Epidyolex® in Switzerland — CBD for treatment-resistant epilepsy
Epidyolex® is the only Swissmedic-approved highly purified CBD drug (100 mg/ml oral suspension) for rare treatment-resistant epilepsy syndromes.
Highly pure pharma CBD (99.9 %), no psychoactive effect.
Approval for 3 rare treatment-resistant epilepsy forms.
Standard dose: 5–20 mg/kg/day in 2 doses.
Price: CHF 700–1,200 per 100 ml bottle — often > CHF 2,000/month.
Basic-insurance coverage for approved indication with prior approval.
What is Epidyolex®?
Epidyolex® is a standardised oral suspension containing 100 mg of cannabidiol per ml. The active substance is extracted from cannabis plants and pharmaceutically purified (99.9 % purity), with THC content below 0.1 %.
Unlike Sativex®, Epidyolex® contains no THC and is not psychoactive — no narcotic prescription required, but a medical prescription is.
Use and dosing
Starting dose: 2.5 mg/kg twice daily (5 mg/kg/day). After 1 week, increase to 5 mg/kg twice daily (10 mg/kg/day). Weekly further increases possible up to max. 25 mg/kg/day depending on response and tolerance.
Taking with a fat-rich meal significantly increases bioavailability. Important: consistent dosing with or without food.
Price and coverage
Ex-factory Epidyolex® 100 ml (100 mg/ml): CHF 700–1,200. For a 20 kg child at 10 mg/kg/day, that is ~60 ml/month — monthly cost CHF 400–700. For adults at 15–20 mg/kg/day, costs can exceed CHF 2,000.
Basic insurance (KVG): Epidyolex® is on the SL for Dravet, LGS and TSC with limitation. Reimbursed after prior approval.
Side effects and interactions
Common: somnolence, decreased appetite, diarrhoea, elevated liver transaminases. Liver tests before start and at 1, 3, 6 months mandatory.
Important interaction: markedly increases clobazam levels — dose adjustment needed. Also relevant: valproate (hepatotoxicity), CYP3A4/CYP2C19 substrates.
Is Epidyolex® a narcotic?
No. Epidyolex® contains pure CBD (no THC above 0.1 %) and does not fall under the Narcotics Act. Prescription required, but not a narcotic prescription.
Does Epidyolex® work for all epilepsies?
Swissmedic approval only for Dravet, Lennox-Gastaut and TSC. Off-label use is possible but rarely reimbursed.
Can children take Epidyolex®?
Yes — approved from age 2. Dosing is weight-adjusted.
How fast does Epidyolex® work?
First seizure reduction often after 2–4 weeks. Full effect after reaching optimal dose (4–8 weeks).
Does insurance cover Epidyolex®?
For approved indication with prior approval: yes. Off-label: rarely.
Epidyolex® is a prescription drug. Use only under specialist supervision (neuropediatrics/epileptology).