Nabilone
CESAMET
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
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
NO BOXED WARNINGS
Principal riskprolonged psychotomimetic reactions, including hallucinations or psychosis
Cost, est. cash$200–$1,500/month
Generic entryBy 2023
Classes and tags
Clinical profile
Legacy pregnancy categoryC
Defining liabilitySedation, QT prolongation, extrapyramidal symptoms or anticholinergic toxicity vary by receptor target.
Mechanism of action: Nabilone ballicule
