Classifications: synthetic cannabinoid; antiemetic; Therapeutic:antiemetic; cannabinoid
Pregnancy Category: C
Controlled Substance: Schedule II
1 mg capsules
Nabilone is a synthetic cannabinoid with multiple effects on the CNS. It is thought that the antiemetic effect results from
its interaction with the cannabinoid receptor system (CB 1 receptor) in neural tissues. In therapeutic doses, it produces
relaxation, drowsiness, and euphoria.
It effectively controls emesis in patients receiving chemotherapy when other drugs have failed.
Prevention and treatment of nausea and vomiting in adult patients induced by cancer chemotherapy refractory to standard antiemetic
Hypersensitivity to any cannabinoid; hypovolemia; pregnancy (category C); lactation.
Children; older adults; history of psychosis.
Route & Dosage
|Nausea and Vomiting
Adult: PO Initial dose of 1 or 2 mg b.i.d. 13 h before chemotherapy. May increase to max of 2 mg t.i.d. May continue for 48 h
after last dose of chemotherapy.
- Give 13 h before chemotherapy is begun. A dose of 12 mg the night before chemotherapy may be helpful in relieving
- Store at 15°30° C (59°86° F).
Adverse Effects (≥1%)CNS:
Asthenia, ataxia, confusion difficulties,
disorientation, drowsiness, dysphoria, euphoria,
headache, sedation, sleep disturbance, vertigo. CV:
Anorexia, dry mouth,
increased appetite, nausea. Special Senses: Visual disturbances.
InteractionsDrug: sedatives, hypnotics,
and other psychoactive substances can potentiate the CNS
effects of nabilone. Coadministration of cannabinoids with amphetamine, cocaine, tricyclic antidepressants,
and/or sympathomimetic agents
can produce additive hypertension and tachycardia. Coadministration of cannabinoids with antihistamines
or anticholinergic agents
can produce additive tachycardia and drowsiness. Coadministration of cannabinoids with barbiturates, benzodiazepines
, buspirone, ethanol, lithium, muscle relaxants
, and other cns depressants
can produce additive drowsiness and CNS-depressant effects. Food: Alcohol
can potentiate the CNS
effects of nabilone.
Complete absorption from GI tract. Peak:
2 h. Metabolism:
Extensive hepatic metabolism
Fecal (major) and urine. Half-Life:
Assessment & Drug Effects
- Monitor for and report S&S of adverse psychiatric reactions (e.g., disorientation, hallucinations, psychosis) for 4872
h after last dose of nabilone.
- Monitor for S&S of tachycardia and postural hypotension, especially in the older adult and those with a history of heart
disease or hypertension.
- Lab tests: Periodic CBC with Hgb & Hct.
Patient & Family Education
- Do not use alcohol or other CNS depressants while using this medication.
- Do not drive or engage in potentially hazardous activities until response to drug is known.
- Report any of the following to a health care provider: confusion, disorientation, hallucinations, or other bizarre behavior.