitor/Modify Tx

cannabidiol + dexmedetomidine

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• dexmedetomidine injection
Epidiolex (cannabidiol (CBD))

+

dexmedetomidine injection

1 interaction

Monitor/Modify Tx

cannabidiol + dexmedetomidine injection

monitor respiratory rate, consider decr. dose of one or both drugs: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• diazepam
Epidiolex (cannabidiol (CBD))

+

diazepam

1 interaction

Monitor/Modify Tx

cannabidiol + diazepam

monitor respiratory rate, use lowest effective doses and shortest duration of concomitant tx: combo may incr. diazepam levels, risk of profound CNS and respiratory depression, psychomotor impairment, other adverse effects (hepatic metabolism inhibited, additive effects)

• digoxin
Epidiolex (cannabidiol (CBD))

+

digoxin

1 interaction

Monitor/Modify Tx

cannabidiol + digoxin

monitor oral digoxin levels, HR; decr. oral digoxin frequency or dose by 30-50%: combo may incr. digoxin levels, risk of bradycardia, AV block, other adverse effects (gut P-gp-mediated transport inhibited)

• dihydrocodeine
Epidiolex (cannabidiol (CBD))

+

dihydrocodeine

1 interaction

Monitor/Modify Tx

cannabidiol + dihydrocodeine

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, dihydrocodeine may decr. seizure threshold)

• diltiazem
Epidiolex (cannabidiol (CBD))

+

diltiazem

1 interaction

Monitor/Modify Tx

cannabidiol + diltiazem

monitor BP, HR w/ oral diltiazem: combo may incr. diltiazem levels, risk of hypotension, bradycardia, AV block, other adverse effects (gut P-gp-mediated transport inhibited)

• droperidol
Epidiolex (cannabidiol (CBD))

+

droperidol

1 interaction

Monitor/Modify Tx

cannabidiol + droperidol

decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• edoxaban
Epidiolex (cannabidiol (CBD))

+

edoxaban

1 interaction

Monitor/Modify Tx

cannabidiol + edoxaban

monitor bleeding s/sx; decr. edoxaban dose to 30 mg/day in DVT/PE pts; no dose adjustment recommended in atrial fibrillation pts: combo may incr. edoxaban levels, risk of bleeding, other adverse effects (gut P-gp-mediated transport inhibited)

• encorafenib
Epidiolex (cannabidiol (CBD))

+

encorafenib

1 interaction

Monitor/Modify Tx

cannabidiol + encorafenib

consider cannabidiol dose adjustment: combo may decr. cannabidiol levels, efficacy (hepatic metabolism induced)

• enzalutamide
Epidiolex (cannabidiol (CBD))

+

enzalutamide

1 interaction

Monitor/Modify Tx

cannabidiol + enzalutamide

consider cannabidiol dose adjustment: combo may decr. cannabidiol and active metabolite levels, efficacy; may alter seizure control (hepatic metabolism induced; antagonistic effects, enzalutamide may decr. seizure threshold)

• esketamine
Epidiolex (cannabidiol (CBD))

+

esketamine

1 interaction

Monitor/Modify Tx

cannabidiol + esketamine

monitor respiratory rate: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• esomeprazole
Epidiolex (cannabidiol (CBD))

+

esomeprazole

1 interaction

Monitor/Modify Tx

cannabidiol + esomeprazole

consider decr. esomeprazole dose if hypersecretory condition tx; otherwise, caution advised: combo may incr. esomeprazole levels, risk of adverse effects (hepatic metabolism inhibited)

• estazolam
Epidiolex (cannabidiol (CBD))

+

estazolam

1 interaction

Monitor/Modify Tx

cannabidiol + estazolam

monitor respiratory rate: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• eszopiclone
Epidiolex (cannabidiol (CBD))

+

eszopiclone

1 interaction

Monitor/Modify Tx

cannabidiol + eszopiclone

consider dose reduction of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• ethanol (in some formulations)
Epidiolex (cannabidiol (CBD))

+

ethanol (in some formulations)

1 interaction

Monitor/Modify Tx

cannabidiol + ethanol (in some formulations)

monitor respiratory rate: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• etomidate
Epidiolex (cannabidiol (CBD))

+

etomidate

1 interaction

Monitor/Modify Tx

cannabidiol + etomidate

monitor respiratory rate: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• etoposide
Epidiolex (cannabidiol (CBD))

+

etoposide

1 interaction

Monitor/Modify Tx

cannabidiol + etoposide

monitor CBC w/ oral etoposide: combo may incr. etoposide levels, risk of serious infection, myelosuppression, other adverse effects (gut P-gp-mediated transport inhibited)

• everolimus
Epidiolex (cannabidiol (CBD))

+

everolimus

1 interaction

Monitor/Modify Tx

cannabidiol + everolimus

TSC-ASSOC. SEGA, TSC-ASSOC. PARTIAL ONSET SEIZURES, TRANSPLANT: monitor everolimus levels, CBC; OTHER INDICATIONS: monitor CBC: combo may incr. everolimus levels, risk of serious infection, other adverse effects (gut P-gp-mediated transport inhibited)

• fedratinib
Epidiolex (cannabidiol (CBD))

+

fedratinib

1 interaction

Monitor/Modify Tx

cannabidiol + fedratinib

if also combined w/ moderate or weak CYP3A4 inhibitor, monitor CBC, LFTs: combo may incr. fedratinib levels, risk of myelosuppression, hepatotoxicity, other adverse effects (hepatic metabolism inhibited)

• fentanyl
Epidiolex (cannabidiol (CBD))

+

fentanyl

1 interaction

Monitor/Modify Tx

cannabidiol + fentanyl

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, fentanyl may decr. seizure threshold)

• flibanserin
Epidiolex (cannabidiol (CBD))

+

flibanserin

1 interaction

Monitor/Modify Tx

cannabidiol + flibanserin

monitor BP: combo may incr. flibanserin levels, risk of CNS depression, psychomotor impairment, severe hypotension (including syncope), other adverse effects (hepatic metabolism inhibited, additive effects)

• fluphenazine
Epidiolex (cannabidiol (CBD))

+

fluphenazine

1 interaction

Monitor/Modify Tx

cannabidiol + fluphenazine

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, fluphenazine may decr. seizure threshold)

• flurazepam
Epidiolex (cannabidiol (CBD))

+

flurazepam

1 interaction

Monitor/Modify Tx

cannabidiol + flurazepam

monitor respiratory rate; consider decr. dose of one or both drugs: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• fosphenytoin
Epidiolex (cannabidiol (CBD))

+

fosphenytoin

1 interaction

Monitor/Modify Tx

cannabidiol + fosphenytoin

monitor phenytoin levels; consider cannabidiol dose adjustment: combo may incr. phenytoin levels, risk of CNS depression, psychomotor impairment, other adverse effects; may decr. cannabidiol and active metabolite levels, efficacy (hepatic metabolism inhibited, additive effects; hepatic metabolism induced)

• gabapentin
Epidiolex (cannabidiol (CBD))

+

gabapentin

1 interaction

Monitor/Modify Tx

cannabidiol + gabapentin

monitor respiratory rate; consider decreasing gabapentin dose: combo may increase risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• gabapentin enacarbil
Epidiolex (cannabidiol (CBD))

+

gabapentin enacarbil

1 interaction

Monitor/Modify Tx

cannabidiol + gabapentin enacarbil

monitor respiratory rate: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• ganaxolone
Epidiolex (cannabidiol (CBD))

+

ganaxolone

1 interaction

Monitor/Modify Tx

cannabidiol + ganaxolone

consider decr. ganaxolone maintenance dose when starting cannabidiol: combo may incr. ganaxolone levels, risk of CNS depression, psychomotor impairment, other adverse effects (UGT possibly inhibited, additive effects)

• gilteritinib
Epidiolex (cannabidiol (CBD))

+

gilteritinib

1 interaction

Monitor/Modify Tx

cannabidiol + gilteritinib

monitor ECG: combo may incr. gilteritinib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (gut P-gp-mediated transport inhibited)

• hydromorphone
Epidiolex (cannabidiol (CBD))

+

hydromorphone

1 interaction

Monitor/Modify Tx

cannabidiol + hydromorphone

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, hydromorphone may decr. seizure threshold)

• hydroxyzine
Epidiolex (cannabidiol (CBD))

+

hydroxyzine

1 interaction

Monitor/Modify Tx

cannabidiol + hydroxyzine

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• idelalisib
Epidiolex (cannabidiol (CBD))

+

idelalisib

1 interaction

Monitor/Modify Tx

cannabidiol + idelalisib

monitor LFTs, CBC, GI toxicity sx: combo may incr. idelalisib levels, risk of hepatotoxicity, serious infection, myelosuppression, GI toxicity, pneumonitis, other adverse effects (gut P-gp-mediated transport inhibited)

• ifosfamide
Epidiolex (cannabidiol (CBD))

+

ifosfamide

1 interaction

Monitor/Modify Tx

cannabidiol + ifosfamide

monitor CBC, renal, cardiac fxn; consider ifosfamide dose adjustment, especially w/ cannabidiol doses greater than 7.5 mg/kg/dose bid; D/C one or both drugs if encephalopathy occurs: combo may incr. ifosfamide active and toxic metabolite levels, risk of myelosuppression, serious infection, encephalopathy, nephrotoxicity, cardiotoxicity, CNS depression, psychomotor impairment, other adverse effects; may alter seizure control (hepatic metabolism possibly induced, incr. metabolite formation; additive effects; antagonistic effects, ifosfamide may decr. seizure threshold)

• isoflurane
Epidiolex (cannabidiol (CBD))

+

isoflurane

1 interaction

Monitor/Modify Tx

cannabidiol + isoflurane

monitor respiratory rate: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• ivosidenib
Epidiolex (cannabidiol (CBD))

+

ivosidenib

1 interaction

Monitor/Modify Tx

cannabidiol + ivosidenib

monitor ECG; consider cannabidiol dose adjustment: combo may incr. ivosidenib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects; may decr. cannabidiol levels, efficacy (gut P-gp-mediated transport inhibited; hepatic metabolism induced)

• ketamine
Epidiolex (cannabidiol (CBD))

+

ketamine

1 interaction

Monitor/Modify Tx

cannabidiol + ketamine

monitor respiratory rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression (including life-threatening), psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, ketamine may decr. seizure threshold)

• lapatinib
Epidiolex (cannabidiol (CBD))

+

lapatinib

1 interaction

Monitor/Modify Tx

cannabidiol + lapatinib

monitor ECG: combo may incr. lapatinib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (gut P-gp-mediated transport inhibited)

• lemborexant
Epidiolex (cannabidiol (CBD))

+

lemborexant

1 interaction

Monitor/Modify Tx

cannabidiol + lemborexant

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• levorphanol
Epidiolex (cannabidiol (CBD))

+

levorphanol

1 interaction

Monitor/Modify Tx

cannabidiol + levorphanol

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, levorphanol may decr. seizure threshold)

• loperamide
Epidiolex (cannabidiol (CBD))

+

loperamide

1 interaction

Monitor/Modify Tx

cannabidiol + loperamide

monitor ECG, esp. if also combined w/ CYP3A4 inhibitors or if loperamide dose >16mg/day: combo may incr. loperamide levels, risk of QT prolongation, cardiac arrhythmias, CNS depression, psychomotor impairment, other adverse effects (hepatic metabolism possibly inhibited, gut P-gp-mediated transport inhibited)

• lorazepam
Epidiolex (cannabidiol (CBD))

+

lorazepam

1 interaction

Monitor/Modify Tx

cannabidiol + lorazepam

monitor respiratory rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• lovastatin
Epidiolex (cannabidiol (CBD))

+

lovastatin

1 interaction

Monitor/Modify Tx

cannabidiol + lovastatin

monitor CK, myopathy sx: combo may incr. lovastatin levels, risk of myopathy, rhabdomyolysis, other adverse effects (gut P-gp-mediated transport inhibited)

• lumacaftor/ivacaftor
Epidiolex (cannabidiol (CBD))

+

lumacaftor/ ivacaftor

1 interaction

Monitor/Modify Tx

cannabidiol + lumacaftor/ ivacaftor

consider cannabidiol dose adjustment: combo may decr. cannabidiol levels, efficacy (hepatic metabolism induced)

• mavacamten
Epidiolex (cannabidiol (CBD))

+

mavacamten

1 interaction

Monitor/Modify Tx

cannabidiol + mavacamten

monitor cardiac fxn, incl. LVEF; if patient stable on cannabidiol tx, initiate mavacamten at 2.5 mg qd; if adding short-term (<1wk) cannabidiol tx to existing mavacamten tx, hold mavacamten until cannabidiol D/C; if adding longer-term (>1wk) cannabidiol tx, decr. mavacamten dose as follows for at least 12wk: decr. mavacamten 15 mg qd to 10 mg qd; decr. mavacamten 10 mg qd to 5 mg qd; decr. mavacamten 5 mg qd to 2.5 mg qd; do not start cannabidiol tx if on mavacamten 2.5 mg qd: combo may incr. mavacamten levels, risk of heart failure, other adverse effects; may decr. cannabidiol and active metabolite levels, efficacy (hepatic metabolism inhibited; hepatic metabolism induced)

• mavorixafor
Epidiolex (cannabidiol (CBD))

+

mavorixafor

1 interaction

Monitor/Modify Tx

cannabidiol + mavorixafor

monitor ECG: combo may incr. mavorixafor levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (gut P-gp-mediated transport inhibited)

• methohexital
Epidiolex (cannabidiol (CBD))

+

methohexital

1 interaction

Monitor/Modify Tx

cannabidiol + methohexital

monitor respiratory rate: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• mirtazapine
Epidiolex (cannabidiol (CBD))

+

mirtazapine

1 interaction

Monitor/Modify Tx

cannabidiol + mirtazapine

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, mirtazapine may decr. seizure threshold)

• mitotane
Epidiolex (cannabidiol (CBD))

+

mitotane

1 interaction

Monitor/Modify Tx

cannabidiol + mitotane

consider cannabidiol dose adjustment: combo may decr. cannabidiol levels, efficacy; may incr. risk of CNS depression, psychomotor impairment (hepatic metabolism induced; additive effects)

• morphine
Epidiolex (cannabidiol (CBD))

+

morphine

1 interaction

Monitor/Modify Tx

cannabidiol + morphine

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. oral morphine levels, risk of profound CNS and respiratory depression, psychomotor impairment; may alter seizure control (gut P-gp-mediated transport inhibited, additive effects; antagonistic effects, morphine may decr. seizure threshold)

• mycophenolate mofetil
Epidiolex (cannabidiol (CBD))

+

mycophenolate mofetil

1 interaction

Monitor/Modify Tx

cannabidiol + mycophenolate mofetil

monitor CBC, consider monitoring mycophenolic acid levels: combo may incr. mycophenolic acid levels, risk of serious infection, myelosuppression, CNS depression, psychomotor impairment, other adverse effects (UGT inhibited, additive effects)

• mycophenolic acid
Epidiolex (cannabidiol (CBD))

+

mycophenolic acid

1 interaction

Monitor/Modify Tx

cannabidiol + mycophenolic acid

monitor CBC: combo may incr. mycophenolic acid levels, risk of serious infection, myelosuppression, other adverse effects (UGT inhibited)

• nalbuphine
Epidiolex (cannabidiol (CBD))

+

nalbuphine

1 interaction

Monitor/Modify Tx

cannabidiol + nalbuphine

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, nalbuphine may decr. seizure threshold)

• nelarabine
Epidiolex (cannabidiol (CBD))

+

nelarabine

1 interaction

Monitor/Modify Tx

cannabidiol + nelarabine

withhold nelarabine if Grade 2 or greater somnolence occurs: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, nelarabine may decr. seizure threshold)

• nintedanib
Epidiolex (cannabidiol (CBD))

+

nintedanib

1 interaction

Monitor/Modify Tx

cannabidiol + nintedanib

consider decr. nintedanib dose: combo may incr. nintedanib levels, risk of adverse effects (gut P-gp-mediated transport inhibited)

• olanzapine
Epidiolex (cannabidiol (CBD))

+

olanzapine

1 interaction

Monitor/Modify Tx

cannabidiol + olanzapine

monitor BP: combo may incr. risk of CNS depression, psychomotor impairment, hypotension, including orthostasis; may alter seizure control (additive effects; antagonistic effects, olanzapine may decr. seizure threshold)

• oliceridine
Epidiolex (cannabidiol (CBD))

+

oliceridine

1 interaction

Monitor/Modify Tx

cannabidiol + oliceridine

monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, hypotension; may alter seizure control (additive effects; antagonistic effects, oliceridine may decr. seizure threshold)

• omeprazole
Epidiolex (cannabidiol (CBD))

+

omeprazole

1 interaction

Monitor/Modify Tx

cannabidiol + omeprazole

consider decr. omeprazole dose if hypersecretory condition tx; otherwise, caution advised: combo may incr. omeprazole levels, risk of adverse effects (hepatic metabolism inhibited)

• opicapone
Epidiolex (cannabidiol (CBD))

+

opicapone

1 interaction

Monitor/Modify Tx

cannabidiol + opicapone

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• opium
Epidiolex (cannabidiol (CBD))

+

opium

1 interaction

Monitor/Modify Tx

cannabidiol + opium

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, morphine in opium may decr. seizure threshold)

• oxazepam
Epidiolex (cannabidiol (CBD))

+

oxazepam

1 interaction

Monitor/Modify Tx

cannabidiol + oxazepam

monitor respiratory rate: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• oxybutynin
Epidiolex (cannabidiol (CBD))

+

oxybutynin

1 interaction

Monitor/Modify Tx

cannabidiol + oxybutynin

decr. dose of one or both drugs or consider oxybutynin transdermal patch: combo may incr. risk of CNS depression, psychomotor impairment; somnolence less likely with oxybutynin transdermal patch (additive effects)

• oxycodone
Epidiolex (cannabidiol (CBD))

+

oxycodone

1 interaction

Monitor/Modify Tx

cannabidiol + oxycodone

monitor respiratory rate; decr. oxycodone start dose by at least 50%, consider decr. cannabidiol dose, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, oxycodone may decr. seizure threshold)

• oxymorphone
Epidiolex (cannabidiol (CBD))

+

oxymorphone

1 interaction

Monitor/Modify Tx

cannabidiol + oxymorphone

monitor respiratory rate; decr. oxymorphone start dose by at least 50%, consider decr. cannabidiol dose, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, oxymorphone may decr. seizure threshold)

• paclitaxel
Epidiolex (cannabidiol (CBD))

+

paclitaxel

1 interaction

Monitor/Modify Tx

cannabidiol + paclitaxel

monitor CBC: combo may incr. paclitaxel levels, risk of serious infection, myelosuppression, other adverse effects (hepatic metabolism possibly inhibited)

• pentazocine
Epidiolex (cannabidiol (CBD))

+

pentazocine

1 interaction

Monitor/Modify Tx

cannabidiol + pentazocine

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, pentazocine may decr. seizure threshold)

• pentobarbital
Epidiolex (cannabidiol (CBD))

+

pentobarbital

1 interaction

Monitor/Modify Tx

cannabidiol + pentobarbital

monitor respiratory rate; consider cannabidiol dose adjustment: combo may decr. cannabidiol levels, efficacy; may incr. risk of CNS and respiratory depression, psychomotor impairment (hepatic metabolism induced; additive effects)

• perphenazine
Epidiolex (cannabidiol (CBD))

+

perphenazine

1 interaction

Monitor/Modify Tx

cannabidiol + perphenazine

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, perphenazine may decr. seizure threshold)

• phenobarbital
Epidiolex (cannabidiol (CBD))

+

phenobarbital

1 interaction

Monitor/Modify Tx

cannabidiol + phenobarbital

monitor respiratory rate; consider cannabidiol dose adjustment: combo may decr. cannabidiol levels, efficacy; may incr. risk of CNS and respiratory depression, psychomotor impairment (hepatic metabolism induced; additive effects)

• phenytoin
Epidiolex (cannabidiol (CBD))

+

phenytoin

1 interaction

Monitor/Modify Tx

cannabidiol + phenytoin

monitor phenytoin levels; consider cannabidiol dose adjustment: combo may incr. phenytoin levels, risk of CNS depression, psychomotor impairment, other adverse effects; may decr. cannabidiol and active metabolite levels, efficacy (hepatic metabolism inhibited, additive effects; hepatic metabolism induced)

• pitavastatin
Epidiolex (cannabidiol (CBD))

+

pitavastatin

1 interaction

Monitor/Modify Tx

cannabidiol + pitavastatin

monitor CK, myopathy sx: combo may incr. pitavastatin levels, risk of myopathy, rhabdomyolysis, other adverse effects (gut P-gp-mediated transport inhibited)

• posaconazole
Epidiolex (cannabidiol (CBD))

+

posaconazole

1 interaction

Monitor/Modify Tx

cannabidiol + posaconazole

monitor ECG w/ oral posaconazole: combo may incr. posaconazole levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (gut P-gp-mediated transport inhibited)

• pravastatin
Epidiolex (cannabidiol (CBD))

+

pravastatin

1 interaction

Monitor/Modify Tx

cannabidiol + pravastatin

monitor CK, myopathy sx: combo may incr. pravastatin levels, risk of myopathy, rhabdomyolysis, other adverse effects (gut P-gp-mediated transport inhibited)

• pregabalin
Epidiolex (cannabidiol (CBD))

+

pregabalin

1 interaction

Monitor/Modify Tx

cannabidiol + pregabalin

monitor respiratory rate: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• primidone
Epidiolex (cannabidiol (CBD))

+

primidone

1 interaction

Monitor/Modify Tx

cannabidiol + primidone

monitor respiratory rate; consider cannabidiol dose adjustment: combo may decr. cannabidiol levels, efficacy; may incr. risk of CNS and respiratory depression, psychomotor impairment (hepatic metabolism induced; additive effects)

• propofol
Epidiolex (cannabidiol (CBD))

+

propofol

1 interaction

Monitor/Modify Tx

cannabidiol + propofol

monitor respiratory rate; consider decr. dose of one or both drugs: combo may incr. propofol levels, risk of CNS and respiratory depression, psychomotor impairment, other adverse effects; may alter seizure control (UGT inhibited, additive effects; antagonistic effects, propofol may decr. seizure threshold)

• quazepam
Epidiolex (cannabidiol (CBD))

+

quazepam

1 interaction

Monitor/Modify Tx

cannabidiol + quazepam

monitor respiratory rate; consider decr. dose of one or both drugs: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• quinidine (antiarrhythmic)
Epidiolex (cannabidiol (CBD))

+

quinidine (antiarrhythmic)

1 interaction

Monitor/Modify Tx

cannabidiol + quinidine (antiarrhythmic)

monitor quinidine levels, ECG: combo may incr. quinidine levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (gut P-gp-mediated transport inhibited)

• quinidine (CYP2D6 inhibitor)
Epidiolex (cannabidiol (CBD))

+

quinidine (CYP2D6 inhibitor)

1 interaction

Monitor/Modify Tx

cannabidiol + quinidine (CYP2D6 inhibitor)

monitor ECG: combo may incr. quinidine levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (gut P-gp-mediated transport inhibited)

• quinine
Epidiolex (cannabidiol (CBD))

+

quinine

1 interaction

Monitor/Modify Tx

cannabidiol + quinine

monitor ECG: combo may incr. quinine levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects; may alter seizure control (gut P-gp-mediated transport inhibited; antagonistic effects, quinine may decr. seizure threshold)

• ranolazine
Epidiolex (cannabidiol (CBD))

+

ranolazine

1 interaction

Monitor/Modify Tx

cannabidiol + ranolazine

monitor ECG; consider decr. ranolazine dose: combo may incr. ranolazine levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (gut P-gp-mediated transport inhibited)

• red yeast rice
Epidiolex (cannabidiol (CBD))

+

red yeast rice

1 interaction

Monitor/Modify Tx

cannabidiol + red yeast rice

monitor CK, myopathy sx w/ large amounts of red yeast rice: combo may incr. lovastatin levels, risk of myopathy, rhabdomyolysis, other adverse effects (gut P-gp-mediated transport inhibited, red yeast rice contains varying amounts of lovastatin)

• remifentanil
Epidiolex (cannabidiol (CBD))

+

remifentanil

1 interaction

Monitor/Modify Tx

cannabidiol + remifentanil

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, remifentanil may decr. seizure threshold)

• remimazolam
Epidiolex (cannabidiol (CBD))

+

remimazolam

1 interaction

Monitor/Modify Tx

cannabidiol + remimazolam

monitor respiratory rate; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• repaglinide
Epidiolex (cannabidiol (CBD))

+

repaglinide

1 interaction

Monitor/Modify Tx

cannabidiol + repaglinide

monitor glucose: combo may incr. repaglinide levels, risk of hypoglycemia, other adverse effects (hepatic metabolism possibly inhibited)

• rifabutin
Epidiolex (cannabidiol (CBD))

+

rifabutin

1 interaction

Monitor/Modify Tx

cannabidiol + rifabutin

consider cannabidiol dose adjustment: combo may decr. cannabidiol levels, efficacy (hepatic metabolism induced)

• rifampin
Epidiolex (cannabidiol (CBD))

+

rifampin

1 interaction

Monitor/Modify Tx

cannabidiol + rifampin

consider cannabidiol dose adjustment: combo may incr. oral rifampin levels, risk of adverse effects; may decr. cannabidiol and active metabolite levels, efficacy (gut P-gp-mediated transport inhibited; hepatic metabolism induced)

• rimegepant
Epidiolex (cannabidiol (CBD))

+

rimegepant

1 interaction

Monitor/Modify Tx

cannabidiol + rimegepant

separate rimegepant doses by at least 48h: combo may incr. rimegepant levels, risk of adverse effects (gut P-gp-mediated transport inhibited)

• riociguat
Epidiolex (cannabidiol (CBD))

+

riociguat

1 interaction

Monitor/Modify Tx

cannabidiol + riociguat

monitor BP; consider decr. riociguat start dose to 0.5 mg PO tid: combo may incr. riociguat levels, risk of severe hypotension, other adverse effects (gut P-gp-mediated transport inhibited)

• sevoflurane
Epidiolex (cannabidiol (CBD))

+

sevoflurane

1 interaction

Monitor/Modify Tx

cannabidiol + sevoflurane

monitor respiratory rate: combo may incr. risk of CNS and respiratory depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, sevoflurane may decr. seizure threshold)

• simvastatin
Epidiolex (cannabidiol (CBD))

+

simvastatin

1 interaction

Monitor/Modify Tx

cannabidiol + simvastatin

monitor CK, myopathy sx: combo may incr. simvastatin levels, risk of myopathy, rhabdomyolysis, other adverse effects (gut P-gp-mediated transport inhibited)

• sirolimus
Epidiolex (cannabidiol (CBD))

+

sirolimus

1 interaction

Monitor/Modify Tx

cannabidiol + sirolimus

monitor sirolimus levels: combo may incr. sirolimus levels, risk of serious infection, other adverse effects (gut P-gp-mediated transport inhibited)

• St. John's wort
Epidiolex (cannabidiol (CBD))

+

St. John's wort

1 interaction

Monitor/Modify Tx

cannabidiol + St. John's wort

consider cannabidiol dose adjustment: combo may decr. cannabidiol levels, efficacy (hepatic metabolism induced)

• sufentanil
Epidiolex (cannabidiol (CBD))

+

sufentanil

1 interaction

Monitor/Modify Tx

cannabidiol + sufentanil

monitor respiratory rate; decr. sufentanil start dose, consider decr. cannabidiol dose, use lowest effective doses: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, sufentanil may decr. seizure threshold)

• suvorexant
Epidiolex (cannabidiol (CBD))

+

suvorexant

1 interaction

Monitor/Modify Tx

cannabidiol + suvorexant

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• tacrolimus
Epidiolex (cannabidiol (CBD))

+

tacrolimus

1 interaction

Monitor/Modify Tx

cannabidiol + tacrolimus

monitor tacrolimus levels, ECG, renal fxn: combo may incr. tacrolimus levels, risk of QT prolongation, cardiac arrhythmias, nephrotoxicity, other adverse effects; may alter seizure control (gut P-gp-mediated transport inhibited; antagonistic effects, tacrolimus may decr. seizure threshold)

• talazoparib
Epidiolex (cannabidiol (CBD))

+

talazoparib

1 interaction

Monitor/Modify Tx

cannabidiol + talazoparib

monitor CBC: combo may incr. talazoparib levels, risk of myelosuppression, other adverse effects (gut P-gp-mediated transport inhibited)

• tapentadol
Epidiolex (cannabidiol (CBD))

+

tapentadol

1 interaction

Monitor/Modify Tx

cannabidiol + tapentadol

monitor respiratory rate, BP; decrease dose of one or both drugs, use lowest effective doses and shortest duration of concomitant treatment: combo may increase risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope; may alter seizure control (additive effects; antagonistic effects, tapentadol may decrease seizure threshold)

• temazepam
Epidiolex (cannabidiol (CBD))

+

temazepam

1 interaction

Monitor/Modify Tx

cannabidiol + temazepam

monitor respiratory rate: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• tenofovir alafenamide
Epidiolex (cannabidiol (CBD))

+

tenofovir alafenamide

1 interaction

Monitor/Modify Tx

cannabidiol + tenofovir alafenamide

if tenofovir alafenamide not admin. w/ cobicistat, monitor renal fxn w/ oral cannabidiol: combo may incr. tenofovir levels, risk of nephrotoxicity, other adverse effects (gut P-gp-mediated transport inhibited)

• tenofovir disoproxil
Epidiolex (cannabidiol (CBD))

+

tenofovir disoproxil

1 interaction

Monitor/Modify Tx

cannabidiol + tenofovir disoproxil

monitor renal fxn w/ oral cannabidiol: combo may incr. tenofovir levels, risk of nephrotoxicity, other adverse effects (gut P-gp-mediated transport inhibited)

• theophylline
Epidiolex (cannabidiol (CBD))

+

theophylline

1 interaction

Monitor/Modify Tx

cannabidiol + theophylline

monitor theophylline levels: combo may incr. theophylline levels, risk of cardiac arrhythmias, seizures, other toxicities; may alter seizure control (hepatic metabolism inhibited; antagonistic effects, theophylline may decr. seizure threshold)

• thioridazine
Epidiolex (cannabidiol (CBD))

+

thioridazine

1 interaction

Monitor/Modify Tx

cannabidiol + thioridazine

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, thioridazine may decr. seizure threshold)

• thiothixene
Epidiolex (cannabidiol (CBD))

+

thiothixene

1 interaction

Monitor/Modify Tx

cannabidiol + thiothixene

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, thiothixene may decr. seizure threshold)

• tofacitinib
Epidiolex (cannabidiol (CBD))

+

tofacitinib

1 interaction

Monitor/Modify Tx

cannabidiol + tofacitinib

ALL USES: monitor CBC; if also combined w/ strong CYP3A4 inhibitor, adjust as follows: ADULT RHEUMATOID or PSORIATIC ARTHRITIS or ANKYLOSING SPONDYLITIS: decr. tofacitinib to 5 mg qd; ADULT ULCERATIVE COLITIS: decr. tofacitinib induction to 5 mg tablet bid or 11 mg XR tablet qd for up to 16 wks, then 5 mg tablet qd maintenance; do not use XR tablet for maintenance; PEDIATRIC PSORIATIC ARTHRITIS, POLYARTICULAR COURSE JUVENILE IDIOPATHIC ARTHRITIS: decr. usual tofacitinib bid dose to qd: combo may incr. tofacitinib levels, risk of serious infection, myelosuppression, other adverse effects (hepatic metabolism inhibited)

• tramadol
Epidiolex (cannabidiol (CBD))

+

tramadol

1 interaction

Monitor/Modify Tx

cannabidiol + tramadol

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, tramadol may decr. seizure threshold)

• triazolam
Epidiolex (cannabidiol (CBD))

+

triazolam

1 interaction

Monitor/Modify Tx

cannabidiol + triazolam

monitor respiratory rate: combo may incr. risk of CNS and respiratory depression, psychomotor impairment (additive effects)

• ubrogepant
Epidiolex (cannabidiol (CBD))

+

ubrogepant

1 interaction

Monitor/Modify Tx

cannabidiol + ubrogepant

limit ubrogepant dose to 50 mg, may give second 50 mg dose after 2h if needed: combo may incr. ubrogepant levels, risk of adverse effects (gut P-gp-mediated transport inhibited)

• valproic acid
Epidiolex (cannabidiol (CBD))

+

valproic acid

1 interaction

Monitor/Modify Tx

cannabidiol + valproic acid

monitor ALT, AST, total bilirubin, ammonia levels: combo may incr. risk of CNS depression, psychomotor impairment, hepatocellular injury, hyperammonemia (additive effects)

• voriconazole
Epidiolex (cannabidiol (CBD))

+

voriconazole

1 interaction

Monitor/Modify Tx

cannabidiol + voriconazole

monitor ECG: combo may incr. voriconazole levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• warfarin
Epidiolex (cannabidiol (CBD))

+

warfarin

1 interaction

Monitor/Modify Tx

cannabidiol + warfarin

monitor INR, bleeding s/sx, especially during initiation/titration: combo may incr. warfarin levels, risk of bleeding (including life-threatening), other adverse effects (hepatic metabolism inhibited)

• zaleplon
Epidiolex (cannabidiol (CBD))

+

zaleplon

1 interaction

Monitor/Modify Tx

cannabidiol + zaleplon

consider dose reduction of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• ziconotide
Epidiolex (cannabidiol (CBD))

+

ziconotide

1 interaction

Monitor/Modify Tx

cannabidiol + ziconotide

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• zolpidem
Epidiolex (cannabidiol (CBD))

+

zolpidem

1 interaction

Monitor/Modify Tx

cannabidiol + zolpidem

consider decr. dose of one or both drugs: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

Caution Advised

• 5-HTP
Epidiolex (cannabidiol (CBD))

+

5-HTP

1 interaction

Caution Advised

cannabidiol + 5-HTP

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• acyclovir
Epidiolex (cannabidiol (CBD))

+

acyclovir

1 interaction

Caution Advised

cannabidiol + acyclovir

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, acyclovir may decr. seizure threshold)

• aliskiren
Epidiolex (cannabidiol (CBD))

+

aliskiren

1 interaction

Caution Advised

cannabidiol + aliskiren

caution advised: combo may incr. aliskiren levels, risk of adverse effects (gut P-gp-mediated transport inhibited)

• allopurinol
Epidiolex (cannabidiol (CBD))

+

allopurinol

1 interaction

Caution Advised

cannabidiol + allopurinol

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• almotriptan
Epidiolex (cannabidiol (CBD))

+

almotriptan

1 interaction

Caution Advised

cannabidiol + almotriptan

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• alosetron
Epidiolex (cannabidiol (CBD))

+

alosetron

1 interaction

Caution Advised

cannabidiol + alosetron

caution advised: combo may incr. alosetron levels, risk of adverse effects (hepatic metabolism inhibited)

• amantadine
Epidiolex (cannabidiol (CBD))

+

amantadine

1 interaction

Caution Advised

cannabidiol + amantadine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• amitriptyline
Epidiolex (cannabidiol (CBD))

+

amitriptyline

1 interaction

Caution Advised

cannabidiol + amitriptyline

caution advised: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, amitriptyline may decr. seizure threshold)

• amoxapine
Epidiolex (cannabidiol (CBD))

+

amoxapine

1 interaction

Caution Advised

cannabidiol + amoxapine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, amoxapine may decr. seizure threshold)

• amoxicillin
Epidiolex (cannabidiol (CBD))

+

amoxicillin

1 interaction

Caution Advised

cannabidiol + amoxicillin

caution advised, especially w/ high amoxicillin doses or concomitant renal impairment: combo may alter seizure control (antagonistic effects, amoxicillin may decr. seizure threshold)

• amphetamine
Epidiolex (cannabidiol (CBD))

+

amphetamine

1 interaction

Caution Advised

cannabidiol + amphetamine

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, amphetamine may decr. seizure threshold)

• ampicillin
Epidiolex (cannabidiol (CBD))

+

ampicillin

1 interaction

Caution Advised

cannabidiol + ampicillin

caution advised, especially w/ high ampicillin doses or concomitant renal impairment: combo may alter seizure control (antagonistic effects, ampicillin may decr. seizure threshold)

• apomorphine
Epidiolex (cannabidiol (CBD))

+

apomorphine

1 interaction

Caution Advised

cannabidiol + apomorphine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• apraclonidine ophthalmic
Epidiolex (cannabidiol (CBD))

+

apraclonidine ophthalmic

1 interaction

Caution Advised

cannabidiol + apraclonidine ophthalmic

caution advised if apraclonidine IOP adjunct use; postop use OK: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• aripiprazole bimonthly injection
Epidiolex (cannabidiol (CBD))

+

aripiprazole bimonthly injection

1 interaction

Caution Advised

cannabidiol + aripiprazole bimonthly injection

caution advised: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, aripiprazole may decr. seizure threshold)

• aripiprazole lauroxil
Epidiolex (cannabidiol (CBD))

+

aripiprazole lauroxil

1 interaction

Caution Advised

cannabidiol + aripiprazole lauroxil

caution advised: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, aripiprazole may decr. seizure threshold)

• aripiprazole monthly injection
Epidiolex (cannabidiol (CBD))

+

aripiprazole monthly injection

1 interaction

Caution Advised

cannabidiol + aripiprazole monthly injection

caution advised: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, aripiprazole may decr. seizure threshold)

• aripiprazole oral
Epidiolex (cannabidiol (CBD))

+

aripiprazole oral

1 interaction

Caution Advised

cannabidiol + aripiprazole oral

caution advised: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, aripiprazole may decr. seizure threshold)

• artesunate
Epidiolex (cannabidiol (CBD))

+

artesunate

1 interaction

Caution Advised

cannabidiol + artesunate

caution advised: combo may incr. dihydroartemisinin levels, risk of adverse effects (UGT inhibited; artesunate converted to dihydroartemisinin by esterases)

• asenapine
Epidiolex (cannabidiol (CBD))

+

asenapine

1 interaction

Caution Advised

cannabidiol + asenapine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, asenapine may decr. seizure threshold)

• axicabtagene ciloleucel
Epidiolex (cannabidiol (CBD))

+

axicabtagene ciloleucel

1 interaction

Caution Advised

cannabidiol + axicabtagene ciloleucel

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, axicabtagene ciloleucel may decr. seizure threshold)

• baclofen
Epidiolex (cannabidiol (CBD))

+

baclofen

1 interaction

Caution Advised

cannabidiol + baclofen

caution advised: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, baclofen may decr. seizure threshold)

• benzphetamine
Epidiolex (cannabidiol (CBD))

+

benzphetamine

1 interaction

Caution Advised

cannabidiol + benzphetamine

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, benzphetamine may decr. seizure threshold)

• betamethasone
Epidiolex (cannabidiol (CBD))

+

betamethasone

1 interaction

Caution Advised

cannabidiol + betamethasone

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, betamethasone may decr. seizure threshold)

• brexpiprazole
Epidiolex (cannabidiol (CBD))

+

brexpiprazole

1 interaction

Caution Advised

cannabidiol + brexpiprazole

caution advised: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, brexpiprazole may decr. seizure threshold)

• brexucabtagene autoleucel
Epidiolex (cannabidiol (CBD))

+

brexucabtagene autoleucel

1 interaction

Caution Advised

cannabidiol + brexucabtagene autoleucel

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, brexucabtagene autoleucel may decr. seizure threshold)

• brimonidine ophthalmic
Epidiolex (cannabidiol (CBD))

+

brimonidine ophthalmic

1 interaction

Caution Advised

cannabidiol + brimonidine ophthalmic

caution advised if elevated IOP or presbyopia use; OTC ocular redness use OK: combo may increase risk of CNS depression, psychomotor impairment (additive effects)

• brimonidine topical
Epidiolex (cannabidiol (CBD))

+

brimonidine topical

1 interaction

Caution Advised

cannabidiol + brimonidine topical

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• brivaracetam
Epidiolex (cannabidiol (CBD))

+

brivaracetam

1 interaction

Caution Advised

cannabidiol + brivaracetam

caution advised: combo may incr. brivaracetam levels, risk of CNS depression, psychomotor impairment, other adverse effects (mechanism unknown, additive effects)

• bromocriptine
Epidiolex (cannabidiol (CBD))

+

bromocriptine

1 interaction

Caution Advised

cannabidiol + bromocriptine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• brompheniramine
Epidiolex (cannabidiol (CBD))

+

brompheniramine

1 interaction

Caution Advised

cannabidiol + brompheniramine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• buspirone
Epidiolex (cannabidiol (CBD))

+

buspirone

1 interaction

Caution Advised

cannabidiol + buspirone

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• busulfan
Epidiolex (cannabidiol (CBD))

+

busulfan

1 interaction

Caution Advised

cannabidiol + busulfan

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, busulfan may decr. seizure threshold)

• carbinoxamine
Epidiolex (cannabidiol (CBD))

+

carbinoxamine

1 interaction

Caution Advised

cannabidiol + carbinoxamine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• cariprazine
Epidiolex (cannabidiol (CBD))

+

cariprazine

1 interaction

Caution Advised

cannabidiol + cariprazine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, cariprazine may decr. seizure threshold)

• carisoprodol
Epidiolex (cannabidiol (CBD))

+

carisoprodol

1 interaction

Caution Advised

cannabidiol + carisoprodol

caution advised: combo may incr. carisoprodol levels, decr. active metabolite meprobamate levels, alter risk of adverse effects and efficacy; may incr. risk of CNS depression, psychomotor impairment (hepatic metabolism inhibited, decr. conversion to active metabolite; additive effects)

• cefazolin
Epidiolex (cannabidiol (CBD))

+

cefazolin

1 interaction

Caution Advised

cannabidiol + cefazolin

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, cefazolin may decr. seizure threshold)

• cefepime
Epidiolex (cannabidiol (CBD))

+

cefepime

1 interaction

Caution Advised

cannabidiol + cefepime

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, cefepime may decr. seizure threshold)

• cefiderocol
Epidiolex (cannabidiol (CBD))

+

cefiderocol

1 interaction

Caution Advised

cannabidiol + cefiderocol

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, cefiderocol may decr. seizure threshold)

• ceftaroline
Epidiolex (cannabidiol (CBD))

+

ceftaroline

1 interaction

Caution Advised

cannabidiol + ceftaroline

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, ceftaroline may decr. seizure threshold)

• ceftazidime
Epidiolex (cannabidiol (CBD))

+

ceftazidime

1 interaction

Caution Advised

cannabidiol + ceftazidime

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, ceftazidime may decr. seizure threshold)

• ceftobiprole
Epidiolex (cannabidiol (CBD))

+

ceftobiprole

1 interaction

Caution Advised

cannabidiol + ceftobiprole

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, ceftobiprole may decr. seizure threshold)

• cenobamate
Epidiolex (cannabidiol (CBD))

+

cenobamate

1 interaction

Caution Advised

cannabidiol + cenobamate

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• cetirizine
Epidiolex (cannabidiol (CBD))

+

cetirizine

1 interaction

Caution Advised

cannabidiol + cetirizine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• chamomile, German
Epidiolex (cannabidiol (CBD))

+

chamomile, German

1 interaction

Caution Advised

cannabidiol + chamomile, German

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• chlophedianol
Epidiolex (cannabidiol (CBD))

+

chlophedianol

1 interaction

Caution Advised

cannabidiol + chlophedianol

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• chlorambucil
Epidiolex (cannabidiol (CBD))

+

chlorambucil

1 interaction

Caution Advised

cannabidiol + chlorambucil

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, chlorambucil may decr. seizure threshold)

• chlorcyclizine
Epidiolex (cannabidiol (CBD))

+

chlorcyclizine

1 interaction

Caution Advised

cannabidiol + chlorcyclizine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• chloroquine
Epidiolex (cannabidiol (CBD))

+

chloroquine

1 interaction

Caution Advised

cannabidiol + chloroquine

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, chloroquine may decr. seizure threshold)

• chlorpheniramine
Epidiolex (cannabidiol (CBD))

+

chlorpheniramine

1 interaction

Caution Advised

cannabidiol + chlorpheniramine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• chlorzoxazone
Epidiolex (cannabidiol (CBD))

+

chlorzoxazone

1 interaction

Caution Advised

cannabidiol + chlorzoxazone

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• ciltacabtagene autoleucel
Epidiolex (cannabidiol (CBD))

+

ciltacabtagene autoleucel

1 interaction

Caution Advised

cannabidiol + ciltacabtagene autoleucel

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, ciltacabtagene autoleucel may decr. seizure threshold)

• ciprofloxacin
Epidiolex (cannabidiol (CBD))

+

ciprofloxacin

1 interaction

Caution Advised

cannabidiol + ciprofloxacin

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, ciprofloxacin may decr. seizure threshold)

• cisatracurium
Epidiolex (cannabidiol (CBD))

+

cisatracurium

1 interaction

Caution Advised

cannabidiol + cisatracurium

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, cisatracurium active metabolite may decr. seizure threshold)

• clemastine
Epidiolex (cannabidiol (CBD))

+

clemastine

1 interaction

Caution Advised

cannabidiol + clemastine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• clomipramine
Epidiolex (cannabidiol (CBD))

+

clomipramine

1 interaction

Caution Advised

cannabidiol + clomipramine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, clomipramine may decr. seizure threshold)

• cocaine
Epidiolex (cannabidiol (CBD))

+

cocaine

1 interaction

Caution Advised

cannabidiol + cocaine

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, cocaine may decr. seizure threshold)

• cortisone
Epidiolex (cannabidiol (CBD))

+

cortisone

1 interaction

Caution Advised

cannabidiol + cortisone

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, cortisone may decr. seizure threshold)

• cyclobenzaprine
Epidiolex (cannabidiol (CBD))

+

cyclobenzaprine

1 interaction

Caution Advised

cannabidiol + cyclobenzaprine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, cyclobenzaprine may decr. seizure threshold)

• cycloserine
Epidiolex (cannabidiol (CBD))

+

cycloserine

1 interaction

Caution Advised

cannabidiol + cycloserine

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, cycloserine may decr. seizure threshold)

• cyproheptadine
Epidiolex (cannabidiol (CBD))

+

cyproheptadine

1 interaction

Caution Advised

cannabidiol + cyproheptadine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• dantrolene
Epidiolex (cannabidiol (CBD))

+

dantrolene

1 interaction

Caution Advised

cannabidiol + dantrolene

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• darbepoetin alfa
Epidiolex (cannabidiol (CBD))

+

darbepoetin alfa

1 interaction

Caution Advised

cannabidiol + darbepoetin alfa

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, darbepoetin alfa may decr. seizure threshold)

• darifenacin
Epidiolex (cannabidiol (CBD))

+

darifenacin

1 interaction

Caution Advised

cannabidiol + darifenacin

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• darolutamide
Epidiolex (cannabidiol (CBD))

+

darolutamide

1 interaction

Caution Advised

cannabidiol + darolutamide

if also combined w/ strong CYP3A4 inhibitor, caution advised: combo may incr. darolutamide levels, risk of adverse effects; may alter seizure control (gut P-gp-mediated transport inhibited; antagonistic effects, darolutamide may decr. seizure threshold)

• deflazacort
Epidiolex (cannabidiol (CBD))

+

deflazacort

1 interaction

Caution Advised

cannabidiol + deflazacort

caution advised: combo may incr. deflazacort active metabolite levels, risk of systemic corticosteroid effects including Cushing syndrome and adrenal suppression; may alter seizure control (gut P-gp-mediated transport inhibited; antagonistic effects, deflazacort may decr. seizure threshold)

• delafloxacin
Epidiolex (cannabidiol (CBD))

+

delafloxacin

1 interaction

Caution Advised

cannabidiol + delafloxacin

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, delafloxacin may decr. seizure threshold)

• desipramine
Epidiolex (cannabidiol (CBD))

+

desipramine

1 interaction

Caution Advised

cannabidiol + desipramine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, desipramine may decr. seizure threshold)

• desvenlafaxine
Epidiolex (cannabidiol (CBD))

+

desvenlafaxine

1 interaction

Caution Advised

cannabidiol + desvenlafaxine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, desvenlafaxine may decr. seizure threshold)

• deutetrabenazine
Epidiolex (cannabidiol (CBD))

+

deutetrabenazine

1 interaction

Caution Advised

cannabidiol + deutetrabenazine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• dexamethasone
Epidiolex (cannabidiol (CBD))

+

dexamethasone

1 interaction

Caution Advised

cannabidiol + dexamethasone

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, dexamethasone may decr. seizure threshold)

• dexbrompheniramine
Epidiolex (cannabidiol (CBD))

+

dexbrompheniramine

1 interaction

Caution Advised

cannabidiol + dexbrompheniramine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• dexchlorpheniramine
Epidiolex (cannabidiol (CBD))

+

dexchlorpheniramine

1 interaction

Caution Advised

cannabidiol + dexchlorpheniramine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• dexlansoprazole
Epidiolex (cannabidiol (CBD))

+

dexlansoprazole

1 interaction

Caution Advised

cannabidiol + dexlansoprazole

caution advised: combo may incr. dexlansoprazole levels, risk of adverse effects (hepatic metabolism inhibited)

• dexmethylphenidate
Epidiolex (cannabidiol (CBD))

+

dexmethylphenidate

1 interaction

Caution Advised

cannabidiol + dexmethylphenidate

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, (ser)dexmethylphenidate may decr. seizure threshold)

• dextroamphetamine
Epidiolex (cannabidiol (CBD))

+

dextroamphetamine

1 interaction

Caution Advised

cannabidiol + dextroamphetamine

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, dextroamphetamine may decr. seizure threshold)

• dichlorphenamide
Epidiolex (cannabidiol (CBD))

+

dichlorphenamide

1 interaction

Caution Advised

cannabidiol + dichlorphenamide

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• dicloxacillin
Epidiolex (cannabidiol (CBD))

+

dicloxacillin

1 interaction

Caution Advised

cannabidiol + dicloxacillin

caution advised: combo may decr. cannabidiol and active metabolite levels, efficacy; may alter seizure control (hepatic metabolism induced; antagonistic effects, dicloxacillin may decr. seizure threshold)

• diethylpropion
Epidiolex (cannabidiol (CBD))

+

diethylpropion

1 interaction

Caution Advised

cannabidiol + diethylpropion

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, diethylpropion may decr. seizure threshold)

• difelikefalin
Epidiolex (cannabidiol (CBD))

+

difelikefalin

1 interaction

Caution Advised

cannabidiol + difelikefalin

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• difenoxin
Epidiolex (cannabidiol (CBD))

+

difenoxin

1 interaction

Caution Advised

cannabidiol + difenoxin

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• diflunisal
Epidiolex (cannabidiol (CBD))

+

diflunisal

1 interaction

Caution Advised

cannabidiol + diflunisal

caution advised: combo may incr. diflunisal levels, risk of adverse effects (UGT inhibited)

• dimenhydrinate
Epidiolex (cannabidiol (CBD))

+

dimenhydrinate

1 interaction

Caution Advised

cannabidiol + dimenhydrinate

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• diphenhydramine
Epidiolex (cannabidiol (CBD))

+

diphenhydramine

1 interaction

Caution Advised

cannabidiol + diphenhydramine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• diphenoxylate
Epidiolex (cannabidiol (CBD))

+

diphenoxylate

1 interaction

Caution Advised

cannabidiol + diphenoxylate

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• domperidone
Epidiolex (cannabidiol (CBD))

+

domperidone

1 interaction

Caution Advised

cannabidiol + domperidone

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• donepezil
Epidiolex (cannabidiol (CBD))

+

donepezil

1 interaction

Caution Advised

cannabidiol + donepezil

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, donepezil may decr. seizure threshold)

• doxepin
Epidiolex (cannabidiol (CBD))

+

doxepin

1 interaction

Caution Advised

cannabidiol + doxepin

caution advised: combo may incr. doxepin levels, risk of CNS depression, psychomotor impairment, other adverse effects; may alter seizure control (hepatic metabolism inhibited, additive effects; antagonistic effects, doxepin may decr. seizure threshold)

• doxepin topical
Epidiolex (cannabidiol (CBD))

+

doxepin topical

1 interaction

Caution Advised

cannabidiol + doxepin topical

caution advised: combo may incr. doxepin levels, risk of CNS depression, psychomotor impairment, other adverse effects (hepatic metabolism inhibited, additive effects)

• dronabinol
Epidiolex (cannabidiol (CBD))

+

dronabinol

1 interaction

Caution Advised

cannabidiol + dronabinol

caution advised: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, dronabinol may decr. seizure threshold)

• duloxetine
Epidiolex (cannabidiol (CBD))

+

duloxetine

1 interaction

Caution Advised

cannabidiol + duloxetine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, duloxetine may decr. seizure threshold)

• efavirenz
Epidiolex (cannabidiol (CBD))

+

efavirenz

1 interaction

Caution Advised

cannabidiol + efavirenz

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• eletriptan
Epidiolex (cannabidiol (CBD))

+

eletriptan

1 interaction

Caution Advised

cannabidiol + eletriptan

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• elinzanetant
Epidiolex (cannabidiol (CBD))

+

elinzanetant

1 interaction

Caution Advised

cannabidiol + elinzanetant

caution advised if seizure disorder use: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, elinzanetant may decr. seizure threshold)

• elivaldogene autotemcel
Epidiolex (cannabidiol (CBD))

+

elivaldogene autotemcel

1 interaction

Caution Advised

cannabidiol + elivaldogene autotemcel

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, elivaldogene autotemcel may decr. seizure threshold)

• entacapone
Epidiolex (cannabidiol (CBD))

+

entacapone

1 interaction

Caution Advised

cannabidiol + entacapone

caution advised: combo may incr. entacapone levels, risk of CNS depression, psychomotor impairment, other adverse effects (UGT inhibited, additive effects)

• entrectinib
Epidiolex (cannabidiol (CBD))

+

entrectinib

1 interaction

Caution Advised

cannabidiol + entrectinib

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• ephedra
Epidiolex (cannabidiol (CBD))

+

ephedra

1 interaction

Caution Advised

cannabidiol + ephedra

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, ephedra may decr. seizure threshold)

• epoetin alfa
Epidiolex (cannabidiol (CBD))

+

epoetin alfa

1 interaction

Caution Advised

cannabidiol + epoetin alfa

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, epoetin alfa may decr. seizure threshold)

• ertapenem
Epidiolex (cannabidiol (CBD))

+

ertapenem

1 interaction

Caution Advised

cannabidiol + ertapenem

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, ertapenem may decr. seizure threshold)

• escitalopram
Epidiolex (cannabidiol (CBD))

+

escitalopram

1 interaction

Caution Advised

cannabidiol + escitalopram

caution advised: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, escitalopram may decr. seizure threshold)

• eslicarbazepine acetate
Epidiolex (cannabidiol (CBD))

+

eslicarbazepine acetate

1 interaction

Caution Advised

cannabidiol + eslicarbazepine acetate

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• ethosuximide
Epidiolex (cannabidiol (CBD))

+

ethosuximide

1 interaction

Caution Advised

cannabidiol + ethosuximide

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• felbamate
Epidiolex (cannabidiol (CBD))

+

felbamate

1 interaction

Caution Advised

cannabidiol + felbamate

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• fenfluramine
Epidiolex (cannabidiol (CBD))

+

fenfluramine

1 interaction

Caution Advised

cannabidiol + fenfluramine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• fenofibrate
Epidiolex (cannabidiol (CBD))

+

fenofibrate

1 interaction

Caution Advised

cannabidiol + fenofibrate

caution advised: combo may incr. fenofibric acid levels, risk of adverse effects (UGT inhibited)

• fenofibric acid
Epidiolex (cannabidiol (CBD))

+

fenofibric acid

1 interaction

Caution Advised

cannabidiol + fenofibric acid

caution advised: combo may incr. fenofibric acid levels, risk of adverse effects (UGT inhibited)

• fesoterodine
Epidiolex (cannabidiol (CBD))

+

fesoterodine

1 interaction

Caution Advised

cannabidiol + fesoterodine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• fluoxetine
Epidiolex (cannabidiol (CBD))

+

fluoxetine

1 interaction

Caution Advised

cannabidiol + fluoxetine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, fluoxetine may decr. seizure threshold)

• fluvoxamine
Epidiolex (cannabidiol (CBD))

+

fluvoxamine

1 interaction

Caution Advised

cannabidiol + fluvoxamine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, fluvoxamine may decr. seizure threshold)

• foscarnet
Epidiolex (cannabidiol (CBD))

+

foscarnet

1 interaction

Caution Advised

cannabidiol + foscarnet

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, foscarnet may decr. seizure threshold)

• foslevodopa
Epidiolex (cannabidiol (CBD))

+

foslevodopa

1 interaction

Caution Advised

cannabidiol + foslevodopa

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• frovatriptan
Epidiolex (cannabidiol (CBD))

+

frovatriptan

1 interaction

Caution Advised

cannabidiol + frovatriptan

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• galantamine
Epidiolex (cannabidiol (CBD))

+

galantamine

1 interaction

Caution Advised

cannabidiol + galantamine

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, galantamine may decr. seizure threshold)

• ganciclovir
Epidiolex (cannabidiol (CBD))

+

ganciclovir

1 interaction

Caution Advised

cannabidiol + ganciclovir

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, ganciclovir may decr. seizure threshold)

• glecaprevir
Epidiolex (cannabidiol (CBD))

+

glecaprevir

1 interaction

Caution Advised

cannabidiol + glecaprevir

caution advised: combo may incr. glecaprevir levels, risk of adverse effects (gut P-gp-mediated transport inhibited)

• glofitamab
Epidiolex (cannabidiol (CBD))

+

glofitamab

1 interaction

Caution Advised

cannabidiol + glofitamab

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• glycopyrrolate
Epidiolex (cannabidiol (CBD))

+

glycopyrrolate

1 interaction

Caution Advised

cannabidiol + glycopyrrolate

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• goserelin
Epidiolex (cannabidiol (CBD))

+

goserelin

1 interaction

Caution Advised

cannabidiol + goserelin

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, goserelin may decr. seizure threshold)

• guanfacine
Epidiolex (cannabidiol (CBD))

+

guanfacine

1 interaction

Caution Advised

cannabidiol + guanfacine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• histrelin
Epidiolex (cannabidiol (CBD))

+

histrelin

1 interaction

Caution Advised

cannabidiol + histrelin

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, histrelin may decr. seizure threshold)

• hydroxychloroquine
Epidiolex (cannabidiol (CBD))

+

hydroxychloroquine

1 interaction

Caution Advised

cannabidiol + hydroxychloroquine

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, hydroxychloroquine may decr. seizure threshold)

• hyoscyamine
Epidiolex (cannabidiol (CBD))

+

hyoscyamine

1 interaction

Caution Advised

cannabidiol + hyoscyamine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• idecabtagene vicleucel
Epidiolex (cannabidiol (CBD))

+

idecabtagene vicleucel

1 interaction

Caution Advised

cannabidiol + idecabtagene vicleucel

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, idecabtagene vicleucel may decr. seizure threshold)

• iloperidone
Epidiolex (cannabidiol (CBD))

+

iloperidone

1 interaction

Caution Advised

cannabidiol + iloperidone

caution advised: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, iloperidone may decr. seizure threshold)

• imipenem
Epidiolex (cannabidiol (CBD))

+

imipenem

1 interaction

Caution Advised

cannabidiol + imipenem

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, imipenem may decr. seizure threshold)

• imipramine
Epidiolex (cannabidiol (CBD))

+

imipramine

1 interaction

Caution Advised

cannabidiol + imipramine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, imipramine may decr. seizure threshold)

• interferon beta 1a
Epidiolex (cannabidiol (CBD))

+

interferon beta 1a

1 interaction

Caution Advised

cannabidiol + interferon beta 1a

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, interferon beta 1a may decr. seizure threshold)

• interferon beta 1b
Epidiolex (cannabidiol (CBD))

+

interferon beta 1b

1 interaction

Caution Advised

cannabidiol + interferon beta 1b

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, interferon beta 1b may decr. seizure threshold)

• iohexol
Epidiolex (cannabidiol (CBD))

+

iohexol

1 interaction

Caution Advised

cannabidiol + iohexol

caution advised if intrathecal iohexol use: combo may alter seizure control (antagonistic effects, intrathecal iohexol may decr. seizure threshold)

• iopamidol
Epidiolex (cannabidiol (CBD))

+

iopamidol

1 interaction

Caution Advised

cannabidiol + iopamidol

caution advised if intrathecal iopamidol use: combo may alter seizure control (antagonistic effects, intrathecal iopamidol may decr. seizure threshold)

• isoniazid
Epidiolex (cannabidiol (CBD))

+

isoniazid

1 interaction

Caution Advised

cannabidiol + isoniazid

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, isoniazid may decr. seizure threshold)

• ketorolac
Epidiolex (cannabidiol (CBD))

+

ketorolac

1 interaction

Caution Advised

cannabidiol + ketorolac

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, ketorolac may decr. seizure threshold)

• lacosamide
Epidiolex (cannabidiol (CBD))

+

lacosamide

1 interaction

Caution Advised

cannabidiol + lacosamide

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• lamotrigine
Epidiolex (cannabidiol (CBD))

+

lamotrigine

1 interaction

Caution Advised

cannabidiol + lamotrigine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• lansoprazole
Epidiolex (cannabidiol (CBD))

+

lansoprazole

1 interaction

Caution Advised

cannabidiol + lansoprazole

caution advised: combo may incr. lansoprazole levels, risk of adverse effects (hepatic metabolism inhibited)

• larotrectinib
Epidiolex (cannabidiol (CBD))

+

larotrectinib

1 interaction

Caution Advised

cannabidiol + larotrectinib

caution advised: combo may incr. larotrectinib levels, risk of adverse effects (gut P-gp-mediated transport inhibited)

• leuprolide
Epidiolex (cannabidiol (CBD))

+

leuprolide

1 interaction

Caution Advised

cannabidiol + leuprolide

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, leuprolide may decr. seizure threshold)

• levetiracetam
Epidiolex (cannabidiol (CBD))

+

levetiracetam

1 interaction

Caution Advised

cannabidiol + levetiracetam

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• levocarnitine
Epidiolex (cannabidiol (CBD))

+

levocarnitine

1 interaction

Caution Advised

cannabidiol + levocarnitine

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, levocarnitine may decr. seizure threshold)

• levocetirizine
Epidiolex (cannabidiol (CBD))

+

levocetirizine

1 interaction

Caution Advised

cannabidiol + levocetirizine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• levodopa
Epidiolex (cannabidiol (CBD))

+

levodopa

1 interaction

Caution Advised

cannabidiol + levodopa

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• levofloxacin
Epidiolex (cannabidiol (CBD))

+

levofloxacin

1 interaction

Caution Advised

cannabidiol + levofloxacin

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, levofloxacin may decr. seizure threshold)

• levomilnacipran
Epidiolex (cannabidiol (CBD))

+

levomilnacipran

1 interaction

Caution Advised

cannabidiol + levomilnacipran

caution advised: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, levomilnacipran may decr. seizure threshold)

• lidocaine
Epidiolex (cannabidiol (CBD))

+

lidocaine

1 interaction

Caution Advised

cannabidiol + lidocaine

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, lidocaine may decr. seizure threshold)

• lidocaine topical
Epidiolex (cannabidiol (CBD))

+

lidocaine topical

1 interaction

Caution Advised

cannabidiol + lidocaine topical

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, lidocaine may decr. seizure threshold)

• linezolid
Epidiolex (cannabidiol (CBD))

+

linezolid

1 interaction

Caution Advised

cannabidiol + linezolid

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, linezolid may decr. seizure threshold)

• linvoseltamab
Epidiolex (cannabidiol (CBD))

+

linvoseltamab

1 interaction

Caution Advised

cannabidiol + linvoseltamab

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• lisdexamfetamine
Epidiolex (cannabidiol (CBD))

+

lisdexamfetamine

1 interaction

Caution Advised

cannabidiol + lisdexamfetamine

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, dextroamphetamine may decr. seizure threshold)

• lisocabtagene maraleucel
Epidiolex (cannabidiol (CBD))

+

lisocabtagene maraleucel

1 interaction

Caution Advised

cannabidiol + lisocabtagene maraleucel

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, lisocabtagene maraleucel may decr. seizure threshold)

• lithium
Epidiolex (cannabidiol (CBD))

+

lithium

1 interaction

Caution Advised

cannabidiol + lithium

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, lithium may decr. seizure threshold)

• lofexidine
Epidiolex (cannabidiol (CBD))

+

lofexidine

1 interaction

Caution Advised

cannabidiol + lofexidine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• lorlatinib
Epidiolex (cannabidiol (CBD))

+

lorlatinib

1 interaction

Caution Advised

cannabidiol + lorlatinib

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, lorlatinib may decr. seizure threshold)

• loxapine
Epidiolex (cannabidiol (CBD))

+

loxapine

1 interaction

Caution Advised

cannabidiol + loxapine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, loxapine may decr. seizure threshold)

• lumateperone
Epidiolex (cannabidiol (CBD))

+

lumateperone

1 interaction

Caution Advised

cannabidiol + lumateperone

caution advised: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, lumateperone may decr. seizure threshold)

• lurasidone
Epidiolex (cannabidiol (CBD))

+

lurasidone

1 interaction

Caution Advised

cannabidiol + lurasidone

caution advised: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, lurasidone may decr. seizure threshold)

• magnesium citrate
Epidiolex (cannabidiol (CBD))

+

magnesium citrate

1 interaction

Caution Advised

cannabidiol + magnesium citrate

caution advised, especially if magnesium citrate bowel prep use: combo may alter seizure control (antagonistic effects, magnesium citrate may decr. seizure threshold)

• maraviroc
Epidiolex (cannabidiol (CBD))

+

maraviroc

1 interaction

Caution Advised

cannabidiol + maraviroc

caution advised: combo may incr. maraviroc levels, risk of adverse effects (gut P-gp-mediated transport inhibited)

• meclizine
Epidiolex (cannabidiol (CBD))

+

meclizine

1 interaction

Caution Advised

cannabidiol + meclizine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• mefloquine
Epidiolex (cannabidiol (CBD))

+

mefloquine

1 interaction

Caution Advised

cannabidiol + mefloquine

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, mefloquine may decr. seizure threshold)

• melatonin
Epidiolex (cannabidiol (CBD))

+

melatonin

1 interaction

Caution Advised

cannabidiol + melatonin

caution advised: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, melatonin may decr. seizure threshold)

• meprobamate
Epidiolex (cannabidiol (CBD))

+

meprobamate

1 interaction

Caution Advised

cannabidiol + meprobamate

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• meropenem
Epidiolex (cannabidiol (CBD))

+

meropenem

1 interaction

Caution Advised

cannabidiol + meropenem

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, meropenem may decr. seizure threshold)

• methamphetamine
Epidiolex (cannabidiol (CBD))

+

methamphetamine

1 interaction

Caution Advised

cannabidiol + methamphetamine

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, methamphetamine may decr. seizure threshold)

• methocarbamol
Epidiolex (cannabidiol (CBD))

+

methocarbamol

1 interaction

Caution Advised

cannabidiol + methocarbamol

caution advised: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, methocarbamol may decr. seizure threshold)

• methotrexate
Epidiolex (cannabidiol (CBD))

+

methotrexate

1 interaction

Caution Advised

cannabidiol + methotrexate

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, methotrexate may decr. seizure threshold)

• methoxy polyethylene glycol-epoetin beta
Epidiolex (cannabidiol (CBD))

+

methoxy polyethylene glycol-epoetin beta

1 interaction

Caution Advised

cannabidiol + methoxy polyethylene glycol-epoetin beta

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, methoxy polyethylene glycol-epoetin beta may decr. seizure threshold)

• methsuximide
Epidiolex (cannabidiol (CBD))

+

methsuximide

1 interaction

Caution Advised

cannabidiol + methsuximide

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• methyldopa
Epidiolex (cannabidiol (CBD))

+

methyldopa

1 interaction

Caution Advised

cannabidiol + methyldopa

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• metronidazole
Epidiolex (cannabidiol (CBD))

+

metronidazole

1 interaction

Caution Advised

cannabidiol + metronidazole

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, metronidazole may decr. seizure threshold)

• metyrapone
Epidiolex (cannabidiol (CBD))

+

metyrapone

1 interaction

Caution Advised

cannabidiol + metyrapone

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• metyrosine
Epidiolex (cannabidiol (CBD))

+

metyrosine

1 interaction

Caution Advised

cannabidiol + metyrosine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• mexiletine
Epidiolex (cannabidiol (CBD))

+

mexiletine

1 interaction

Caution Advised

cannabidiol + mexiletine

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, mexiletine may decr. seizure threshold)

• milnacipran
Epidiolex (cannabidiol (CBD))

+

milnacipran

1 interaction

Caution Advised

cannabidiol + milnacipran

caution advised: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, milnacipran may decr. seizure threshold)

• milsaperidone
Epidiolex (cannabidiol (CBD))

+

milsaperidone

1 interaction

Caution Advised

cannabidiol + milsaperidone

caution advised: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, milsaperidone may lower seizure threshold)

• molindone
Epidiolex (cannabidiol (CBD))

+

molindone

1 interaction

Caution Advised

cannabidiol + molindone

caution advised: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, molindone may decr. seizure threshold)

• mosunetuzumab
Epidiolex (cannabidiol (CBD))

+

mosunetuzumab

1 interaction

Caution Advised

cannabidiol + mosunetuzumab

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• moxifloxacin
Epidiolex (cannabidiol (CBD))

+

moxifloxacin

1 interaction

Caution Advised

cannabidiol + moxifloxacin

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, moxifloxacin may decr. seizure threshold)

• nafarelin nasal
Epidiolex (cannabidiol (CBD))

+

nafarelin nasal

1 interaction

Caution Advised

cannabidiol + nafarelin nasal

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, nafarelin may decr. seizure threshold)

• nafcillin
Epidiolex (cannabidiol (CBD))

+

nafcillin

1 interaction

Caution Advised

cannabidiol + nafcillin

caution advised if seizure disorder use, especially w/ high nafcillin doses or concomitant renal impairment: combo may alter seizure control (antagonistic effects, nafcillin may decr. seizure threshold)

• naldemedine
Epidiolex (cannabidiol (CBD))

+

naldemedine

1 interaction

Caution Advised

cannabidiol + naldemedine

caution advised: combo may incr. naldemedine levels, risk of adverse effects (gut P-gp-mediated transport inhibited)

• naltrexone
Epidiolex (cannabidiol (CBD))

+

naltrexone

1 interaction

Caution Advised

cannabidiol + naltrexone

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• naratriptan
Epidiolex (cannabidiol (CBD))

+

naratriptan

1 interaction

Caution Advised

cannabidiol + naratriptan

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• nefazodone
Epidiolex (cannabidiol (CBD))

+

nefazodone

1 interaction

Caution Advised

cannabidiol + nefazodone

caution advised: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, nefazodone may decr. seizure threshold)

• nevirapine
Epidiolex (cannabidiol (CBD))

+

nevirapine

1 interaction

Caution Advised

cannabidiol + nevirapine

caution advised, especially w/ cannabidiol doses greater than 7.5 mg/kg/dose bid: combo may decr. nevirapine levels, efficacy (hepatic metabolism induced)

• nortriptyline
Epidiolex (cannabidiol (CBD))

+

nortriptyline

1 interaction

Caution Advised

cannabidiol + nortriptyline

caution advised: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, nortriptyline may decr. seizure threshold)

• obecabtagene autoleucel
Epidiolex (cannabidiol (CBD))

+

obecabtagene autoleucel

1 interaction

Caution Advised

cannabidiol + obecabtagene autoleucel

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, obecabtagene autoleucel may decr. seizure threshold)

• ofloxacin
Epidiolex (cannabidiol (CBD))

+

ofloxacin

1 interaction

Caution Advised

cannabidiol + ofloxacin

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, ofloxacin may decr. seizure threshold)

• orlistat
Epidiolex (cannabidiol (CBD))

+

orlistat

1 interaction

Caution Advised

cannabidiol + orlistat

caution advised w/ oral cannabidiol if seizure disorder use: combo may decr. cannabidiol levels, efficacy (absorption possibly decreased)

• orphenadrine
Epidiolex (cannabidiol (CBD))

+

orphenadrine

1 interaction

Caution Advised

cannabidiol + orphenadrine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• oxacillin
Epidiolex (cannabidiol (CBD))

+

oxacillin

1 interaction

Caution Advised

cannabidiol + oxacillin

caution advised, especially w/ high oxacillin doses or concomitant renal impairment: combo may alter seizure control (antagonistic effects, oxacillin may decr. seizure threshold)

• oxcarbazepine
Epidiolex (cannabidiol (CBD))

+

oxcarbazepine

1 interaction

Caution Advised

cannabidiol + oxcarbazepine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• pacritinib
Epidiolex (cannabidiol (CBD))

+

pacritinib

1 interaction

Caution Advised

cannabidiol + pacritinib

caution advised: combo may decr. cannabidiol and active metabolite levels, efficacy (hepatic metabolism induced)

• paliperidone
Epidiolex (cannabidiol (CBD))

+

paliperidone

1 interaction

Caution Advised

cannabidiol + paliperidone

caution advised: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, paliperidone may decr. seizure threshold)

• paroxetine
Epidiolex (cannabidiol (CBD))

+

paroxetine

1 interaction

Caution Advised

cannabidiol + paroxetine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, paroxetine may decr. seizure threshold)

• passion flower
Epidiolex (cannabidiol (CBD))

+

passion flower

1 interaction

Caution Advised

cannabidiol + passion flower

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• peginterferon beta 1a
Epidiolex (cannabidiol (CBD))

+

peginterferon beta 1a

1 interaction

Caution Advised

cannabidiol + peginterferon beta 1a

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, peginterferon beta 1a may decr. seizure threshold)

• penicillin G
Epidiolex (cannabidiol (CBD))

+

penicillin G

1 interaction

Caution Advised

cannabidiol + penicillin G

caution advised, especially w/ high penicillin G doses or concomitant renal impairment: combo may alter seizure control (antagonistic effects, penicillin G may decr. seizure threshold)

• penicillin V
Epidiolex (cannabidiol (CBD))

+

penicillin V

1 interaction

Caution Advised

cannabidiol + penicillin V

caution advised, especially w/ high penicillin V doses or concomitant renal impairment: combo may alter seizure control (antagonistic effects, penicillin V may decr. seizure threshold)

• perampanel
Epidiolex (cannabidiol (CBD))

+

perampanel

1 interaction

Caution Advised

cannabidiol + perampanel

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• phendimetrazine
Epidiolex (cannabidiol (CBD))

+

phendimetrazine

1 interaction

Caution Advised

cannabidiol + phendimetrazine

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, phendimetrazine may decr. seizure threshold)

• pheniramine
Epidiolex (cannabidiol (CBD))

+

pheniramine

1 interaction

Caution Advised

cannabidiol + pheniramine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• phentermine
Epidiolex (cannabidiol (CBD))

+

phentermine

1 interaction

Caution Advised

cannabidiol + phentermine

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, phentermine may decr. seizure threshold)

• pibrentasvir
Epidiolex (cannabidiol (CBD))

+

pibrentasvir

1 interaction

Caution Advised

cannabidiol + pibrentasvir

caution advised: combo may incr. pibrentasvir levels, risk of adverse effects (gut P-gp-mediated transport inhibited)

• pimozide
Epidiolex (cannabidiol (CBD))

+

pimozide

1 interaction

Caution Advised

cannabidiol + pimozide

caution advised: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, pimozide may decr. seizure threshold)

• piperacillin
Epidiolex (cannabidiol (CBD))

+

piperacillin

1 interaction

Caution Advised

cannabidiol + piperacillin

caution advised, especially w/ high piperacillin doses or concomitant renal impairment: combo may alter seizure control (antagonistic effects, piperacillin may decr. seizure threshold)

• polyethylene glycol
Epidiolex (cannabidiol (CBD))

+

polyethylene glycol

1 interaction

Caution Advised

cannabidiol + polyethylene glycol

caution advised if polyethylene glycol bowel prep use: combo may alter seizure control (antagonistic effects, polyethylene glycol may decr. seizure threshold)

• polyethylene glycol/electrolytes
Epidiolex (cannabidiol (CBD))

+

polyethylene glycol/ electrolytes

1 interaction

Caution Advised

cannabidiol + polyethylene glycol/ electrolytes

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, polyethylene glycol/electrolytes may decr. seizure threshold)

• pramipexole
Epidiolex (cannabidiol (CBD))

+

pramipexole

1 interaction

Caution Advised

cannabidiol + pramipexole

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• procarbazine
Epidiolex (cannabidiol (CBD))

+

procarbazine

1 interaction

Caution Advised

cannabidiol + procarbazine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, procarbazine may decr. seizure threshold)

• prochlorperazine
Epidiolex (cannabidiol (CBD))

+

prochlorperazine

1 interaction

Caution Advised

cannabidiol + prochlorperazine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, prochlorperazine may decr. seizure threshold)

• proguanil
Epidiolex (cannabidiol (CBD))

+

proguanil

1 interaction

Caution Advised

cannabidiol + proguanil

caution advised: combo may incr. proguanil levels, risk of adverse effects; may decr. proguanil active metabolite levels, efficacy (hepatic metabolism inhibited, decr. conversion to active metabolite)

• protriptyline
Epidiolex (cannabidiol (CBD))

+

protriptyline

1 interaction

Caution Advised

cannabidiol + protriptyline

caution advised: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, protriptyline may decr. seizure threshold)

• pyridostigmine
Epidiolex (cannabidiol (CBD))

+

pyridostigmine

1 interaction

Caution Advised

cannabidiol + pyridostigmine

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, pyridostigmine may decr. seizure threshold)

• pyrilamine
Epidiolex (cannabidiol (CBD))

+

pyrilamine

1 interaction

Caution Advised

cannabidiol + pyrilamine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• pyrimethamine
Epidiolex (cannabidiol (CBD))

+

pyrimethamine

1 interaction

Caution Advised

cannabidiol + pyrimethamine

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, pyrimethamine may decr. seizure threshold)

• quetiapine
Epidiolex (cannabidiol (CBD))

+

quetiapine

1 interaction

Caution Advised

cannabidiol + quetiapine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, quetiapine may decr. seizure threshold)

• ramelteon
Epidiolex (cannabidiol (CBD))

+

ramelteon

1 interaction

Caution Advised

cannabidiol + ramelteon

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• rasagiline
Epidiolex (cannabidiol (CBD))

+

rasagiline

1 interaction

Caution Advised

cannabidiol + rasagiline

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• regadenoson
Epidiolex (cannabidiol (CBD))

+

regadenoson

1 interaction

Caution Advised

cannabidiol + regadenoson

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, regadenoson may decr. seizure threshold)

• rifaximin
Epidiolex (cannabidiol (CBD))

+

rifaximin

1 interaction

Caution Advised

cannabidiol + rifaximin

caution advised: combo may incr. rifaximin levels, risk of adverse effects (gut P-gp-mediated transport inhibited)

• risperidone
Epidiolex (cannabidiol (CBD))

+

risperidone

1 interaction

Caution Advised

cannabidiol + risperidone

caution advised: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, risperidone may decr. seizure threshold)

• rivastigmine
Epidiolex (cannabidiol (CBD))

+

rivastigmine

1 interaction

Caution Advised

cannabidiol + rivastigmine

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, rivastigmine may decr. seizure threshold)

• rizatriptan
Epidiolex (cannabidiol (CBD))

+

rizatriptan

1 interaction

Caution Advised

cannabidiol + rizatriptan

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• roflumilast
Epidiolex (cannabidiol (CBD))

+

roflumilast

1 interaction

Caution Advised

cannabidiol + roflumilast

if also combined w/ CYP3A4 inhibitor, caution advised: combo may incr. roflumilast levels, risk of adverse effects (hepatic metabolism inhibited)

• roflumilast topical
Epidiolex (cannabidiol (CBD))

+

roflumilast topical

1 interaction

Caution Advised

cannabidiol + roflumilast topical

if also combined w/ CYP3A4 inhibitor, caution advised: combo may incr. roflumilast levels, risk of adverse effects (hepatic metabolism inhibited)

• ropinirole
Epidiolex (cannabidiol (CBD))

+

ropinirole

1 interaction

Caution Advised

cannabidiol + ropinirole

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• rotigotine transdermal
Epidiolex (cannabidiol (CBD))

+

rotigotine transdermal

1 interaction

Caution Advised

cannabidiol + rotigotine transdermal

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• rufinamide
Epidiolex (cannabidiol (CBD))

+

rufinamide

1 interaction

Caution Advised

cannabidiol + rufinamide

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• safinamide
Epidiolex (cannabidiol (CBD))

+

safinamide

1 interaction

Caution Advised

cannabidiol + safinamide

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• selegiline
Epidiolex (cannabidiol (CBD))

+

selegiline

1 interaction

Caution Advised

cannabidiol + selegiline

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• selegiline transdermal
Epidiolex (cannabidiol (CBD))

+

selegiline transdermal

1 interaction

Caution Advised

cannabidiol + selegiline transdermal

caution advised: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, selegiline transdermal may decr. seizure threshold)

• selinexor
Epidiolex (cannabidiol (CBD))

+

selinexor

1 interaction

Caution Advised

cannabidiol + selinexor

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• sertraline
Epidiolex (cannabidiol (CBD))

+

sertraline

1 interaction

Caution Advised

cannabidiol + sertraline

caution advised: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, sertraline may decr. seizure threshold)

• sodium picosulfate
Epidiolex (cannabidiol (CBD))

+

sodium picosulfate

1 interaction

Caution Advised

cannabidiol + sodium picosulfate

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, sodium picosulfate may decr. seizure threshold)

• solifenacin
Epidiolex (cannabidiol (CBD))

+

solifenacin

1 interaction

Caution Advised

cannabidiol + solifenacin

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• stiripentol
Epidiolex (cannabidiol (CBD))

+

stiripentol

1 interaction

Caution Advised

cannabidiol + stiripentol

caution advised: combo may incr. stiripentol levels, risk of CNS depression, psychomotor impairment, other adverse effects (mechanism unknown; additive effects)

• sulfate bowel prep
Epidiolex (cannabidiol (CBD))

+

sulfate bowel prep

1 interaction

Caution Advised

cannabidiol + sulfate bowel prep

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, sulfate bowel prep may decr. seizure threshold)

• sumatriptan
Epidiolex (cannabidiol (CBD))

+

sumatriptan

1 interaction

Caution Advised

cannabidiol + sumatriptan

caution advised: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, sumatriptan may decr. seizure threshold)

• tasimelteon
Epidiolex (cannabidiol (CBD))

+

tasimelteon

1 interaction

Caution Advised

cannabidiol + tasimelteon

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• teclistamab
Epidiolex (cannabidiol (CBD))

+

teclistamab

1 interaction

Caution Advised

cannabidiol + teclistamab

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, teclistamab may decr. seizure threshold)

• terbutaline
Epidiolex (cannabidiol (CBD))

+

terbutaline

1 interaction

Caution Advised

cannabidiol + terbutaline

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, terbutaline may decr. seizure threshold)

• tetrabenazine
Epidiolex (cannabidiol (CBD))

+

tetrabenazine

1 interaction

Caution Advised

cannabidiol + tetrabenazine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• thiotepa
Epidiolex (cannabidiol (CBD))

+

thiotepa

1 interaction

Caution Advised

cannabidiol + thiotepa

caution advised: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, thiotepa may decr. seizure threshold)

• tiagabine
Epidiolex (cannabidiol (CBD))

+

tiagabine

1 interaction

Caution Advised

cannabidiol + tiagabine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• ticagrelor
Epidiolex (cannabidiol (CBD))

+

ticagrelor

1 interaction

Caution Advised

cannabidiol + ticagrelor

caution advised: combo may incr. ticagrelor levels, risk of dyspnea, bleeding, other adverse effects (gut P-gp-mediated transport inhibited)

• tinidazole
Epidiolex (cannabidiol (CBD))

+

tinidazole

1 interaction

Caution Advised

cannabidiol + tinidazole

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, tinidazole may decr. seizure threshold)

• tipranavir
Epidiolex (cannabidiol (CBD))

+

tipranavir

1 interaction

Caution Advised

cannabidiol + tipranavir

caution advised: combo may incr. tipranavir levels, risk of adverse effects; may decr. cannabidiol and active metabolite levels, efficacy (gut P-gp-mediated transport inhibited; hepatic metabolism induced)

• tisagenlecleucel
Epidiolex (cannabidiol (CBD))

+

tisagenlecleucel

1 interaction

Caution Advised

cannabidiol + tisagenlecleucel

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, tisagenlecleucel may decr. seizure threshold)

• tolcapone
Epidiolex (cannabidiol (CBD))

+

tolcapone

1 interaction

Caution Advised

cannabidiol + tolcapone

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• tolterodine
Epidiolex (cannabidiol (CBD))

+

tolterodine

1 interaction

Caution Advised

cannabidiol + tolterodine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• tolvaptan
Epidiolex (cannabidiol (CBD))

+

tolvaptan

1 interaction

Caution Advised

cannabidiol + tolvaptan

caution advised: combo may incr. tolvaptan levels, risk of adverse effects (gut P-gp-mediated transport inhibited)

• topiramate
Epidiolex (cannabidiol (CBD))

+

topiramate

1 interaction

Caution Advised

cannabidiol + topiramate

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• tranexamic acid
Epidiolex (cannabidiol (CBD))

+

tranexamic acid

1 interaction

Caution Advised

cannabidiol + tranexamic acid

if seizure disorder use, caution advised w/ high-dose IV tranexamic acid: combo may alter seizure control (antagonistic effects, tranexamic acid may decr. seizure threshold)

• trazodone
Epidiolex (cannabidiol (CBD))

+

trazodone

1 interaction

Caution Advised

cannabidiol + trazodone

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• treosulfan
Epidiolex (cannabidiol (CBD))

+

treosulfan

1 interaction

Caution Advised

cannabidiol + treosulfan

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, treosulfan may decr. seizure threshold)

• triamcinolone
Epidiolex (cannabidiol (CBD))

+

triamcinolone

1 interaction

Caution Advised

cannabidiol + triamcinolone

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, triamcinolone may decr. seizure threshold)

• trifluoperazine
Epidiolex (cannabidiol (CBD))

+

trifluoperazine

1 interaction

Caution Advised

cannabidiol + trifluoperazine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, trifluoperazine may decr. seizure threshold)

• trihexyphenidyl
Epidiolex (cannabidiol (CBD))

+

trihexyphenidyl

1 interaction

Caution Advised

cannabidiol + trihexyphenidyl

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• trimipramine
Epidiolex (cannabidiol (CBD))

+

trimipramine

1 interaction

Caution Advised

cannabidiol + trimipramine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, trimipramine may decr. seizure threshold)

• triprolidine
Epidiolex (cannabidiol (CBD))

+

triprolidine

1 interaction

Caution Advised

cannabidiol + triprolidine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• triptorelin
Epidiolex (cannabidiol (CBD))

+

triptorelin

1 interaction

Caution Advised

cannabidiol + triptorelin

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, triptorelin may decr. seizure threshold)

• trospium
Epidiolex (cannabidiol (CBD))

+

trospium

1 interaction

Caution Advised

cannabidiol + trospium

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• vadadustat
Epidiolex (cannabidiol (CBD))

+

vadadustat

1 interaction

Caution Advised

cannabidiol + vadadustat

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, vadadustat may decr. seizure threshold)

• valacyclovir
Epidiolex (cannabidiol (CBD))

+

valacyclovir

1 interaction

Caution Advised

cannabidiol + valacyclovir

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, acyclovir may decr. seizure threshold)

• valbenazine
Epidiolex (cannabidiol (CBD))

+

valbenazine

1 interaction

Caution Advised

cannabidiol + valbenazine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• valerian
Epidiolex (cannabidiol (CBD))

+

valerian

1 interaction

Caution Advised

cannabidiol + valerian

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• valganciclovir
Epidiolex (cannabidiol (CBD))

+

valganciclovir

1 interaction

Caution Advised

cannabidiol + valganciclovir

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, ganciclovir may decr. seizure threshold)

• varenicline
Epidiolex (cannabidiol (CBD))

+

varenicline

1 interaction

Caution Advised

cannabidiol + varenicline

caution advised if seizure disorder use: combo may alter seizure control (antagonistic effects, varenicline may decr. seizure threshold)

• velpatasvir
Epidiolex (cannabidiol (CBD))

+

velpatasvir

1 interaction

Caution Advised

cannabidiol + velpatasvir

caution advised, especially w/ cannabidiol doses greater than 7.5 mg/kg/dose bid: combo may decr. velpatasvir levels, efficacy (hepatic metabolism induced)

• venlafaxine
Epidiolex (cannabidiol (CBD))

+

venlafaxine

1 interaction

Caution Advised

cannabidiol + venlafaxine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, venlafaxine may decr. seizure threshold)

• vigabatrin
Epidiolex (cannabidiol (CBD))

+

vigabatrin

1 interaction

Caution Advised

cannabidiol + vigabatrin

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• vilazodone
Epidiolex (cannabidiol (CBD))

+

vilazodone

1 interaction

Caution Advised

cannabidiol + vilazodone

caution advised: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, vilazodone may decr. seizure threshold)

• viloxazine
Epidiolex (cannabidiol (CBD))

+

viloxazine

1 interaction

Caution Advised

cannabidiol + viloxazine

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• vorasidenib
Epidiolex (cannabidiol (CBD))

+

vorasidenib

1 interaction

Caution Advised

cannabidiol + vorasidenib

caution advised: combo may incr. vorasidenib levels, risk of adverse effects (hepatic metabolism inhibited)

• ziprasidone
Epidiolex (cannabidiol (CBD))

+

ziprasidone

1 interaction

Caution Advised

cannabidiol + ziprasidone

caution advised: combo may incr. risk of CNS depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, ziprasidone may decr. seizure threshold)

• zolmitriptan
Epidiolex (cannabidiol (CBD))

+

zolmitriptan

1 interaction

Caution Advised

cannabidiol + zolmitriptan

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

• zonisamide
Epidiolex (cannabidiol (CBD))

+

zonisamide

1 interaction

Caution Advised

cannabidiol + zonisamide

caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)