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Treatment-resistant epilepsy

Medical cannabis (CBD-dominant) in treatment-resistant epilepsy in South Africa. Evidence base for Dravet and Lennox-Gastaut, and how Section 21 is assessed.

/conditions/treatment-resistant-epilepsy

CBD (cannabidiol)

Non-psychoactive cannabinoid with established use in some seizure disorders and emerging use in anxiety.

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CBG (cannabigerol)

Precursor cannabinoid from which THC and CBD are biosynthesised; limited clinical evidence to date.

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Cannabinoid

A class of compounds that interact with the endocannabinoid system — includes plant-derived (THC, CBD), synthetic, and endogenous forms.

/glossary/cannabinoid

CYP2C9

CYP450 isoform that metabolises warfarin and NSAIDs; inhibited by CBD and THC.

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CYP3A4

Most abundant hepatic CYP450 isoform; affected by both THC and CBD.

/glossary/cyp3a4

Schedule 0

OTC category in South Africa; allows low-dose CBD under Gazette 43347 conditions.

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Schedule 4

Prescription-only medicines; includes most THC:CBD combination oils.

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Government Gazette 43347

The 2020 SA Government Gazette that created the Schedule 0 carve-out for low-dose CBD.

/glossary/gazette-43347

Cannabidiol (CBD) products in South Africa — Schedule 0 vs Section 21 explained

You can buy low-dose CBD over-the-counter in any SA pharmacy under Gazette 43347, but clinically relevant doses require Section 21 access. Here is the regulatory split, why it exists, and what it means for patients.

/articles/cbd-schedule-0-vs-section-21