Cesamet
Cesamet (nabilone) is a controlled medication used for nausea and vomiting after other medications have failed, but it has a risk of altering your mental state.
What is Cesamet (nabilone)?
What is Cesamet (nabilone) used for?
- Nausea and vomiting associated with cancer chemotherapy after other antiemetics haven't worked
How Cesamet (nabilone) works
Cesamet (nabilone) is a synthetic cannabinoid. It's believed that the medication attaches to the cannabinoid receptor system in your brain to prevent nausea and vomiting.
Drug facts
Risks and warnings for Cesamet (nabilone)
Cesamet (nabilone) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Inability to focus and mental health-related side effects
- Risk factors: Older adults | History of mental health conditions | Taking other medications that cause drowsiness, dizziness, or confusion
Cesamet (nabilone) works on receptors in your brain and can sometimes cause unwanted side effects, which are more common in older adults. People with certain mental health conditions like mania, depression, or schizophrenia might have worsening problems after starting Cesamet (nabilone). It can also make you dizzy, drowsy, and affect your ability to concentrate. Don't drive, operate heavy machinery, or do any activities where you have to focus until you know how Cesamet (nabilone) affects you.
Heart and blood pressure changes
- Risk factors: History of heart problems | Taking other medications that have similar effects on the heart and blood pressure
Some people taking Cesamet (nabilone) might notice changes in their blood pressure or heartbeat. In some cases, the change in blood pressure can cause you to faint. These issues are more common in people who have a history of heart conditions or take medications that can have similar side effects. Make sure your care team knows your past medical history and has a full list of the medications you're taking. Let them know if you notice any changes in your blood pressure or heartbeat.
Side effects of Cesamet (nabilone)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Dizziness (52%)
- Drowsiness (52%)
- Dry mouth (36%)
- Slurred speech, not being able to walk straight (14%)
- Feeling "high," euphoria (11%)
- Sleep problems (11%)
Less Common Side Effects
- Feeling unhappy or unwell
- Nausea
- Feeling disoriented and disconnected
The following Cesamet (nabilone) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
Changes in mood
confusion
convulsions (seizures)
delusions
dizziness or fainting
fast or pounding heartbeat
hallucinations (seeing, hearing, or feeling things that are not there)
mental depression
nervousness or anxiety
unusual tiredness or weakness (severe)
Symptoms of overdose
Difficulty in breathing
hallucinations (seeing, hearing, or feeling things that are not there)
mental changes (severe)
nervousness or anxiety (severe)
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Clumsiness or unsteadiness
drowsiness
dryness of mouth
false sense of well-being
headache
Less common or rare
Blurred vision or any changes in vision
dizziness or lightheadedness, especially when getting up from a lying or sitting position—more common with high doses
loss of appetite
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Cesamet (nabilone)
Pros
- Stored at room temperature unlike other cannabinoids
- Sometimes covered by insurance (medical marijuana is not usually covered)
- Good option for people when first choice antiemetics haven't worked for
Cons
- Schedule II controlled medication, meaning there is risk for abuse and misuse; it can also be harder to get refills
- Has a lot of side effects especially in older adults
- Expensive, currently only available as brand
Pharmacist tips for Cesamet (nabilone)
- Your dose will usually start low and can be adjusted based on how your body responds to the medication. Make sure you work closely with your care team to let them know if it's helping with nausea and vomiting and if you're having side effects.
- The first dose is usually taken 1 to 3 hours before you start a chemotherapy cycle and can be continued up to 48 hours after the last dose of each cycle.
- Common side effects include dizziness and drowsiness, which can affect your ability to focus. Avoid doing tasks that require you to be alert until you know how the medication affects you.
- Let your provider know if you currently use or have a history of using recreational marijuana. Since Cesamet (nabilone) works similarly, it's helpful if your provider knows how your body responds to cannabis products.
- Do not take Cesamet (nabilone) with alcohol, sedatives, hypnotics, or other medications that affect your mental status. Taking these substances together can raise your risk of side effects.
Common questions about Cesamet
Yes, euphoria or "feeling high" is a common side effect of Cesamet.
Usually in the U.S., the term "narcotic" refers to opioid pain medications. As a cannabinoid, Cesamet works differently and belongs to a different drug class. Cesamet and opioid narcotics are all schedule II controlled medications.
The marijuana plant has two main types of cannabinioids, they are cannabidiol (CBD) and tetrahydrocannabinol (THC). Cesamet is a synthetic form of THC, which is responsible for most of the appetite stimulating effects of marijuana.
Yes, it's possible to overdose on Cesamet. Common signs of an overdose are hallucinations, anxiety, slurred speech, fast heartbeat, high or low blood pressure, and lack of coordination. If these symptoms happen, or you think someone accidentally took your medication, call poison control at 1-800-222-1222.
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Cesamet (nabilone) dosage
Typical dosage for Cesamet (nabilone)
The typical starting dose is 1 mg or 2 mg by mouth two times a day, with the first dose given 1 to 3 hours before chemotherapy.
Interactions between Cesamet (nabilone) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.
What are alternatives to Cesamet (nabilone)?
