Medical Cannabis

Approved products

Medical cannabis in Australia is tightly regulated, with only two products fully approved by the TGA and many others available only through special access pathways.

The product currently approved for epilepsy is Cannabidiol (Epidyolex®), a CBD only product. High-quality evidence supports the use of Epidyolex® for seizures associated with two severe epilepsy syndromes:

• Lennox-Gastaut syndrome (LGS), and 
• Dravet syndrome (DS)

Clinical trials have demonstrated that for some people with these conditions, CBD can lead to a 50% or greater reduction in seizures, and a small percentage of people may even achieve complete seizure freedom.

Other benefits

Many people and caregivers report an improved quality of life, including better mood, sleep, and alertness, when using medicinal cannabis as part of their treatment regimen.

See the TGA for more information about the use of medical cannabis in Australia.

For more information about Epidyolex(R) 

Medical cannabis in Australia is regulated by the Therapeutic Goods Administration (TGA). Only a small number of products are fully TGA‑approved, while most are unapproved and need to be accessed through pathways such as the Special Access Scheme (SAS‑B) or the Authorised Prescriber (AP) Scheme. These unapproved products have not undergone full TGA assessment for safety, quality, or effectiveness, but can be prescribed when clinically appropriate.

This means that you can’t simply go to a doctor, obtain a prescription, and fill it at a pharmacy as you would with conventional registered medicines. A doctor must either:

• be an ‘Authorised Prescriber’ or
• apply for access through the TGA’s Special Access Scheme (SAS‑B).

These applications are usually processed quickly, but the exact rules can differ between states and territories, especially for products containing THC.

Advertising medical cannabis is not allowed in Australia. This means companies can’t promote their products, which can make it hard for patients to know what’s available. Despite this, there are now medical cannabis products that doctors can access through TGA pathways, and some doctors may also prescribe compounded products when appropriate.

Read here about accessing medical cannabis

Current regulation

In most states any doctor can prescribe medical cannabis for any patient with any condition, if they have the required approvals. In addition to a doctor prescribing the treatment, the legal use of cannabis for medical purposes differs by States and Territories. See below for the regulations in your state.

• Federal Government – The Federal Government relaxed medicinal cannabis restrictions in March 2018 and has passed legislation legalising the cultivation of cannabis for medicinal purposes.
• ACT – See ACT Health for details
• New South Wales – See Centre for Medicinal Cannabis Research and Innovation for clinical guidelines. See also NSW Health
• Northern Territory – See NT Government for details
• Queensland – See Queensland Health for details.
• South Australia See SA Health for details or Patient Access in SA.
• Tasmania See Tasmanian Department of Health for details.
• Victoria – See Health.Vic for details
• Western Australia – See WA Department of Health for details
• See here for TGA’s information about Access to Medicinal Cannabis Products

It should be noted that people should be advised that they are not able to drive while treated with medicinal cannabis that contains THC. Measurable concentrations of THC can be detected in saliva for many hours after administration (TGA 2024). Speak to your specialist about this if you have concerns.

CBD may or may not work for you. It is comparable to trying a new medication for your seizures – sometimes they work, sometimes they don’t. They all have side-effects. We hear different reports and the results vary from person to person. However, there is evidence that the use of CBD improves seizure control in people with specific epilepsy syndromes – Lennox Gastaut Syndrome and Dravet Syndrome.

Bear these points in mind if you are thinking about trying CBD:

• There is no certainty it will be effective for your epilepsy or seizure type. You may have a honeymoon period initially, like any other anti-seizure medication, but there is no guarantee it will work long-term for you.
• There can be benefits such as improved sleep, enhanced mood, increased alertness and better cognitive functioning.
• It has side effects just like any other medication.
• It can also affect or interact with medications you may be taking therefore medical advice and supervision is necessary.
• It may impact your driving license, and traces of THC may be found on a roadside drug test. Check your state laws around this.
• People with epilepsy generally need high doses, so costs may be high.
• There can sometimes be issues with supply, so there may be occasions where you are unable to get your CBD product which can increase the risk of seizures.
• You should not stop your anti-seizure medication, CBD is regarded as an add-on treatment to be used alongside your medication.
• If you have side effects or little effectiveness or decide CBD isn’t for you, then you need to wean off the CBD like any other anti-seizure medication, so you will still be outlaying a lot of money whilst weaning.

If you are thinking of trying medical cannabis it is very important that you first speak to your neurologist or treating doctor.

In this context, we are referring to medical cannabis which is prescribed by a registered healthcare practitioner to relieve the symptoms of certain medical conditions. This information is not in relation to unregulated or non-prescribed cannabis products.

Currently the Royal Australasian College of Physicians advises patients taking CBD-only products can drive unless they feel impaired. If the medical cannabis contains THC, then the person will not be able to drive, because any detectable amount of THC is an offence under Australia’s Presence Law.  A valid prescription for medical cannabis cannot be used as a defence against a charge of testing positive for THC on a roadside drug test.

Your suitability to drive depends on the type of treatment you have been prescribed, and this should be discussed with your prescribing doctor.

Driving and Cannabidiol (CBD)

There is no evidence that CBD affects driving.

There are no legal driving restrictions for people taking prescription CBD only medicines. However, if the CBD side effects cause impairment, such as drowsiness or fatigue, then you must not drive.

Like other medications, CBD has side effects and can cause drowsiness, fatigue and in some instances lowered blood pressure when first starting the medication. These symptoms are seen more often when the CBD is taken at high doses or with another interacting medication so extreme caution is required when operating heavy machinery or driving.

Driving and Tetrahydrocannabinol (THC)

In Australia, there is zero tolerance for driving with the presence of Tetrahydrocannabinol (THC) in oral fluid, blood or urine. Even if the driver has a prescription for medical cannabis, there is no exemption or legal defence for driving with even a trace of THC.

THC can affect thinking and motor skills necessary for safe driving such as attention, judgement, memory, vision and coordination.

People taking medical cannabis need to be aware that THC can be detected in urine for many days after the last dose of medicinal cannabis. It can take up to five days for 80 – 90% to be excreted from the body.

More research is needed in the area of driving and medical cannabis but so far the research has shown:

• vaporised cannabis containing THC can increase lane weaving and impair cognitive function in a driving simulator
• combining cannabis containing THC and alcohol dramatically impairs performance
• risks are greatest when a person first starts taking medicinal cannabis containing THC or if the dosage increases.

Unlike alcohol, a direct relationship between blood levels of THC and levels of driving impairment has not yet been established.

There is zero tolerance for driving with the presence of Tetrahydrocannabinol (THC) in oral fluid, blood or urine. It is important to discuss the impact of medicinal cannabis on your driving with your doctor.

Studies are underway to look at how medical cannabis impacts driving in people who take it for long-term health conditions

Read the Driving Factsheet from the Centre for Medical Cannabis Research

See TGA Medical Cannabis Hub

If you have a legal* prescription for medical cannabis from a doctor, then you are able to travel with it. Travelling with prescribed medical cannabis in Australia should be no different from any other medication.

Planning ahead will reduce anxiety about carrying medical cannabis across borders and ensure you are following the laws of the country you are leaving.

*a prescription from a medical practitioner who have had the cannabis medicine supplied in accordance with that prescription (i.e. by dispensing through a pharmacist)

When travelling interstate

THC is considered a Schedule 8 drug whilst CBD is a Schedule 4 drug. See the TGA for information about scheduling.

Each Australian state and territory has specific requirements about carrying Schedule 8 and other restricted medications across borders; some require a script written by a local medical practitioner to lawfully possess that product. Queensland and Tasmania have additional requirements for CBD products even though they are not Schedule 8 drugs.

If in doubt about what is required, contact your local state or territory health department.

It is generally accepted that medicinal cannabis, as a prescribed medication in the original packaging, will be exempt from confiscation and prosecution for patients travelling between states.

Travelling out of Australia

There are very few restrictions about the medications or medical devices you can take out of Australia. It is important, however, to check whether they are permitted in the country you are travelling to, as well as any country you will past through in transit.

At this time it is generally difficult to fly internationally carrying medical cannabis, even if it has been legally prescribed in Australia, because it is a controlled or prohibited product in some countries.

Before you leave Australia you should contact the Embassy or Consulate of the countries you intend to visit. Each country has its own required documentation for customs clearance when carrying medicinal cannabis.

Always check the specific requirements of your destination and transit countries before travelling.

Always carry a letter from your doctor stating the name of the medicine, how much you are taking and that it is for your personal use. Keep the medicine in the original packaging for easy identification.

If you will be away for more than three months, ask your doctor about access overseas as not all medicines are available in all countries.

Travelling into Australia

For personal use

To bring medical cannabis into Australia for personal use, you must meet the requirements of the traveller’s exemption. This means the medicine must have been prescribed for you (or an immediate family member travelling with you) by a medical practitioner and supplied in accordance with that prescription, usually by a pharmacist.

In some countries, the way medical cannabis is provided will not meet Australian requirements. Documents such as a “medicinal cannabis licence” or a general “recommendation” may not be enough on their own—you may still need a formal prescription and pharmacist‑dispensed product to legally bring the medicine into Australia.

You should:

• Keep the medical cannabis in its original packaging with the pharmacist’s dispensing label
• Carry a copy of the medical prescription with the medicine
• Bring no more than three months’ supply for personal use under the traveller’s exemption
• Ensure the medicine is carried by you or an immediate family member (such as a parent or carer) who is travelling with you
• It is also important to check how much medical cannabis you are allowed to take out of the country you are departing from, as those rules are set by that country, not Australia.

Because laws vary widely, you should not rely on fixed rules for specific countries.

Instead:

• Check the legal requirements for each country you are travelling to, as well as any country where you will be in transit
• Be aware that some countries have very strict laws and serious penalties, including jail terms, for possessing cannabis products that are not permitted in that jurisdiction
• Contact the Embassy or Consulate of each country you plan to visit or transit through to confirm their rules and documentation requirements

For more detailed information, visit the Therapeutic Goods Administration (TGA) and Office of Drug Control websites and search for information on the traveller’s exemption for medicinal cannabis.

Like other medicines, medical cannabis can interact with some prescription medicines. This doesn’t mean you can’t use it — but it does mean your doctor and pharmacist need to know other medication you’re taking so they can prevent this from happening.

Medical cannabis contains CBD and/or THC. These may affect how your body processes other medication, especially those broken down by the liver.

• CBD is the most likely to cause interactions
• THC can also interact, but usually to a lesser extent

This may interfere with how other medications are metabolised and change the levels in the blood, causing them to either become stronger, weaker, or more likely to cause side effects.

Medication where interactions are more likely

Recent studies show interactions are most common with the below medication types – which require careful monitoring:

1. Anti‑seizure medication

• CBD can increase levels of some anti‑seizure medication
• This may cause extra tiredness, unsteadiness, or other side effects

Researchers at the University of Alabama USA studied interactions between CBD and anti-seizure medications. They found significant changes in serum levels for clobazam (Frisium), rufinamide (Banzel), topiramate (Topamax) and eslicarbazepine (Zebinix or ESL) in the presence of CBD. They also noted abnormal liver function tests when CBD was taken with Valproate (Epilim). This study emphasises the importance of monitoring antiseizure medication blood levels and liver function tests during treatment with CBD.

Gaston TE, Bebin EM, Cutter GR, Lui Y, Szaflarski JP, 2017, Interactions between cannabidiol and commonly used antiepileptic drugs, Epilepsia, Vol. 58, No. 9, p.p. 1586-92.

2. Blood thinners

• CBD may increase warfarin levels
• This can raise the risk of bleeding

3. Medicines that cause drowsiness

Examples: opioids, benzodiazepines, sleeping tablets

• THC and CBD can add to the sedating effects
• This may affect alertness, driving, and falls risk

5. Some antidepressants and antipsychotics

• Interactions vary depending on the medication
• Your doctor may adjust the dose or monitor more closely

CBD interactions can be complex. Always:

• Tell your doctor and pharmacist all medications you are taking (bring a full list)
• Ask your doctorwhat symptoms to watch for
• Avoid changing doses without speaking to your doctor

Before starting any form of medical cannabis it is worthwhile to check for any potential drug to drug interactions not only with anti-seizure medications but any other prescription, over-the-counter, or supplements.

Epilepsy Action believes in a thorough pharmacologic and clinical investigation into medical cannabis to confirm or disprove its safety and anti-seizure potential. We are at the forefront of advocating for increased research into this area of new hope, and assisting through various Government and University constituted Boards and Steering Committees.

For more information and guidance around medicinal cannabis go to the TGA Medical Cannabis Hub

Further Information

• Lambert Initiative for Cannabinoid Therapeutics
• Health Direct – Medical Cannabis
• Understanding Cannabinoids video
• Medical Cannabis and Epilepsy Factsheet
• Documentary covering the life work of Professor Raphael Mechoulam, considered to be the founding father in the field of cannabinoid research

Epilepsy Action Australia acknowledges and thanks David and Erin Oudshoorn for their significant contribution to the development of the medicinal cannabis resources. Their work was shaped by lived experience and a commitment to supporting families navigating complex information.

We also honour their daughter, Luella, whose journey inspired this work. Her legacy lives on through the knowledge shared and the support provided to families across Australia.