Nabilone

CESAMET

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Pronunciation: NAB-i-loen

Nabilone ballicule: receptor binding, kinetics and half-life diagram — Mechanism of action: Nabilone ballicule

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.

Nabilone molecular structure (skeletal formula) — Molecular structure: Nabilone

Nabilone prescription history

Animated chart of estimated U.S. prescriptions per year, Antiemetics (1946–2026). Nabilone enters in 2006 (estimated).

FDA-approved for

chemo nausea (1985)

Off-label

PTSD-related nightmares
fibromyalgia pain

Principal riskprolonged psychotomimetic reactions, including hallucinations or psychosis

Classes and tags

Clinical profile

Therapeutic safety burden2 / 4

Overdose danger2 / 4

Weight-gain liability1 / 4

Sedation liability2 / 4

QT / Torsades0 / 4

Direct muscarinic antagonism0 / 4

Embryofetal risk1 / 4

Legacy pregnancy categoryC

Defining liabilitySedation, QT prolongation, extrapyramidal symptoms or anticholinergic toxicity vary by receptor target.

FDA label

Read the full label on DailyMed ↗

NO BOXED WARNINGS

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

Nabilone (CESAMET)

Strength		#/mo	generic $/mo	CostPlus
1 mg	cap	60 BID		not offered

NADAC is a voluntary CMS survey of what retail community pharmacies pay for the drugs they stock. Nabilone is dispensed outside retail pharmacies, so it rarely appears on surveyed invoices.

Generic entryBy 2023

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Self-check

How does nabilone differ chemically from dronabinol?
A cannabinoid analog rather than THC itself.
Can nabilone’s psychotomimetic effects outlast dosing?
Yes.