Comprehensive medication guide to Epidiolex including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0 per prescription for commercially insured patients enrolled in the JazzCares Copay Savings Program; specialty tier copay typically $50–$300+ without copay assistance. Prior authorization is almost always required. Medicare Part D patients benefit from the $2,000 annual OOP cap as of 2025.
Estimated Cash Pricing
$1,050–$1,500+ retail per 100 mL bottle; monthly costs can reach $2,500–$6,000+ depending on dose and body weight. No generic is available. The JazzCares Patient Assistance Program can provide Epidiolex at no charge for eligible uninsured/underinsured patients.
Medfinder Findability Score
45/100
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Epidiolex is the first and only FDA-approved prescription cannabidiol (CBD) medication in the United States. Approved on June 25, 2018, it is manufactured by Jazz Pharmaceuticals (formerly GW Pharmaceuticals). Epidiolex is indicated for the treatment of seizures associated with Lennox-Gastaut syndrome (LGS), Dravet syndrome, and tuberous sclerosis complex (TSC) in patients 1 year of age and older.
Epidiolex is formulated as a 100 mg/mL oral solution with a strawberry flavor, supplied in 105 mL amber glass bottles with calibrated dosing syringes. It is nearly 100% pure CBD derived from greenhouse-grown, non-GMO cannabis plants. Unlike THC — the psychoactive component of marijuana — CBD does not produce a 'high,' making Epidiolex safe for use in children and adults without psychoactive effects.
More than 55,000 families have started on Epidiolex since its approval, and its safety profile has been evaluated in clinical studies spanning over three years. It is available exclusively through specialty pharmacies and requires a prescription from a neurologist or epileptologist.
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Epidiolex (cannabidiol) is a structurally novel antiseizure medication with a mechanism of action that is not fully understood. Importantly, it does not work through CB1 cannabinoid receptors (the pathway by which THC causes psychoactive effects), nor does it work primarily through voltage-gated sodium channels — the mechanism of many common antiseizure drugs. This unique profile is part of why Epidiolex shows efficacy in treatment-resistant epilepsies like LGS and Dravet syndrome.
Several mechanisms have been proposed for CBD's antiseizure activity, likely working in combination: modulation of GABA signaling (the brain's main inhibitory neurotransmitter system); interaction with serotonin 5-HT receptors, which regulate brain excitability; antagonism of GPR55 receptors (which, when activated, increase neuronal firing); modulation of transient receptor potential (TRP) ion channels; and inhibition of adenosine reuptake, increasing the brain's natural anti-seizure adenosine levels. The active metabolite 7-OH-CBD also contributes to antiseizure activity.
This multi-target approach may explain Epidiolex's ability to reduce seizures in conditions that haven't responded to single-mechanism drugs. Dosing is weight-based, starting at 2.5 mg/kg twice daily (5 mg/kg/day) and titrated up to a maximum of 10 mg/kg twice daily (20 mg/kg/day) as tolerated.
2.5 mg/kg twice daily — oral solution
Starting dose for LGS and Dravet syndrome (5 mg/kg/day total)
5 mg/kg twice daily — oral solution
Maintenance dose after 1 week titration (10 mg/kg/day total)
10 mg/kg twice daily — oral solution
Maximum dose for patients requiring greater seizure control (20 mg/kg/day total)
100 mg/mL — oral solution
Standard concentration; comes in 105 mL amber glass bottles with calibrated dosing syringes
Epidiolex is not on the FDA's official drug shortage list, but patients consistently face significant access challenges. The primary barrier is the specialty pharmacy-only distribution model — Epidiolex cannot be filled at regular retail pharmacies like CVS, Walgreens, or Walmart. It is only dispensed through specialty pharmacies, which are separate from the retail pharmacy network and typically deliver by mail.
Insurance prior authorization is nearly universally required and typically takes 2-4 weeks. Many plans also require step therapy (proof of prior treatment failures). The high retail cost — over $1,000 per bottle — makes cash-pay access impossible for most families. Together, these structural factors create a findability score of 45 out of 100, reflecting frequent localized access challenges even though national supply is stable.
If you're having trouble filling your Epidiolex prescription, medfinder can help. medfinder contacts specialty pharmacies near you to find which ones have Epidiolex in stock and can fill your prescription — then texts you the results. You can also call JazzCares at 1-833-426-4243 for insurance support and pharmacy navigation.
Epidiolex is not a controlled substance (descheduled by DEA in April 2020), so any licensed prescriber with DEA registration can technically prescribe it. However, in practice, Epidiolex is almost exclusively initiated by specialists due to the complexity of the conditions it treats and insurance prior authorization requirements.
Epileptologists — the primary specialists for LGS, Dravet syndrome, and TSC management
Neurologists — board-certified neurologists with experience in epilepsy
Pediatric neurologists — for the pediatric patients who comprise the majority of LGS, Dravet, and TSC diagnoses
Child neurologists at epilepsy centers — NAEC-accredited epilepsy centers have the most experience with these complex syndromes
Nurse practitioners and physician assistants — may prescribe in most states when working within a neurology practice
Because Epidiolex is non-scheduled, it can be prescribed via telehealth without additional DEA registration requirements. This is particularly valuable for patients in rural areas or those with transportation challenges. However, initial diagnosis of LGS, Dravet syndrome, or TSC typically requires in-person testing including EEG, MRI, and genetic testing that must be established before remote prescribing begins.
No. Epidiolex is not a controlled substance. When it was first approved by the FDA on June 25, 2018, the DEA placed it in Schedule V — the least restrictive schedule under the Controlled Substances Act — due to its CBD (cannabidiol) content derived from cannabis. However, on April 6, 2020, the DEA descheduled Epidiolex entirely, removing all federal controlled-substance restrictions.
Since April 2020, Epidiolex has been a non-scheduled prescription medication. This means prescriptions are valid for one year, can be transferred between pharmacies, and can be prescribed via telehealth without special DEA registration requirements. There are no prescription drug monitoring program (PDMP) requirements for Epidiolex at the federal level, though state laws may vary. Some states that mirrored the federal Schedule V designation separately updated their state-level scheduling to reflect the descheduling — check your state's specific regulations if relevant.
Epidiolex carries an FDA boxed warning for hepatotoxicity (liver injury). The following side effects occurred in at least 10% of patients in clinical trials:
Somnolence and sedation (32% — especially in patients also taking clobazam)
Decreased appetite
Diarrhea
Pyrexia (fever)
Vomiting
Fatigue, malaise, and asthenia (weakness)
Rash
Insomnia and poor-quality sleep
Liver transaminase elevations (ALT/AST >3x ULN in 13% of patients; higher risk with concomitant valproate)
Hepatic injury (boxed warning): Jaundice, dark urine, right abdominal pain, severe nausea/vomiting — call your doctor immediately
Suicidal thoughts or behavior: Risk is ~1 in 500 patients; call 988 (Suicide & Crisis Lifeline) or go to emergency room immediately
Severe allergic reactions: Angioedema, urticaria, difficulty breathing — call 911 immediately
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Fintepla (fenfluramine)
FDA-approved for Dravet syndrome (2020) and LGS (2022). Serotonin-targeting mechanism; considered highly effective for Dravet. Schedule V controlled substance; requires REMS cardiac monitoring program. Specialty pharmacy only.
Diacomit (stiripentol)
FDA-approved for Dravet syndrome as adjunctive therapy with clobazam. GABAergic mechanism plus CYP inhibition that boosts clobazam levels. Specialty medication. Must be used with clobazam per FDA requirement.
Clobazam (Onfi, Sympazan)
FDA-approved for LGS; first-line or add-on therapy for both LGS and Dravet. Benzodiazepine class. Schedule IV controlled substance. Available as tablets (Onfi) and oral film strips (Sympazan). Generic available for tablet form.
Valproic acid / valproate (Depakote, Depakene)
Broad-spectrum first-line antiseizure medication for both LGS and Dravet. Widely available as generic. Affordable compared to Epidiolex. Important interaction with Epidiolex — increases hepatotoxicity risk if used together.
Rufinamide (Banzel)
FDA-approved specifically for adjunctive treatment of LGS in patients 1 year and older. Effective for tonic and atonic (drop) seizures. Specialty medication. Not indicated for Dravet syndrome.
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Clobazam (Onfi)
majorEpidiolex increases active clobazam metabolite (N-desmethylclobazam) levels by ~3-fold, significantly increasing sedation. Monitor closely; clobazam dose reduction may be needed.
Valproate / valproic acid
majorConcurrent use significantly increases risk of liver transaminase elevations and hepatotoxicity. Monitor LFTs closely; consider dose reduction if elevations occur.
Everolimus (Afinitor)
majorEpidiolex inhibits everolimus metabolism (via P-gp and CYP3A4), significantly increasing everolimus levels. Dose reduction of everolimus required; regular therapeutic drug monitoring needed. Especially important for TSC patients.
CYP3A4 inducers (carbamazepine, rifampin, phenytoin)
moderateStrong CYP3A4 inducers can significantly reduce cannabidiol blood levels, potentially reducing Epidiolex efficacy. Note: carbamazepine and phenytoin are also contraindicated in Dravet syndrome.
CYP2C19 substrates (diazepam, stiripentol, omeprazole)
moderateCannabidiol inhibits CYP2C19, potentially increasing levels of co-administered CYP2C19 substrates. Monitor and adjust doses as needed.
CNS depressants and alcohol
moderateAdditive sedation and somnolence. Avoid alcohol; use other CNS depressants with caution and medical guidance.
St. John's Wort
moderatePotent CYP3A4 inducer that can significantly reduce Epidiolex blood levels. Avoid while taking Epidiolex.
Epidiolex (cannabidiol) represents a genuine breakthrough in the treatment of rare, treatment-resistant epilepsies. As the first and only FDA-approved prescription CBD, it has provided meaningful seizure reduction for patients with Lennox-Gastaut syndrome, Dravet syndrome, and tuberous sclerosis complex — conditions for which prior treatment options were severely limited. More than 55,000 families have started on Epidiolex, with its safety profile established over more than three years of clinical study.
The most significant challenges with Epidiolex are not medical, but logistical: specialty-pharmacy-only distribution, insurance prior authorization requirements, and high retail costs create real barriers even when the medication is medically indicated and available. The JazzCares support program (1-833-426-4243) addresses most of these barriers — from copay assistance to free bridge medication — and should be activated for every new patient at the time of prescription.
If you or a family member has been prescribed Epidiolex and are having difficulty locating it at a pharmacy, medfinder can help by contacting specialty pharmacies on your behalf to find which ones have it in stock and can fill your prescription, then texting you the results.
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