nabilone: clinical use

Prescribing considerations

• Licensed for adults with chemotherapy-induced nausea and vomiting inadequately controlled by conventional antiemetics.
• Review psychiatric history, substance or alcohol misuse, cardiovascular disease, hepatic and renal function, and interacting medicines.
• Effects can be variable and psychiatric reactions may continue after treatment has stopped.
• Potential euphoria, misuse and dependence warrant controlled-drug safeguards.

Contraindications and cautions

• Known allergy to cannabinoid agents.
• Nausea or vomiting caused by something other than cancer chemotherapy.
• Mental illness, including depression or manic-depressive illness.
• Not recommended in severe liver impairment or for people younger than 18 years.

Monitoring

• Mental state, mood, behaviour, hallucinations and confusion.
• Sedation, visual disturbance, coordination and ability to perform safety-critical tasks.
• Blood pressure and heart rate when clinically relevant.
• Signs of misuse, dependence or additive central nervous system depression.

Clinical pharmacology

Nabilone is an orally absorbed synthetic cannabinoid with antiemetic activity. Its precise antiemetic mechanism is unresolved; it acts at several points within central vomiting-control pathways.

Formulation and product differences

• The selected product is a hard gelatin oral capsule supplied in bottles or blister packs.
• The capsule shell contains gelatin and colouring agents; no special storage conditions are required.

Capsule

Route: Oral

Strengths: 0.25 mg, 1 mg