EMERALD OLE trial is an open-label extension of the EMERALD trial. Long term tolerability and safety of the MediCabilis CBD oil has not been extensively studied. EMERALD OLE aims to establish data on the prolonged used of the study drug product.

All participants who completed the EMERALD trial will be offered to enter EMERALD OLE. Participants will be taking the active drug MediCabilis CBD oil for 6 months.

Inclusion Criteria:

• Diagnosed with ALS/MND, either definite or probable according to the El Escorial revised criteria
• Can provide written informed consent
• Able and willing to comply with all study requirement
• Male or female, 25-80 years old
• Randomised into the EMERALD trial

Exclusion Criteria:

• Participants who are bedridden
• History of any psychiatric disorder other than depression associated with their underlying condition including immediate family history of schizophrenia
• Heavy consumption of alcohol or use of illicit drug
• Hypersensitivity to cannabinoids or any of the excipients
• Any of the following: eGFR <30 mL/min/1.73m2, ejection fraction <35%, or AST and ALT >5 X ULN
• Unwillingness of a female participant of child-bearing potential, or their partner, to use effective contraception during the study and 30 days thereafter
• Pregnant, lactating mother or female participant planning pregnancy during the course of the study and for 30 days thereafter
• Received any investigational drug or medical device within 30 days prior randomisation except MediCabilis CBD Oil
• Any other significant disease or disorder which, in the opinion of the investigator, may either put the participant at risk because of participation in the study, or may influence the result of the study, or the participant's ability to participate in the study
• Inability to cooperate with the study procedures
• Unwilling to stop driving vehicle or operating dangerous machinery whilst on study drug.
• Close affiliation with the study team, e.g. close relative of the investigator