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Cesamet

nabilone
Used for Nausea
Used for Nausea

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.

Last reviewed on September 13, 2021
Cesamet (nabilone) is a controlled substance, which means that it's more likely to be misused or cause dependence. There are federal and state laws that limit the amount of medication that can be prescribed or dispensed within a certain period of time.
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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

Common BrandsCesamet
Drug ClassCannabinoid
Controlled Substance ClassificationSchedule II
Generic StatusNo lower-cost generic available
AvailabilityPrescription only
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What are the 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.

risk-warning

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.

    risk-warning

    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.

      basics-icon

      What are the 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%)

      Other Side Effects

      • Feeling unhappy or unwell
      • Nausea
      • Feeling disoriented and disconnected

      Source: DailyMed

      The following 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

      Pros and cons of Cesamet (nabilone)

      thumbs-up

      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

      thumbs-down

      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

      Pharmacist tips for Cesamet (nabilone)

      pharmacist
      • 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.

                faqs

                Frequently asked questions about Cesamet (nabilone)

                Does Cesamet (nabilone) make you feel high?
                Yes, euphoria or "feeling high" is a common side effect of Cesamet (nabilone).
                Is Cesamet (nabilone) a narcotic?
                Usually in the U.S., the term "narcotic" refers to opioid pain medications. As a cannabinoid, Cesamet (nabilone) works differently and belongs to a different drug class. Cesamet (nabilone) and opioid narcotics are all schedule II controlled medications.
                Is Cesamet (nabilone) a CBD?
                The marijuana plant has two main types of cannabinioids, they are cannabidiol (CBD) and tetrahydrocannabinol (THC). Cesamet (nabilone) is a synthetic form of THC, which is responsible for most of the appetite stimulating effects of marijuana.
                Can you overdose on Cesamet (nabilone)?
                Yes, it's possible to overdose on Cesamet (nabilone). 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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                dosage

                Cesamet (nabilone) dosage forms

                Typical dosing 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

                Interactions between Cesamet (nabilone) and other drugs

                Cesamet (nabilone) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Cesamet (nabilone). Please note that only the generic name of each medication is listed below.

                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.

                alternatives

                What are alternatives to Cesamet (nabilone)?

                There are a number of medications that your doctor can prescribe in place of Cesamet (nabilone). Compare a few possible alternatives below.
                Cesamet (nabilone)
                Used for:
                • Nausea and vomiting associated with cancer chemotherapy after other antiemetics haven't worked

                Used for:
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