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Drugs and Lactation Database (LactMed®) [Internet]. Bethesda (MD): National Institute of Child Health and Human Development; 2006-.
CASRN: 13956-29-1
Drug Levels and Effects
Summary of Use during Lactation
Cannabidiol is a component of cannabis. Cannabidiol has not been studied in nursing women taking the pharmaceutical product (Epidiolex), but it has been detected in the breastmilk of some mothers who used cannabis products.[1-3] Because no published information is available with cannabidiol use as an antiepileptic during breastfeeding, an alternate drug may be preferred, especially while nursing a newborn or preterm infant.
Drug Levels
In published reports of anticonvulsant use during breastfeeding, most women were taking a combination of anticonvulsants. Some other anticonvulsants (e.g., phenytoin, carbamazepine) stimulate the metabolism of other drugs including anticonvulsants, whereas others (e.g., valproic acid) inhibit the metabolism of other drugs. Therefore, the relationship of the maternal dosage to the concentration in breastmilk can be quite variable, making calculation of the weight-adjusted percentage of maternal dosage less meaningful than for other drugs reported in LactMed.
Maternal Levels. Cannabidiol was measured in the milk of mothers who reported using cannabis and donated milk samples. Fifty mothers donated 54 samples of milk to a breastmilk repository. The median concentration of cannabidiol was 5 mcg/L (range 1.3 to 8.6 mcg/L).[2]
A physiologically based pharmacokinetic model of cannabidiol was constructed using data from 181 cannabis-using mothers who donated 200 samples of breastmilk to a breastmilk repository. Of these, 42% had cannabidiol concentration below the level of quantification. Maternal ingestion by oil or pipe tended to result in higher predicted concentrations as compared with joint, blunt or edible forms. The dose in infants was projected to result in exposure of fully breastfed infants of less than 1% of that in children 4 to 10 years old who were receiving the drug therapeutically for seizures.[3]
Infant Levels. Relevant published information was not found as of the revision date.
Effects in Breastfed Infants
Relevant published information was not found as of the revision date.
Effects on Lactation and Breastmilk
Relevant published information was not found as of the revision date.
Alternate Drugs to Consider
(Seizure Disorder) Carbamazepine, Divalproex, Gabapentin, Lamotrigine, Oxcarbazepine, Phenytoin, Valproic Acid
References
- 1.
- Silveira GD, Loddi S, De Oliveira CDR, et al. Headspace solid-phase microextraction and gas chromatography-mass spectrometry for determination of cannabinoids in human breast milk. Forensic Toxicol 2017;35:125-32. doi:10.1007/s11419-016-0346-5 [CrossRef]
- 2.
- Bertrand KA, Hanan NJ, Honerkamp-Smith G, et al. Marijuana use by breastfeeding mothers and cannabinoid concentrations in breast milk. Pediatrics 2018;142:e20181076. [PMC free article: PMC6317767] [PubMed: 30150212]
- 3.
- Yeung CHT, Bertrand KA, Best BM, et al. Cannabidiol exposure through maternal marijuana use: Predictions in breastfed infants. Clin Pharmacokinet 2023;62:1611-9. [PMC free article: PMC10659070] [PubMed: 37735347]
Substance Identification
Substance Name
Cannabidiol
CAS Registry Number
13956-29-1
Disclaimer: Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.
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- Review Cannabidiol: A New Hope for Patients With Dravet or Lennox-Gastaut Syndromes.[Ann Pharmacother. 2019]Review Cannabidiol: A New Hope for Patients With Dravet or Lennox-Gastaut Syndromes.Chen JW, Borgelt LM, Blackmer AB. Ann Pharmacother. 2019 Jun; 53(6):603-611. Epub 2019 Jan 8.
- Analysis of cannabidiol (CBD) and THC in nonprescription consumer products: Implications for patients and practitioners.[Epilepsy Behav. 2022]Analysis of cannabidiol (CBD) and THC in nonprescription consumer products: Implications for patients and practitioners.Miller OS, Elder EJ Jr, Jones KJ, Gidal BE. Epilepsy Behav. 2022 Feb; 127:108514. Epub 2022 Jan 5.
- Pharmacokinetic Profile of ∆9-Tetrahydrocannabinol, Cannabidiol and Metabolites in Blood following Vaporization and Oral Ingestion of Cannabidiol Products.[J Anal Toxicol. 2022]Pharmacokinetic Profile of ∆9-Tetrahydrocannabinol, Cannabidiol and Metabolites in Blood following Vaporization and Oral Ingestion of Cannabidiol Products.Bergeria CL, Spindle TR, Cone EJ, Sholler D, Goffi E, Mitchell JM, Winecker RE, Bigelow GE, Flegel R, Vandrey R. J Anal Toxicol. 2022 Jul 14; 46(6):583-591.
- Review Empagliflozin.[Drugs and Lactation Database (...]Review Empagliflozin.. Drugs and Lactation Database (LactMed®). 2006
- Cannabidiol and Other Cannabinoids: From Toxicology and Pharmacology to the Development of a Regulatory Pathway.[J Diet Suppl. 2020]Cannabidiol and Other Cannabinoids: From Toxicology and Pharmacology to the Development of a Regulatory Pathway.Koturbash I, MacKay D. J Diet Suppl. 2020; 17(5):487-492. Epub 2020 Jul 25.
- Cannabidiol - Drugs and Lactation Database (LactMed®)Cannabidiol - Drugs and Lactation Database (LactMed®)
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