Drug & supplement interaction

Cannabidiol (cbd) + Oxcarbazepine

Oxcarbazepine brand names: Trileptal, Oxtellar XR.

Moderate Interaction
The bottom line Moderate

Oxcarbazepine falls into 3 drug categories that Cannabidiol (cbd) can interact with; the most serious is rated moderate. Theoretically, cannabidiol might have additive effects if used with other CNS depressants.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions3
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Cannabidiol (cbd) and Oxcarbazepine

These two interact in 3 distinct ways. Each one is explained separately below.

Why Are There 3 Interactions?

Cannabidiol (cbd) interacts with whole categories of medication. Oxcarbazepine falls into 3 of those categories, so it can interact with Cannabidiol (cbd) in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

CNS DEPRESSANTS

1 of 3

Why this applies to Oxcarbazepine

Oxcarbazepine falls under CNS DEPRESSANTS — the group Cannabidiol (cbd) interacts with.

Theoretically, cannabidiol might have additive effects if used with other CNS depressants.
Preliminary clinical research, case reports, and animal studies suggest that high dose cannabidiol has sedative and hypnotic effects. Theoretically, concomitant use of cannabidiol with drugs with sedative and anesthetic properties may cause additive therapeutic and adverse effects.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the simple version: oxcarbazepine already tends to make people feel drowsy, dizzy, or a little foggy, especially when you first start it. CBD, particularly at higher supplement doses, can have its own calming, sleepy effect. Put the two together and those effects may stack up, so you could feel more tired, unsteady, or slowed down than you would with either one alone.

I'll be honest, this is mostly a theoretical concern based on how each one acts, not on strong studies with this exact pair, so don't panic. Still, since oxcarbazepine controls seizures, it's worth a quick chat with your pharmacist or doctor before adding CBD. They can watch for extra drowsiness and make sure nothing about your seizure control changes.

References
  1. Carlini EA, Cunha JM. Hypnotic and antiepileptic effects of cannabidiol. J Clin Pharmacol 1981;21(8-9 Suppl):417S-27S. PubMed
  2. Monti JM. Hypnoticlike effects of cannabidiol in the rat. Psychopharmacology (Berl) 1977;55(3):263-5. PubMed
  3. Pickens JT. Sedative activity of cannabis in relation to its delta'-trans-tetrahydrocannabinol and cannabidiol content. Br J Pharmacol 1981;72(4):649-56.
  4. Perez-Vilar S, Karami S, Long K, Leishear K. Cannabidiol exposures in the United States, National Poison Data System, July 2014-June 2021. Clin Toxicol (Phila) 2022. PubMed
Moderate

CYTOCHROME P450 2C19 (CYP2C19) INHIBITORS

2 of 3

Oxcarbazepine also falls under CYTOCHROME P450 2C19 (CYP2C19) INHIBITORS.

Theoretically, CYP2C19 inhibitors might increase cannabidiol levels.
Cannabidiol is a substrate of CYP2C19 enzymes. Theoretically, drugs that inhibit CYP2C19 enzymes might increase levels of cannabidiol, increasing its effects and adverse effects.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the key thing with this pairing: it's the CBD that may build up, not your oxcarbazepine. Oxcarbazepine can act as a mild blocker of an enzyme called CYP2C19, which is one of the pathways your body uses to break down CBD. If that enzyme is slowed down, CBD can clear more slowly and its levels may creep up.

What that could look like in real life is more of CBD's own effects, like drowsiness, tiredness, or an upset stomach. This is only a theoretical concern based on how the drugs are processed, not on strong studies, so don't be alarmed. Still, before adding a CBD product, it's worth a quick chat with your pharmacist or doctor, since both can affect alertness and seizure control.

References
  1. Epidiolex (cannabidiol) prescribing information. Greenwich Biosciences, Inc., Carlsbad, CA, 2019. Available at: https://www.epidiolex.com/sites/default/files/EPIDIOLEX_Full_Prescribing_Information.pdf (accessed 5/9/2019)
Moderate

CYTOCHROME P450 3A4 (CYP3A4) INDUCERS

3 of 3

Oxcarbazepine also falls under CYTOCHROME P450 3A4 (CYP3A4) INDUCERS.

Theoretically, CYP3A4 inducers might decrease cannabidiol levels.
Cannabidiol is a substrate of CYP3A4 enzymes. Theoretically, drugs that induce CYP3A4 enzymes might reduce the levels and effects of cannabidiol.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the important thing to understand about this pairing: the effect goes in one direction. Oxcarbazepine speeds up an enzyme in your liver called CYP3A4, and that same enzyme helps break down CBD. So if you take them together, your body may clear the CBD faster, which can leave less of it in your system. In plain terms, your CBD might not work as well as you'd expect.

Good news for your seizure control: this interaction is not likely to weaken your oxcarbazepine or change how it manages your seizures. This is also a theoretical concern based on how the drugs work, not something proven in big studies, so don't be alarmed. If you're using CBD for a specific reason and notice it's not helping, chat with your pharmacist or doctor before changing anything.

References
  1. Epidiolex (cannabidiol) prescribing information. Greenwich Biosciences, Inc., Carlsbad, CA, 2019. Available at: https://www.epidiolex.com/sites/default/files/EPIDIOLEX_Full_Prescribing_Information.pdf (accessed 5/9/2019)

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Cannabidiol (cbd) Also Interacts With Other Medications

Cannabidiol (cbd) has 1,050 moderate known drug interactions in our database — the Oxcarbazepine one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Cannabidiol (cbd)

Covers the 2,830 medications we’ve checked against Cannabidiol (cbd). Pick one to open its full report.

From our Q&A

Questions About Cannabidiol (cbd) or Oxcarbazepine

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Cannabidiol (cbd) or Oxcarbazepine, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Oxcarbazepine

This page covers Cannabidiol (cbd) only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Oxcarbazepine page lists 122 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Activated Charcoal (major), Beer (major), Gamma-hydroxybutyrate (ghb) (major) and Kava (major).

By severity: 7 major · 99 moderate · 16 minor.

From our pharmacist’s overview on the Oxcarbazepine page

“People take oxcarbazepine (Trileptal, Oxtellar XR) to keep seizures in check, and I want anyone on it to read the seven major-rated interactions below before adding any supplement. Of the 122 ingredients on file, 78 have sedative effects, so the calming and sleep aids many patients reach for, kava among them, can pile drowsiness on top…”

Reviewed by 2 · Jul 18, 2026

Open the Oxcarbazepine interaction page

How much people look this up

Where Cannabidiol (cbd) and Oxcarbazepine Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Cannabidiol (cbd)
Top half

#399 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Oxcarbazepine
Steady interest

#1,857 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Cannabidiol (cbd)

What is Cannabidiol (cbd)?

  • Anxiety and stress
  • Sleep problems
  • Chronic pain
  • Certain seizure disorders
  • Inflammation

CBD is a compound from the cannabis (hemp) plant that does not cause a 'high.' It has strong evidence only for certain rare seizure disorders (as a prescription drug), while most other popular uses are still backed by limited or early research. Product quality varies a lot, so talk with your pharmacist or doctor before using it, especially if you take other medicines.

Read the full Cannabidiol (cbd) monograph & all interactions
Medication

About Oxcarbazepine

What Is Oxcarbazepine Used For?

Brand names: Trileptal, Oxtellar XR

Oxcarbazepine treats partial-onset seizures (seizures that start in one area of the brain). It can be used alone (monotherapy) or alongside other seizure medicines (adjunctive therapy).

For adults, oxcarbazepine tablets, film-coated tablets, and oral suspension are approved for both monotherapy and adjunctive therapy. Oxcarbazepine extended-release tablets are approved for partial-onset seizures in patients 6 years and older. In children, Trileptal and oxcarbazepine oral suspension are approved as monotherapy in children aged 4–16 and as adjunctive therapy in children aged 2–16.

See full Oxcarbazepine drug information
Keep checking

Other Drugs & Cannabidiol (cbd)

Browse every other medication we’ve checked against Cannabidiol (cbd) — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
1,050Moderate
0Minor
1,779No known interaction
Moderate

1,050 interactions

Showing 60 of 1,050 moderate interactions — see all 1,050 on the Cannabidiol (cbd) page.

No interaction 1,779 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Cannabidiol (cbd) and Oxcarbazepine Together: Common Questions

Can you take Cannabidiol (cbd) with Oxcarbazepine?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 3 interactions listed for Cannabidiol (cbd) and Oxcarbazepine?
Oxcarbazepine belongs to more than one drug category, and Cannabidiol (cbd) interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Cannabidiol (cbd) and Oxcarbazepine interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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