{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T02:37:34Z","timestamp":1791859054308,"version":"4.3.4"},"reference-count":37,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2017,8,6]],"date-time":"2017-08-06T00:00:00Z","timestamp":1501977600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100008333","name":"University of Alabama at Birmingham","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008333","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      To identify potential pharmacokinetic interactions between the pharmaceutical formulation of cannabidiol (\n                      <jats:styled-content style=\"fixed-case\">CBD<\/jats:styled-content>\n                      ; Epidiolex) and the commonly used antiepileptic drugs (\n                      <jats:styled-content style=\"fixed-case\">AED<\/jats:styled-content>\n                      s) through an open\u2010label safety study. Serum levels were monitored to identify interactions between\n                      <jats:styled-content style=\"fixed-case\">CBD<\/jats:styled-content>\n                      and\n                      <jats:styled-content style=\"fixed-case\">AED<\/jats:styled-content>\n                      s.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In 39 adults and 42 children,\n                      <jats:styled-content style=\"fixed-case\">CBD<\/jats:styled-content>\n                      dose was started at 5 mg\/kg\/day and increased every 2 weeks by 5 mg\/kg\/day up to a maximum of 50 mg\/kg\/day. Serum\n                      <jats:styled-content style=\"fixed-case\">AED<\/jats:styled-content>\n                      levels were obtained at baseline prior to\n                      <jats:styled-content style=\"fixed-case\">CBD<\/jats:styled-content>\n                      initiation and at most study visits.\n                      <jats:styled-content style=\"fixed-case\">AED<\/jats:styled-content>\n                      doses were adjusted if it was determined that a clinical symptom or laboratory result was related to a potential interaction. The Mixed Procedure was used to determine if there was a significant change in the serum level of each of the 19\n                      <jats:styled-content style=\"fixed-case\">AED<\/jats:styled-content>\n                      s with increasing\n                      <jats:styled-content style=\"fixed-case\">CBD<\/jats:styled-content>\n                      dose.\n                      <jats:styled-content style=\"fixed-case\">AED<\/jats:styled-content>\n                      s with interactions seen in initial analysis were plotted for mean change in serum level over time. Subanalyses were performed to determine if the frequency of sedation in participants was related to the mean serum\n                      <jats:italic>N<\/jats:italic>\n                      \u2010desmethylclobazam level, and if\n                      <jats:styled-content style=\"fixed-case\">aspartate aminotransferase (AST) and alanine aminotransferase (ALT)<\/jats:styled-content>\n                      levels were different in participants taking concomitant valproate.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Increases in topiramate, rufinamide, and\n                      <jats:italic>N<\/jats:italic>\n                      \u2010desmethylclobazam and decrease in clobazam (all p &lt; 0.01) serum levels were seen with increasing\n                      <jats:styled-content style=\"fixed-case\">CBD<\/jats:styled-content>\n                      dose. Increases in serum levels of zonisamide (p = 0.02) and eslicarbazepine (p = 0.04) with increasing\n                      <jats:styled-content style=\"fixed-case\">CBD<\/jats:styled-content>\n                      dose were seen in adults. Except for clobazam and desmethylclobazam, all noted mean level changes were within the accepted therapeutic range. Sedation was more frequent with higher\n                      <jats:italic>N<\/jats:italic>\n                      \u2010desmethylclobazam levels in adults (p = 0.02), and\n                      <jats:styled-content style=\"fixed-case\">AST<\/jats:styled-content>\n                      \/\n                      <jats:styled-content style=\"fixed-case\">ALT<\/jats:styled-content>\n                      levels were significantly higher in participants taking concomitant valproate (p &lt; 0.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>\n                      Significantly changed serum levels of clobazam, rufinamide, topiramate, zonisamide, and eslicarbazepine were seen. Abnormal liver function test results were noted in participants taking concomitant valproate. This study emphasizes the importance of monitoring serum\n                      <jats:styled-content style=\"fixed-case\">AED<\/jats:styled-content>\n                      levels and\n                      <jats:styled-content style=\"fixed-case\">LFT<\/jats:styled-content>\n                      s during treatment with\n                      <jats:styled-content style=\"fixed-case\">CBD<\/jats:styled-content>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/epi.13852","type":"journal-article","created":{"date-parts":[[2017,8,7]],"date-time":"2017-08-07T00:06:34Z","timestamp":1502064394000},"page":"1586-1592","source":"Crossref","is-referenced-by-count":317,"title":["Interactions between cannabidiol and commonly used antiepileptic drugs"],"prefix":"10.1111","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6525-789X","authenticated-orcid":false,"given":"Tyler E.","family":"Gaston","sequence":"first","affiliation":[{"name":"Division of Epilepsy Department of Neurology University of Alabama at Birmingham Birmingham Alabama U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. 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