Nabilone

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|Nabilone

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NABILONE (Systemic)*

Some commonly used brand names are:

In Canada—

  • Cesamet

* Not commercially available in the U.S.

Category

  • Antiemetic

Description

Nabilone (NA-bi-lone) is chemically related to marijuana. It is used to prevent the nausea and vomiting that may occur after treatment with cancer medicines. It is used only when other kinds of medicine for nausea and vomiting do not work.

Nabilone is available only with your doctor"s prescription. Prescriptions cannot be refilled and you must obtain a new prescription from your doctor each time you need this medicine. Nabilone is available in the following dosage form:

  • Oral
  • Capsules (Canada)

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For nabilone, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to nabilone or marijuana products. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—Studies have not been done in pregnant women. However, studies in animals have shown a decrease in successful pregnancies and a decrease in the number of live babies born, when nabilone was given in doses many times the usual human dose.

Breast-feeding—It is not known whether nabilone passes into the breast milk. However, nabilone is not recommended during breast-feeding because other medicines similar to nabilone that pass into the breast milk have been shown to cause unwanted effects in the nursing baby.

Children—Studies on this medicine have been done only in adult patients, and there is no specific information comparing use of nabilone in children with use in other age groups.

Older adults—Fast or pounding heartbeat, feeling faint or lightheaded, and unusual tiredness or weakness may be especially likely to occur in elderly patients, who are usually more sensitive than younger adults to the effects of nabilone. Also, the effects this medicine may have on the mind may be of special concern in the elderly. Therefore, older people should be watched closely while taking this medicine.

Other medicines—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. When you are taking nabilone, it is especially important that your health care professional know if you are taking any of the following:

  • Central nervous system (CNS) depressants (medicine that causes drowsiness) or
  • Tricyclic antidepressants (medicine for depression)—Taking these medicines with nabilone may increase the CNS-depressant effects

Other medical problems—The presence of other medical problems may affect the use of nabilone. Make sure you tell your doctor if you have any other medical problems, especially:

  • Alcohol abuse (or history of) or
  • Drug abuse or dependence (or history of)—Dependence on nabilone may develop
  • Emotional problems or
  • Heart disease or
  • Low blood pressure or
  • Manic or depressive states or
  • Mental illness (severe) or
  • Schizophrenia—Nabilone may make the condition worse
  • Liver disease (severe)—Higher blood levels of nabilone may occur, increasing the chance of side effects

Proper Use of This Medicine

Take this medicine only as directed by your doctor . Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. If too much is taken, it may lead to other medical problems because of an overdose.

Dosing—The dose of nabilone will be different for different patients. Follow your doctor"s orders or the directions on the label . The following information includes only the average doses of nabilone. If your dose is different, do not change it unless your doctor tells you to do so.

  • For oral dosage forms (capsules):
    • For nausea and vomiting caused by cancer medicines:
      • Adults and teenagers—Usually 1 or 2 milligrams (mg) twice a day. Your doctor will tell you how and when to take this medicine while you are taking your cancer medicine.
      • Children—Use and dose must be determined by your doctor.

Missed dose—If you miss a dose of this medicine, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses .

Storage—To store this medicine:

  • Keep out of the reach of children.
  • Store away from heat and direct light.
  • Do not store this medicine in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
  • Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

Precautions While Using This Medicine

Nabilone will add to the effects of alcohol and other central nervous system (CNS) depressants (medicines that make you feel drowsy or less alert). Some examples of CNS depressants are antihistamines or medicine for hay fever, other allergies, or colds; sedatives, tranquilizers, or sleeping medicine; prescription pain medicines, including other narcotics; barbiturates; medicine for seizures; muscle relaxants; or anesthetics, including some dental anesthetics. Check with your doctor before taking any of the above while you are taking this medicine .

If you think you or someone else may have taken an overdose, get emergency help at once . Taking an overdose of this medicine or taking alcohol or CNS depressants with this medicine may cause severe mental effects. Symptoms of overdose include changes in mood; confusion; difficulty in breathing; hallucinations (seeing, hearing, or feeling things that are not there); nervousness or anxiety (severe); and fast or pounding heartbeat.

This medicine may cause some people to become drowsy, dizzy, or lightheaded, or to feel a false sense of well-being. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are dizzy or are not alert and clearheaded .

Dizziness, lightheadedness, or fainting may occur, especially when you get up suddenly from a lying or sitting position. Getting up slowly may help lessen this problem.

Nabilone may cause dryness of the mouth. For temporary relief, use sugarless candy or gum, melt bits of ice in your mouth, or use a saliva substitute. However, if your mouth continues to feel dry for more than 2 weeks, check with your medical doctor or dentist. Continuing dryness of the mouth may increase the chance of dental disease, including tooth decay, gum disease, and fungus infections.

Side Effects of This Medicine

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)

Other 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. However, check with your doctor if any of the following side effects continue or are bothersome:

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 above may also occur in some patients. If you notice any other effects, check with your doctor.

Revised: 01/29/1999

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