Adult Dosing

Chemo-related nausea/vomiting

• 1-2 mg PO bid
• Start: 1 mg PO bid
• Administer first dose 1-3 hrs before chemotherapy; Max: 2 mg tid
• Note: Give 1-2 mg PO night before chemotherapy for patients who fail to respond to conventional antiemetic treatment. May be administered max. 6 mg/day PO divided bid-tid during the entire course of each cycle of chemotherapy. If required, continue up to 48 hours after the last dose of chemotherapy.

Pediatric Dosing

• Safety and effectiveness in pediatric patients have not been established

• Nausea and vomiting associated with cancer chemotherapy in patients who have failed to respond adequately to conventional antiemetic treatments

• Hypersensitivity to any of the ingredients of the product

• N/A

Renal Dose Adjustment

• Renal impairment: Dose adjustments not defined

Hepatic Dose Adjustment

• Hepatic impairment: Dose adjustments not defined

• Therapy may cause tachycardia and orthostatic hypotension
• Due to high abuse potential, limit prescriptions to the amount necessary for a single cycle of chemotherapy
• Adverse psychiatric reactions may persist for 72 hrs following cessation of therapy
• Nabilone may cause adverse reactions such as dizziness, drowsiness, euphoria, ataxia, anxiety, depression, disorientation, hallucinations and psychosis
• It may also cause postural hypotension
• Advise patients to avoid engaging in driving, operating machinery and other hazardous activity
• Avoid concomitant use of alcohol, sedatives, hypnotics, or other psychoactive substances as these substances can potentiate the central nervous system effects of nabilone
• Use with caution in the elderly, and in patients with hypertension or heart disease as therapy may elevate supine and standing heart rates and cause postural hypotension

Cautions: Use cautiously in

• Hypertension
• Coronary artery disease
• Orthostatic hypotension
• Psychiatric disorders (depression, mania, schizophrenia)
• Family hx of psychiatric disorders
• Family hx of substance abuse
• CNS depressants use
• Substance abuse
• Concomitant therapy w/ sedatives/hypnotics/ or other psychoactive drugs
• Elderly patients

Pregnancy Category:C

Breastfeeding: Safety unknown; due to the potential for serious adverse reactions in nursing infants, manufacturer recommends discontinuation of nursing or discontinuation of drug, taking into account the importance of the drug to the mother.

• CNS: Depenendancy, abuse, concentration difficulty, drowsiness, euphoria, sleep disturbance, hallucination, vertigo, sedation, altered mental state, anxiety, psychosis, depression, detachment, disorientation, headache, panic, paranoia, psychotomimetic reactions, asthenia, depersonalization
• EENT: Visual disturbance
• CV: Orthostatic hypotension, tachycardia
• GI: Dry mouth, increased appetite, nausea, anorexia
• NEURO: Ataxia, physical dependence, psychological dependence

• Cannabinoid; produces antiemetic and other complex CNS effects (synthetic cannabinoid agonist) by binding to cannabinoid receptors in neural tissues
• Well absorbed following oral administration
• Extensively metabolized by liver; CYP450: 2C8/2C9 moderate inhibitor, 2E1/3A4 weak inhibitor
• Excreted in feces: 60%; urine: 24%
• Half-life: 2 hrs

US Trade Name(s)

• Cesamet

US Availability

Cesamet

• CAPS: 1 mg

Canadian Trade Name(s)

• Cesamet

Canadian Availability

Cesamet

• CAPS: 0.25, 0.5, 1 mg

UK Trade Name(s)

• Only generic available

UK Availability

nabilone (generic)

• CAPS: 1 mg

Australian Trade Name(s)

• N/A

Australian Availability

• N/A

Gastrointestinal

Antiemetics

Cannabinoids

• Cesamet 1 MG Oral Capsule (Meda Pharmaceuticals Inc.)
• Cesamet 1 MG Oral Capsule (Valeant Pharmaceuticals International)
• Cesamet 1 MG Oral Capsule (Valeant Pharmaceuticals North America)