Nabilone for the Treatment of Nausea and Vomiting or Anorexia: A Review of Clinical Effectiveness and Guidelines

Key Message

Based on data from one systematic review of systematic reviews and three randomized controlled trials, nabilone was not found to be more effective than conventional antiemetics or placebo for the reduction of nausea or vomiting was not proven in patients with chemotherapy-induced nausea and vomiting, radiotherapy-induced nausea and vomiting or post-operative nausea and vomiting. Nabilone was also found to be associated with more safety concerns such as hallucination, drowsiness, dysphoria, and lack of muscle coordination. In patients with cancer diagnosed with anorexia, nabilone increased daily caloric and carbohydrate intake with similar daily proteins, fat and iron intake compared to placebo. The identified Canadian guideline recommends against the use of medical cannabinoids for general nausea and vomiting in primary care and in pregnancy, owing to the lack of evidence and known harms; medical cannabinoids, in particular nabilone, can be considered as third-line therapy for the treatment of refractory chemotherapy-induced nausea and vomiting.