Dosing & monitoring

Epidyolex offers flexible dosing to help optimise treatment response for your patients. There is a recommended dosage range for maintenance dosing and new Epidyolex patients will need to undergo a titration to reach their maintenance dosage.

 

The dosing calculator below will help you calculate titration schedules for new patients, or recalculate the next step for a patient who hasn’t yet found the right maintenance dose.

 

If your patients suffer from hepatic impairment, the calculator can adjust calculations appropriately and automatically for you. No dose adjustment is required for patients with mild, moderate or severe renal impairment.

Please note

The calculator is automatically set to follow the recommended dosing schedule, as per the licensed use of Epidyolex. However, custom doses/titrations can also be calculated at the prescribing physician’s own discretion.

Dosing Calculator

Use the calculator to get your patient’s dose.
Please select type of patient:
kg
Does your patient have hepatic impairment:
Select level of hepatic impairment:
Select level of hepatic impairment:
There is no dosage adjustment required for mild hepatic impairment.
The recommended dosing schedule below has been adjusted accordingly for moderate hepatic impairment.
The recommended dosing schedule below has been adjusted accordingly for severe hepatic impairment.
Dosing options:
Select type of dose
Customise dose
We recommend 5mg/kg/day (2.5mg/kg twice daily).
mg/kg/day
We recommend a maintenance dose of 10mg/kg/day (5mg/kg twice daily).
mg/kg/day

We recommend increasing patient does in weekly increments of 5mg/kg/day (2.5mg/kg dose twice daily) up to 20mg/kg/day.

For patients in whom a more rapid titration from 10 mg/kg/day to 20 mg/kg/day is warranted, the dosage may be increased no more frequently than every other day.

number of titrations
Length of titrations (weeks)

Patients with hepatic impairment

Epidyolex in existing AED regimens

 

Epidyolex can interact with some commonly prescribed antiepileptic drugs, which should be monitored and may require dose adjustment.

Clobazam

Interaction Increase in both CBD and clobazam active metabolites
Adverse events Increased incidence of somnolence
Dose adjustment Consider reduction of clobazam dose
1

Strong or moderate CYP3A4 or CYP2C19 inhibitors

e.g. carbamazepine, enzalutamide, mitotane, St. John’s wort and/or CYP2C19, such as rifampin

Interaction Decrease in CBD active metabolite
Adverse events Reduced effectiveness of CBD
Dose adjustment Consider dose increase of Epidyolex
1

Valproate

Interaction Mechanism of interaction unknown
Adverse events Increase in incidence of transaminase elevations, diarrhoea and vomiting
Dose adjustment Discontinuation or reduction of valproate and/or CBD*
1

Oral contraceptives

Increase in incidence of transaminase elevations, diarrhoea and vomiting Increase in incidence of transaminase elevations, diarrhoea and vomiting
1

Stiripentol

Interaction Decrease in CBD active metabolite and increase in stiripentol levels
Adverse events No clinically relevant effects
1

AED safety information


References

 

1. Epidyolex Summary of Product Characteristics