Ross is a writer for Verywell with years of experience practicing pharmacy in various settings. She is also a board-certified clinical pharmacist and the founder of Off Script Consults.
Lindsay Cook, PharmD is a board-certified consultant pharmacist.
The Food and Drug Administration (FDA) hasn't assigned any black box warnings to Cesamet (nabilone).
Cesamet (nabilone ) is a Schedule II medication treatment option for chemotherapy-induced nausea and vomiting (CINV).
Cesamet is in the cannabinoid medication class. It's thought to work by interacting with the cannabinoid receptor (binding site) system in the brain.
Cesamet is available as prescription capsules.
Brand Name(s): Cesamet
Controlled Substance: Schedule II
Administration Route: Oral (by mouth)
Dosage Form(s): Capsules
Cesamet is used to treat nausea and vomiting in people receiving chemotherapy.
A number of treatments and medications are available for cancer. Chemotherapy (chemo) is a possible option. Unfortunately, approximately 80% of people on chemo will experience nausea and vomiting. This side effect is also known as chemotherapy-induced nausea and vomiting (CINV).
CINV has different types, including:
Experts don't typically recommend Cesamet as a first-choice option for CINV. Cesamet, however, is one of the second-line options for breakthrough CINV. If you experience breakthrough CINV, you'll likely try Zyprexa (olanzapine) first. If olanzapine isn't a viable option for you, then your healthcare provider might consider adding Cesamet to your current medication regimen.
Preventing and treating CINV is important to prevent the following:
Some people are more likely to experience CINV than others. Possible risk factors may include:
The following is some general information about taking Cesamet:
When you receive Cesamet from the pharmacy, place the medication at room temperature at 77 degrees Fahrenheit (F)—with a short-term safety storage range between 59 degrees to 86 degrees F.
With Cesamet being a scheduled II controlled medication, consider using a locked cabinet or closet to keep your medication out of the reach of children and pets.
If you plan to travel with Cesamet, get familiar with your final destination's regulations. Checking with the U.S. embassy or consulate might be a helpful resource. In general, it's a good idea to make a copy of your Cesamet prescription and ask your healthcare provider for a letter of medical necessity. If possible, keep your medication in its original container from your pharmacy with your name on the label. If you have any questions about traveling with your medicine, be sure to ask your pharmacist or healthcare provider.
You can also ask your pharmacist or healthcare provider about the best ways to dispose of your medications. The FDA's website is a potentially helpful resource to know where and how to discard all unused and expired drugs. You can also find disposal boxes in your area.
Cesamet doesn't currently have any off-label uses.
You may notice less nausea and vomiting starting on day one of taking Cesamet.
This is not a complete list of side effects and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 800-FDA-1088.
Common side effects with Cesamet may include:
Get medical help right away if you develop any of the following serious side effects:
Call 911 if your symptoms feel life-threatening.
Cesamet isn't typically considered a long-term medication. It's usually only taken as early as the night before the first day of your chemo treatment and for two days after the last chemo day of your chemotherapy treatment cycle.
This medication, however, does have the potential to be habit-forming. Long-term use of cannabinoids has also been linked to medical conditions relating to motivation, thinking, and decision-making.
Reach out to your healthcare provider if you or loved ones notice the following substance use disorder (SUD)-like symptoms:
Abruptly stopping long-term cannabinoid use might also result in discontinuation symptoms, which may include:
Cesamet may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.
If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).
The following modifications (changes) should be kept in mind when using Cesamet:
Severe allergic reaction: Avoid using Cesamet if you have a known allergy to it or its ingredients. Ask your pharmacist or healthcare provider for a complete list of the ingredients if you're unsure.
Pregnancy: In rat and rabbit animal studies, Cesamet was found to have negative effects on the fetus. We don't know enough about the safety and effectiveness of Cesamet in pregnant people and their unborn fetuses. Discuss with your healthcare provider if you plan to become pregnant or are pregnant. They will help you weigh the benefits and risks of taking Cesamet during pregnancy.
Breastfeeding: It's not known whether Cesamet is present in human breastmilk, but cannabinoids have been found in breastmilk. Therefore, Cesamet isn't recommended while breastfeeding.
Talk with your healthcare provider if you plan to breastfeed. Your healthcare provider will help you weigh the benefits and harms of taking Cesamet while nursing. They can also discuss the different ways available to feed your baby.
Older adults over 65: Clinical studies haven't included a large enough number of people in this age group to see whether they respond differently from younger adults. However, older adults with several medical conditions or taking several medications should use caution with Cesamet. Older adults might also be more sensitive to Cesamet's side effects.
Children: There is limited safety and effectiveness information about Cesamet in children.
Substance use disorder (SUD) risk: You may have a risk for SUD if you have a medical or family history of SUD. Having a mental health condition may also put you at risk. If you have an increased risk of SUD, your healthcare provider may closely monitor you for SUD-like symptoms and help you with any necessary next steps.
If you accidentally forgot your Cesamet dose, take it as soon as you remember. If it's already close to your next scheduled dose, then skip the missed dose and take the following dose at your next scheduled dosing time. Don't try to double up to make up for the missed dose.
Try to find ways that work for you to help yourself remember to keep your appointments and take your medication routinely. If you miss too many doses, Cesamet might be less effective at treating your chemotherapy-induced nausea and vomiting (CINV).
An overdose of Cesamet tends to exaggerate the common or serious side effects of this medication. Some typical symptoms of a suspected overdose may include abnormal blood pressure changes and rapid heartbeat.
If you think that you're experiencing an overdose or life-threatening symptoms, seek immediate medical attention.
If you think you or someone else may have overdosed on Cesamet, call a healthcare provider or the Poison Control Center (800-222-1222).
If someone collapses or isn't breathing after taking Cesamet, call 911 immediately.
Before taking Cesamet, talk with your healthcare provider if any of the following applies to you:
Since Cesamet affects the central nervous system (CNS), be careful with other medications that also affect the CNS (brain and spinal cord). Try to avoid alcohol, too.
Talk with your pharmacist or healthcare provider for more detailed information about medication interactions with Cesamet.
And be sure to talk with your healthcare provider about any other medicines you take or plan to take, including over-the-counter, nonprescription products, vitamins, herbs, or plant-based medicines.
The cannabinoid class is one possible option for breakthrough chemotherapy-induced nausea and vomiting (CINV). Besides Cesamet, the small cannabinoid class also includes Marinol (dronabinol).
The following are some advantages of Cesamet over Marinol:
Since Cesamet and Marinol are both cannabinoids, they're not typically taken together.
Cesamet is available as a prescription from your healthcare provider. Since Cesamet is a controlled Schedule II medication, however, local retail pharmacies in some states might require special paperwork for the prescription. If your pharmacy doesn't have Cesamet in stock, the staff may order the medication for you.
Cesamet isn't available in a generic nabilone product yet. Therefore, it might be expensive.
If cost is a concern, consider the following potential helpful resources: NeedyMeds, Simplefill, BenefitsCheckUp, Medicare Rights Center, State Pharmaceutical Assistance Programs (SPAPs), Rx Outreach, or FundFinder.
If you're still experiencing nausea and vomiting with Cesamet, let your healthcare provider know. They will adjust your current medication regimen to help control the side effects of your chemotherapy treatment.
Cesamet carries a risk for substance use disorder (SUD). Talk with your healthcare provider if you or your loved ones notice abnormal changes in thinking, appetite, mood, or behavior.
Navigating and adjusting to chemotherapy can take time and energy. Consider talking with your loved ones to help with certain tasks like assisting you with the drive to the cancer center and other responsibilities. Websites like Caring Bridge or Lotsa Helping Hands can also help update loved ones about your treatments and organize tasks.
During your treatment, be sure to stay hydrated, especially if you experience vomiting or diarrhea as a treatment side effect. You can do this by drinking more water or even consuming broth. Be sure to eat a balanced diet with enough protein to help your body stay strong. ESPEN nutrition guidelines suggest that people undergoing cancer treatment need more protein (0.5 to 0.8 grams of protein per pound of body weight) compared to sedentary individuals. While some sources may encourage eating animal protein as the best way to increase your protein intake, there are many ways to get enough protein, including a balanced vegetarian diet. There are registered dietitian nutritionists (RDs/RDNs) that specialize in nutrition during cancer treatment to help support you during this time. Talk with your healthcare provider about connecting with a registered dietitian nutritionist as you map out your nutrition plan during treatment. This course may help you avoid malnutrition and can help support your body. Eating smaller meals more frequently throughout the day can help you manage any nausea.
As for nausea, there are things that you can do—in addition to Cesamet and other CINV medications. In general, you can try the following:
For vomiting, keep the following in mind:
Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.
Food and Drug Administration. Cesamet label.
National Cancer Institute. Nausea and vomiting related to cancer treatment (PDQ®)-health professional version.
American Cancer Society. Nausea and vomiting caused by cancer treatment.
Hesketh PJ, Kris MG, Bohlke K, et al. Antiemetics: American Society of Clinical Oncology practice guideline update. Journal of Clinical Oncology. 2017;35(28):3240-3261. doi:10.1200/JCO.2017.74.4789
American Society of Clinical Oncology. Antiemetics: ASCO guideline update.
Ware MA, Daeinck P, Maida V. A review of nabilone in the treatment of chemotherapy-induced nausea and vomiting. Therapeutics and Clinical Risk Management. 2008;4(1):99-107. doi:10.2147/tcrm.s1132
Food and Drug Administration. Orange book: approved drug products with therapeutic equivalence evaluations.
Arends J, Bachmann P, Baracos V, et al. ESPEN guidelines on nutrition in cancer patients. Clin Nutr. 2017;36(1):11-48. doi:10.1016/j.clnu.2016.07.015
American Cancer Society. Managing nausea and vomiting at home.
By Ross Phan, PharmD, BCACP, BCGP, BCPS Ross is a writer for Verywell with years of experience practicing pharmacy in various settings. She is also a board-certified clinical pharmacist and the founder of Off Script Consults.
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