Nabilone
CESAMET
Pronunciation: NAB-i-loen
What it isSynthetic oral CB1-receptor agonist; chemotherapy nausea unresponsive to conventional antiemetics.
Why this oneUnlike dronabinol, it is a cannabinoid analog rather than THC itself, but it retains similar psychoactive liabilities.
What limits itPsychotomimetic effects can outlast dosing; avoid in psychosis or substance-use risk, and use caution in unstable cardiovascular disease.
FDA-approved for
- chemo nausea (1985)
Off-label
- PTSD-related nightmares
- fibromyalgia pain
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Chemotherapy-induced nausea and vomiting | adult | 1–2 mg BID | 6 mg/day (divided TID) |
Renal Undefined
Hepatic Undefined
First dose 1–3 h before chemo; may continue up to 48 h after last chemo dose
Instructions
- Give initial dose 1–3 h before the chemotherapeutic agent
- Use the lower starting dose to minimize side effects; a 1–2 mg dose the night before may help
- Continue 2–3 times daily through the chemotherapy cycle, and if needed up to 48 h after the last chemo dose
Available strengths
- cap 1 mg
Contraindications
- Hypersensitivity to any cannabinoid
Cautions
- Psychiatric reactions (euphoria, dysphoria, hallucinations, psychosis)
- Effects on mental/physical abilities
- Orthostatic hypotension/tachycardia
- Additive CNS depression
Adverse reactions
- Drowsiness
- Vertigo/dizziness
- Dry mouth
- Euphoria
- Ataxia
- Headache
- Concentration difficulty
Pregnancy Undefined
Lactation Undefined
Cost
| Strength | #/mo | generic $/mo | CostPlus | |
|---|---|---|---|---|
| 1 mg | cap | 60 BID | not offered |
Generic entryBy 2023
NO BOXED WARNINGS
Principal riskprolonged psychotomimetic reactions, including hallucinations or psychosis
Classes and tags
Clinical profile
Legacy pregnancy categoryC
Defining liabilitySedation, QT prolongation, extrapyramidal symptoms or anticholinergic toxicity vary by receptor target.