Nabilone

Generic Name: nabilone (NAB il own)Brand Names: Cesamet

What is nabilone?

Nabilone is a man-made form of cannabis (marijuana is an herbal form of cannabis). Nabilone causes many effects on your central nervous system.

Nabilone is used to treat severe nausea and vomiting that is caused by cancer chemotherapy. Nabilone is for use only when other medications have been unable to control the nausea and vomiting.

Nabilone may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about nabilone?

Nabilone may be habit-forming and should be used only by the person it was prescribed for. Nabilone should never be given to another person, especially someone who has a history of drug abuse or habitual marijuana use. Keep the medication in a secure place where others cannot get to it. Do not use nabilone if you have ever had an allergic reaction to natural or man-made marijuana.

Before taking nabilone, tell your doctor if you have high blood pressure, heart disease, a history of mental illness or drug addiction, or if you are also using other medicines that can affect your central nervous system, such as a tranquilizer, sleep medicine, or anti-psychotic medications.

Use this medication exactly as it was prescribed for you. Do not use it in larger amounts or for longer than recommended by your doctor.

Avoid using other medicines that affect the central nervous system (such as stimulants, diet pills, cold medicine, pain medication, muscle relaxers, and medicine for seizures, depression, anxiety, mental illness, or Parkinson's disease). These other drugs can add to the effects of nabilone.

Nabilone causes effects that will impair your thinking or reactions. Do not drive or do anything that requires you to be awake and alert until the effects of nabilone wear off.

There are many other medicines that can add to the side effects of nabilone. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

What should I discuss with my health care provider before taking nabilone?

Do not use nabilone if you have ever had an allergic reaction to natural or man-made marijuana such as dronabinol (Marinol).

Before using nabilone, tell your doctor if you have:

  • high blood pressure (hypertension);

  • heart disease;

  • past or present mental illness such as depression, schizophrenia, or other psychotic disorders;

  • a history of drug or alcohol addiction; or

  • if you are also using other medicines that can affect your central nervous system, such as a tranquilizer, sleep medicine, or anti-psychotic medications.

If you have any of these conditions, you may not be able to use nabilone, or you may need a dosage adjustment or special tests during treatment.

Nabilone may be habit-forming and should be used only by the person it was prescribed for. Nabilone should never be given to another person, especially someone who has a history of drug abuse or habitual marijuana use. Keep the medication in a secure place where others cannot get to it. FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether nabilone passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Older adults may be especially sensitive to the side effects of nabilone.

Nabilone is not for use in patients younger than 18 years old.

How should I take nabilone?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor.

Nabilone is usually given 1 to 3 hours before you receive your chemotherapy treatment. Your doctor may recommend that you take a small dose of nabilone on the night before your chemotherapy.

Nabilone may also be used 2 or 3 times each day of the chemotherapy treatment cycle, and for 48 hours after treatment ends, if needed.

The effects of nabilone may last for 48 to 72 hours, and this length of time may not be the same every time you take the medication.

Store nabilone at room temperature away from moisture and heat.

See also: Nabilone dosage in more detail

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. Symptoms of a nabilone overdose may include extreme drowsiness, fainting, hallucinations, fear, disorientation, unusual thoughts or behaviors, or feeling extremely happy or sad.

What should I avoid while taking nabilone?

Avoid using other medicines that affect the central nervous system (such as stimulants, diet pills, cold medicine, pain medication, muscle relaxers, and medicine for seizures, depression, anxiety, mental illness, or Parkinson's disease). These other drugs can add to the effects of nabilone.

Nabilone causes effects that will impair your thinking or reactions. Do not drive or do anything that requires you to be awake and alert until the effects of nabilone wear off.

Nabilone side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using nabilone and call your doctor at once if you have any of these serious side effects:
  • hallucinations (seeing or hearing things that are not there);

  • paranoia, extreme fear;

  • fast heart rate;

  • feeling light-headed, fainting; or

  • unusual thoughts or behavior.

Continue using nabilone and talk with your doctor if you have any of these less serious side effects:

  • dizziness, drowsiness;

  • feeling "high";

  • weakness, lack of coordination;

  • depression, anxiety, confusion;

  • dry mouth;

  • headache, trouble concentrating; or

  • sleep problems (insomnia).

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. You may report side effects to FDA at 1-800-FDA-1088.

Nabilone Dosing Information

Usual Adult Dose for Nausea/Vomiting -- Chemotherapy Induced:

Initial dosage: 1 mg or 2 mg orally twice daily 1 to 3 hours before the chemotherapeutic agent is administered. A dose of 1 mg to 2 mg by mouth the night before chemotherapy may be useful.Nabilone may be administered two to three times daily during the entire course of each cycle of chemotherapy and, if needed, for 48 hours after the last dose of each cycle of chemotherapy.The maximum recommended daily dose is 6 mg given in divided doses three times daily.

Usual Pediatric Dose for Nausea/Vomiting -- Chemotherapy Induced:

Safety and effectiveness have not been established in patients younger than 18 years of age. Caution is recommended in prescribing nabilone to children because of psychoactive effects.

What other drugs will affect nabilone?

Before taking nabilone, tell your doctor if you are using any of the following drugs:

  • amphetamines, including stimulants and medicine to treat attention deficit hyperactivity disorder (ADHD);

  • prescription or over-the-counter weight loss aids (Dexatrim, Meridia);

  • antidepressants such as amitriptyline (Elavil), amoxapine (Ascendin), clomipramine (Anafranil), desipramine (Norpramin), imipramine (Tofranil), or nortriptyline (Pamelor);

  • barbiturates such as butalbital (Fiorinal), phenobarbital (Luminal, Solfoton), secobarbital (Seconal);

  • sedatives such as Ativan, Dalmane, Halcion, Klonopin, Librium, ProSom, Restoril, Tranxene, Valium, Xanax;

  • lithium;

  • theophylline (Respbid, Slo-Bid, Theo-24, Theo-Dur, Uniphyl);

  • buspirone (BuSpar);

  • atropine (Donnatal, and others);

  • belladonna, dicyclomine (Bentyl);

  • clidinium (Quarzan);

  • glycopyrrolate (Robinul);

  • hyoscyamine (Anaspaz, Cystospaz, Levsin, and others);

  • mepenzolate (Cantil);

  • methscopolamine (Pamine), and scopolamine (Transderm-Scop);

  • methantheline (Provocholine), propantheline (Pro-Banthine); or

  • street drugs such as cocaine or Ectasy.

If you are using any of these drugs, you may not be able to use nabilone, or you may need dosage adjustments or special tests during treatment.

There may be other drugs not listed that can affect nabilone. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist has more information about nabilone written for health professionals that you may read.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Copyright 1996-2006 Cerner Multum, Inc. Version: 1.02. Revision Date: 4/12/2009 4:44:20 PM.
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