Medicinal Cannabis

About

CBD and THC are natural compounds found in the cannabis sativa plant.

Marijuana is the name given to the dried leaves, flowers, stems and seeds of the cannabis sativa plant. 

About
  • Cannabidiol (medical cannabis) is an anti-epileptic drug used to manage seizures in children with Dravet syndrome, Lennox-Gastaut syndrome and Tuberose Sclerosis complex and can be prescribed with other anti-epileptics.
  • Most medicinal cannabis products contain chemicals known as cannabinoids. Two of these are CBD and tetra-hydrocannabinol (THC).1  2  
  • THC is the chemical that affects a person’s mental state (the psychoactive component).3  CBD does not have the same effect.4
  • Although CBD oil is mostly made up of CBD, a small amount of THC may be present. The amount of THC varies depending on the type of CBD oil.
  • Not all cannabis products labelled 'medicinal cannabis' are approved by the regulatory body, the Australian Government Therapeutic Goods Association (TGA).
  • The CBD oil products that are approved by the TGA are very pure forms, which means there is very little or no THC present. 
  • Epidyolex is an oral cannabis medication containing cannabidiol that has the psychoactive component (THC) removed. It is approved by the TGA and can be accessed with a prescription for use in children. Epidyolex has been approved on the PBS for use in Dravet’s syndrome.
  • Cannabis products that may be accessed without prescription may be of lower purity and higher in THC than CBD than is prescribed by a doctor. It is not possible to predict short- or long-term effects if the product ingredients are unknown.  
  • Cannabidiol is best taken at approximately the same time of day and comes in a suspension.
  • The suspension needs to be shaken well before use and can be taken either with/without food. Measure dose accurately with syringe or measuring spoon.
  • 1What medicinal cannabis products are available? The University of Sydney: lambert/how-to-get-medicinal-cannabis/what-products-are-available.html
  • 2Medicinal cannabis. Better health Channel: https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/medicinal-cannabis
  • 3Cannabis (Marijuana) and Cannabinoids: What You Need To Know. National Centre for Complementary and integrative Health: https://www.nccih.nih.gov/health/cannabis-marijuana-and-cannabinoids-what-you-need-to-know
  • 4Iffland. An Update on Safety and Side Effects of Cannabidiol: A Review of Clinical Data and Relevant Animal Studies. 2017: https://pubmed.ncbi.nlm.nih.gov/28861514/

Side effects

All drugs may cause side effects. However, many people have no side effects or only have minor side effects.

Possible side effects include:

  • Sleepiness / drowsiness
  • Irritability, changes in mood and behaviour
  • Fatigue / lack of energy
  • Changes in appetite
  • Diarrhoea and/or vomiting 
  • Fever
  • Upper respiratory tract infection 
  • Increased seizures
  • Elevated liver enzymes
  • CBD oil may also cause side effects if it interacts with other medicines (see interactions tab).

These are not all the side effects that may occur. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away.

Interactions

There are drugs including other anti-epileptics that interact with cannabidiol. It is important that children taking medicinal cannabis are regularly monitored by their usual treating paediatric neurologist to ensure that levels of other medicines are appropriately managed.  There may be significant interactions between medicinal cannabis and other anticonvulsants, for example: 

  1. Sodium valproate
  2. Clobazam
  3. Lamotrigine
  4. Stiripentol
  5. Phenytoin

This is also important if you are giving your child herbal or complementary medicines. The doctor can check to make sure they are compatible.

Need-to-know

Monitoring and medication levels

  • Regular monitoring of liver function and drug interactions by the child's treating doctor is important.

 

Pregnancy and contraception

  • If a pregnancy is planned, a discussion with your neurologist is recommended. For further information, refer to the Contraception and Pregnancy section.

 

Disclaimer: The information provided in this handout is limited and does not replace the need for a  medical consultation. It is very important you speak to your doctor about all aspects of your medication including side effects when medication is first prescribed. Report any concerns to your doctor promptly 

 

Information last reviewed: 09/06/2023.