Dosing & Uses
Dosage Forms & Strengths
capsule: Schedule II
- 1mg
Chemotherapy-Induced Nausea/Vomiting
1-2 mg PO q8-12hr
Renal Impairment
Dose adjustment not necessary
Administration
Give 1-3 hours before chemotherapy
May give one dose the night before chemotherapy
May continue 24 hours after chemotherapy
No more than 6 mg/day
Dosage Forms & Strengths
capsule: Schedule II
- 1mg
Chemotherapy-Induced Nausea/Vomiting (Off-label)
>4 years
- <18 kg: 0.5 mg PO q12hr
- 18-30 kg: 1 mg PO q12hr
- >30 kg: 1 mg PO q8hr
Chemotherapy-induced nausea/vomiting
1-2 mg PO q8-12hr; not to exceed 6 mg divided q8hr
Interactions
Interaction Checker
No Results

Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor

Contraindicated (0)
Serious - Use Alternative (5)
- calcium/magnesium/potassium/sodium oxybates
nabilone, calcium/magnesium/potassium/sodium oxybates. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
- metoclopramide intranasal
nabilone, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.
- olopatadine intranasal
nabilone and olopatadine intranasal both increase sedation. Avoid or Use Alternate Drug. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.
- ropeginterferon alfa 2b
ropeginterferon alfa 2b and nabilone both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.
- sodium oxybate
nabilone, sodium oxybate. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
Monitor Closely (172)
- albuterol
nabilone increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- alfentanil
alfentanil and nabilone both increase sedation. Use Caution/Monitor.
- alprazolam
alprazolam and nabilone both increase sedation. Use Caution/Monitor.
- amitriptyline
amitriptyline and nabilone both increase sedation. Use Caution/Monitor.
- amobarbital
amobarbital and nabilone both increase sedation. Use Caution/Monitor.
- amoxapine
amoxapine and nabilone both increase sedation. Use Caution/Monitor.
- apomorphine
apomorphine and nabilone both increase sedation. Use Caution/Monitor.
- arformoterol
nabilone increases and arformoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- aripiprazole
aripiprazole and nabilone both increase sedation. Use Caution/Monitor.
- armodafinil
nabilone increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- azelastine
azelastine and nabilone both increase sedation. Use Caution/Monitor.
- baclofen
baclofen and nabilone both increase sedation. Use Caution/Monitor.
- belladonna and opium
belladonna and opium and nabilone both increase sedation. Use Caution/Monitor.
- benperidol
benperidol and nabilone both increase sedation. Use Caution/Monitor.
- benzphetamine
nabilone increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- brompheniramine
brompheniramine and nabilone both increase sedation. Use Caution/Monitor.
- buprenorphine
buprenorphine and nabilone both increase sedation. Use Caution/Monitor.
- buprenorphine buccal
buprenorphine buccal and nabilone both increase sedation. Use Caution/Monitor.
- butabarbital
butabarbital and nabilone both increase sedation. Use Caution/Monitor.
- butalbital
butalbital and nabilone both increase sedation. Use Caution/Monitor.
- butorphanol
butorphanol and nabilone both increase sedation. Use Caution/Monitor.
- caffeine
nabilone increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- carbinoxamine
carbinoxamine and nabilone both increase sedation. Use Caution/Monitor.
- carisoprodol
carisoprodol and nabilone both increase sedation. Use Caution/Monitor.
- chloral hydrate
chloral hydrate and nabilone both increase sedation. Use Caution/Monitor.
- chlordiazepoxide
chlordiazepoxide and nabilone both increase sedation. Use Caution/Monitor.
- chlorpheniramine
chlorpheniramine and nabilone both increase sedation. Use Caution/Monitor.
- chlorpromazine
chlorpromazine and nabilone both increase sedation. Use Caution/Monitor.
- chlorzoxazone
chlorzoxazone and nabilone both increase sedation. Use Caution/Monitor.
- cinnarizine
cinnarizine and nabilone both increase sedation. Use Caution/Monitor.
- clemastine
clemastine and nabilone both increase sedation. Use Caution/Monitor.
- clobazam
nabilone, clobazam. Other (see comment). Use Caution/Monitor. Comment: Concomitant administration can increase the potential for CNS effects (e.g., increased sedation or respiratory depression).
- clomipramine
clomipramine and nabilone both increase sedation. Use Caution/Monitor.
- clonazepam
clonazepam and nabilone both increase sedation. Use Caution/Monitor.
- clonidine
clonidine, nabilone. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration enhances CNS depressant effects.
- clorazepate
clorazepate and nabilone both increase sedation. Use Caution/Monitor.
- clozapine
clozapine and nabilone both increase sedation. Use Caution/Monitor.
- codeine
codeine and nabilone both increase sedation. Use Caution/Monitor.
- cyclizine
cyclizine and nabilone both increase sedation. Use Caution/Monitor.
- cyclobenzaprine
cyclobenzaprine and nabilone both increase sedation. Use Caution/Monitor.
- cyproheptadine
cyproheptadine and nabilone both increase sedation. Use Caution/Monitor.
- dantrolene
dantrolene and nabilone both increase sedation. Use Caution/Monitor.
- daridorexant
nabilone and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.
- desflurane
desflurane and nabilone both increase sedation. Use Caution/Monitor.
- desipramine
desipramine and nabilone both increase sedation. Use Caution/Monitor.
- dexchlorpheniramine
dexchlorpheniramine and nabilone both increase sedation. Use Caution/Monitor.
- dexfenfluramine
nabilone increases and dexfenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dexmedetomidine
dexmedetomidine and nabilone both increase sedation. Use Caution/Monitor.
- dexmethylphenidate
nabilone increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dextroamphetamine
nabilone increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dextromoramide
dextromoramide and nabilone both increase sedation. Use Caution/Monitor.
- diamorphine
diamorphine and nabilone both increase sedation. Use Caution/Monitor.
- diazepam
diazepam and nabilone both increase sedation. Use Caution/Monitor.
- diethylpropion
nabilone increases and diethylpropion decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- difelikefalin
difelikefalin and nabilone both increase sedation. Use Caution/Monitor.
- difenoxin hcl
difenoxin hcl and nabilone both increase sedation. Use Caution/Monitor.
- dimenhydrinate
dimenhydrinate and nabilone both increase sedation. Use Caution/Monitor.
- diphenhydramine
diphenhydramine and nabilone both increase sedation. Use Caution/Monitor.
- diphenoxylate hcl
diphenoxylate hcl and nabilone both increase sedation. Use Caution/Monitor.
- dipipanone
dipipanone and nabilone both increase sedation. Use Caution/Monitor.
- dobutamine
nabilone increases and dobutamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dopamine
nabilone increases and dopamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dopexamine
nabilone increases and dopexamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- doxepin
doxepin and nabilone both increase sedation. Use Caution/Monitor.
- doxylamine
doxylamine and nabilone both increase sedation. Use Caution/Monitor.
- droperidol
droperidol and nabilone both increase sedation. Use Caution/Monitor.
- ephedrine
nabilone increases and ephedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- epinephrine
nabilone increases and epinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- epinephrine racemic
nabilone increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- estazolam
estazolam and nabilone both increase sedation. Use Caution/Monitor.
- ethanol
ethanol and nabilone both increase sedation. Use Caution/Monitor.
- etomidate
etomidate and nabilone both increase sedation. Use Caution/Monitor.
- fenfluramine
nabilone increases and fenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- fluphenazine
fluphenazine and nabilone both increase sedation. Use Caution/Monitor.
- flurazepam
flurazepam and nabilone both increase sedation. Use Caution/Monitor.
- formoterol
nabilone increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- haloperidol
haloperidol and nabilone both increase sedation. Use Caution/Monitor.
- hydromorphone
hydromorphone and nabilone both increase sedation. Use Caution/Monitor.
- hydroxyzine
hydroxyzine and nabilone both increase sedation. Use Caution/Monitor.
- iloperidone
iloperidone and nabilone both increase sedation. Use Caution/Monitor.
- imipramine
imipramine and nabilone both increase sedation. Use Caution/Monitor.
- isoproterenol
nabilone increases and isoproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ketamine
ketamine and nabilone both increase sedation. Use Caution/Monitor.
- ketotifen, ophthalmic
ketotifen, ophthalmic and nabilone both increase sedation. Use Caution/Monitor.
- levalbuterol
nabilone increases and levalbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- levorphanol
levorphanol and nabilone both increase sedation. Use Caution/Monitor.
- lisdexamfetamine
nabilone increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- lofepramine
lofepramine and nabilone both increase sedation. Use Caution/Monitor.
- lofexidine
lofexidine and nabilone both increase sedation. Use Caution/Monitor.
- loprazolam
loprazolam and nabilone both increase sedation. Use Caution/Monitor.
- lorazepam
lorazepam and nabilone both increase sedation. Use Caution/Monitor.
- lormetazepam
lormetazepam and nabilone both increase sedation. Use Caution/Monitor.
- loxapine
loxapine and nabilone both increase sedation. Use Caution/Monitor.
- loxapine inhaled
loxapine inhaled and nabilone both increase sedation. Use Caution/Monitor.
- lurasidone
lurasidone, nabilone. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Potential for increased CNS depressant effects when used concurrently; monitor for increased adverse effects and toxicity.
- maprotiline
maprotiline and nabilone both increase sedation. Use Caution/Monitor.
- marijuana
marijuana and nabilone both increase sedation. Use Caution/Monitor.
- melatonin
melatonin and nabilone both increase sedation. Use Caution/Monitor.
- meperidine
meperidine and nabilone both increase sedation. Use Caution/Monitor.
- meprobamate
meprobamate and nabilone both increase sedation. Use Caution/Monitor.
- metaproterenol
nabilone increases and metaproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- metaxalone
metaxalone and nabilone both increase sedation. Use Caution/Monitor.
- methadone
methadone and nabilone both increase sedation. Use Caution/Monitor.
- methamphetamine
nabilone increases and methamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- methocarbamol
methocarbamol and nabilone both increase sedation. Use Caution/Monitor.
- methylenedioxymethamphetamine
nabilone increases and methylenedioxymethamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- midazolam
midazolam and nabilone both increase sedation. Use Caution/Monitor.
- midazolam intranasal
midazolam intranasal, nabilone. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect.
- midodrine
nabilone increases and midodrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- mirtazapine
mirtazapine and nabilone both increase sedation. Use Caution/Monitor.
- modafinil
nabilone increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- morphine
morphine and nabilone both increase sedation. Use Caution/Monitor.
- motherwort
motherwort and nabilone both increase sedation. Use Caution/Monitor.
- moxonidine
moxonidine and nabilone both increase sedation. Use Caution/Monitor.
- nalbuphine
nalbuphine and nabilone both increase sedation. Use Caution/Monitor.
- naltrexone
naltrexone increases effects of nabilone by Other (see comment). Use Caution/Monitor. Comment: Naltrexone may enhance therapeutic effects of cannabinoids. .
- norepinephrine
nabilone increases and norepinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- nortriptyline
nortriptyline and nabilone both increase sedation. Use Caution/Monitor.
- olanzapine
olanzapine and nabilone both increase sedation. Use Caution/Monitor.
- opium tincture
opium tincture and nabilone both increase sedation. Use Caution/Monitor.
- orphenadrine
orphenadrine and nabilone both increase sedation. Use Caution/Monitor.
- oxazepam
oxazepam and nabilone both increase sedation. Use Caution/Monitor.
- oxycodone
oxycodone and nabilone both increase sedation. Use Caution/Monitor.
- oxymorphone
oxymorphone and nabilone both increase sedation. Use Caution/Monitor.
- paliperidone
paliperidone and nabilone both increase sedation. Use Caution/Monitor.
- papaveretum
papaveretum and nabilone both increase sedation. Use Caution/Monitor.
- papaverine
nabilone and papaverine both increase sedation. Use Caution/Monitor.
- pentazocine
pentazocine and nabilone both increase sedation. Use Caution/Monitor.
- pentobarbital
pentobarbital and nabilone both increase sedation. Use Caution/Monitor.
- perphenazine
perphenazine and nabilone both increase sedation. Use Caution/Monitor.
- phendimetrazine
nabilone increases and phendimetrazine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- phenobarbital
phenobarbital and nabilone both increase sedation. Use Caution/Monitor.
- phentermine
nabilone increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- phenylephrine
nabilone increases and phenylephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- phenylephrine PO
nabilone increases and phenylephrine PO decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- pholcodine
nabilone and pholcodine both increase sedation. Use Caution/Monitor.
- pimozide
pimozide and nabilone both increase sedation. Use Caution/Monitor.
- pirbuterol
nabilone increases and pirbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- primidone
primidone and nabilone both increase sedation. Use Caution/Monitor.
- prochlorperazine
prochlorperazine and nabilone both increase sedation. Use Caution/Monitor.
- promethazine
promethazine and nabilone both increase sedation. Use Caution/Monitor.
- propofol
propofol and nabilone both increase sedation. Use Caution/Monitor.
- propylhexedrine
nabilone increases and propylhexedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- protriptyline
protriptyline and nabilone both increase sedation. Use Caution/Monitor.
- quazepam
quazepam and nabilone both increase sedation. Use Caution/Monitor.
- quetiapine
quetiapine and nabilone both increase sedation. Use Caution/Monitor.
- ramelteon
nabilone and ramelteon both increase sedation. Use Caution/Monitor.
- risperidone
risperidone and nabilone both increase sedation. Use Caution/Monitor.
- salmeterol
nabilone increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- scullcap
nabilone and scullcap both increase sedation. Use Caution/Monitor.
- secobarbital
secobarbital and nabilone both increase sedation. Use Caution/Monitor.
- sevoflurane
sevoflurane and nabilone both increase sedation. Use Caution/Monitor.
- shepherd's purse
nabilone and shepherd's purse both increase sedation. Use Caution/Monitor.
- stiripentol
stiripentol, nabilone. Either increases effects of the other by sedation. Use Caution/Monitor. Concomitant use stiripentol with other CNS depressants, including alcohol, may increase the risk of sedation and somnolence.
- sufentanil
sufentanil and nabilone both increase sedation. Use Caution/Monitor.
- tapentadol
tapentadol and nabilone both increase sedation. Use Caution/Monitor.
- temazepam
temazepam and nabilone both increase sedation. Use Caution/Monitor.
- terbutaline
nabilone increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- thioridazine
thioridazine and nabilone both increase sedation. Use Caution/Monitor.
- thiothixene
thiothixene and nabilone both increase sedation. Use Caution/Monitor.
- topiramate
nabilone and topiramate both increase sedation. Modify Therapy/Monitor Closely.
- tramadol
tramadol and nabilone both increase sedation. Use Caution/Monitor.
- trazodone
trazodone and nabilone both increase sedation. Use Caution/Monitor.
- triazolam
triazolam and nabilone both increase sedation. Use Caution/Monitor.
- triclofos
triclofos and nabilone both increase sedation. Use Caution/Monitor.
- trifluoperazine
trifluoperazine and nabilone both increase sedation. Use Caution/Monitor.
- trimipramine
trimipramine and nabilone both increase sedation. Use Caution/Monitor.
- triprolidine
triprolidine and nabilone both increase sedation. Use Caution/Monitor.
- xylometazoline
nabilone increases and xylometazoline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- yohimbine
nabilone increases and yohimbine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ziconotide
nabilone and ziconotide both increase sedation. Use Caution/Monitor.
- ziprasidone
ziprasidone and nabilone both increase sedation. Use Caution/Monitor.
Minor (4)
- benazepril
nabilone, benazepril. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. May increase risk of hypotension.
- captopril
nabilone, captopril. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. May increase risk of hypotension.
- eucalyptus
eucalyptus and nabilone both increase sedation. Minor/Significance Unknown.
- sage
nabilone and sage both increase sedation. Minor/Significance Unknown.
Adverse Effects
>10%
Vertigo (52%)
Drowsiness (52%)
Dry mouth (36%)
Ataxia (14%)
Visual disturbance (13%)
Blurred vision (12.8%)
Concentration difficulties (12%)
Euphoria (11%)
Sleep disturbance (11%)
1-10%
Depersonalization
Disorientation
Dysphoria
Headache
Hypotension
Nausea
Warnings
Contraindications
Hypersensitivity to cannabinoids
History of psychotic reactions
Cautions
Severe liver impairment
Give only to patients in whom conventional antiemetics have failed
Emotionally disturbed patients (non-psychotic)
Concomitant use of alcohol or other psychoactive substances can potentiate psychotropic effects
May cause tachycardia and orthostatic hypotension
May impair ability to drive or perform hazardous tasks
Pregnancy & Lactation
Pregnancy Category: C
Lactation: not recommended
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Cannabinoid antiemetic may act in the central nervous system by acting on cannabinoid receptors
Pharmacokinetics
Excretion: Feces (65%; primarily bile); urine (20%)
Half-life elimination: 2 hr (parent compound); 35 hr (metabolites)
Peak plasma time: 2 hr
Distribution: 12.5 L/kg
Metabolism: Direct enzymatic oxidation and possibly CYP450 enzymes
Images
Formulary
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