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Epilepsia. 2019 Jul;60(7):e74-e77. doi: 10.1111/epi.16071. Epub 2019 Jun 18.

Effects of cannabidiol on brivaracetam plasma levels.

Author information

1
Epilepsy Center, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
2
Department of Neuropediatrics and Muscle Disorders, Center for Pediatrics, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.

Abstract

The use of cannabidiol (CBD) for treatment of pharmacoresistant epilepsies is increasing. CBD is metabolized via UDP-glucuronosyltransferase (UGT) and cytochrome 450 (CYP) enzymes, but information on interactions with common anticonvulsive drugs is incomplete. We report a case series of five patients receiving adjunctive treatment with CBD who showed increases in brivaracetam (BRV) levels by 95% to 280%. Only two patients reported mild adverse events, leading to a reduction of BRV in one patient. One possible mechanism contributing at least partially to increasing BRV level is the inhibition of CYP2C19 by cannabidiol. Further pharmacokinetic studies are required to understand other possible mechanisms of brivaracetam-cannabidiol interaction.

KEYWORDS:

adverse event; epilepsy; plasma level; seizure

PMID:
31211851
DOI:
10.1111/epi.16071

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