{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T12:42:43Z","timestamp":1792154563079,"version":"4.4.0"},"reference-count":21,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,8,26]],"date-time":"2023-08-26T00:00:00Z","timestamp":1693008000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia Open"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The aim of this study was to assess potential drug\u2013drug interactions between highly purified cannabidiol (CBD) and anti\u2010seizure medications (ASMs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Our group previously reported that in a sample of adults and children receiving CBD in an open\u2010label expanded access program, there were several ASMs noted to increase in serum levels with increasing doses of CBD. We analyzed if an increased number of observations over time resulted in changes in potential interactions and if potential interactions were associated with time since enrollment, demographics, or the overall rating of adverse effects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In 169 participants (80 adults), with increasing weight\u2010based CBD dose, there were associated increases in serum levels of clobazam and N\u2010desmethylclobazam, free valproate, felbamate, and topiramate in the adult and pediatric arms combined, levetiracetam in the pediatric arm only, and permapanel in the adult arm only. There were no associations noted in these level changes with time since enrollment, biological sex, and adverse events profile scores.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>This study confirms some previously identified interactions with CBD and identifies other potential pharmacokinetic interactions; however, the clinical significance of these observations is likely minor, and there is no effect of time on these findings.<\/jats:p><\/jats:sec>","DOI":"10.1002\/epi4.12815","type":"journal-article","created":{"date-parts":[[2023,8,19]],"date-time":"2023-08-19T05:26:46Z","timestamp":1692422806000},"page":"1405-1412","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Final analysis of potential <scp>drug\u2013drug<\/scp> interactions between highly purified cannabidiol and <scp>anti\u2010seizure<\/scp> medications in an <scp>open\u2010label<\/scp> expanded access program"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6525-789X","authenticated-orcid":false,"given":"Tyler E.","family":"Gaston","sequence":"first","affiliation":[{"name":"Department of Neurology, Division of Epilepsy University of Alabama at Birmingham  Birmingham Alabama USA"},{"name":"Division of Neurology Birmingham Veterans Affairs Medical Center  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0304-4266","authenticated-orcid":false,"given":"E. Martina","family":"Bebin","sequence":"additional","affiliation":[{"name":"Department of Neurology, Division of Epilepsy University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary R.","family":"Cutter","sequence":"additional","affiliation":[{"name":"Department of Biostatistics University of Alabama at Birmingham School of Public Health  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leslie","family":"Grayson","sequence":"additional","affiliation":[{"name":"Department of Neurology, Division of Epilepsy University of Alabama at Birmingham  Birmingham Alabama USA"},{"name":"Division of Neurology Birmingham Veterans Affairs Medical Center  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5936-6627","authenticated-orcid":false,"given":"Jerzy P.","family":"Szaflarski","sequence":"additional","affiliation":[{"name":"Department of Neurology, Division of Epilepsy University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,8,26]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1714631"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)30136-3"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1611618"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2020.4607"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.14477"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/epi.17496"},{"key":"e_1_2_13_8_1","unstructured":"Epidiolex (cannabidiol) [package insert]. 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