Abstract
Nabilone, a synthetic cannabinoid, and Prochlorperazine were compared in a double-blind crossover study of 34 patients with lung cancer undergoing a 3-day schedule of chemotherapy with Cyclophosphamide, Adriamycin and Etoposide. Symptom scores were significantly better for patients on nabilone for nausea, retching and vomiting (P less than 0.05). Fewer subjects vomited with nabilone (P = 0.05) and the number of vomiting episodes was lower (P less than 0.05); no patients on nabilone required additional parenteral anti-emetic. More patients preferred nabilone for anti-emetic control (P less than 0.005). Adverse effects common with nabilone were drowsiness (57%), postural dizziness (35%) and lightheadedness (18%). Euphoria was seen in 14% and a "high" in 7%. Erect systolic blood pressure was lower in nabilone patients on Day 1 (P = 0.05) but postural hypotension was a major problem in only 7%. Nabilone is an effective oral anti-emetic drug for moderately toxic chemotherapy, but the range and unpredictability of its side-effects warrant caution in its use.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Frytak S., Moertel C. G. Management of nausea and vomiting in the cancer patient. JAMA. 1981 Jan 23;245(4):393–396. [PubMed] [Google Scholar]
- Frytak S., Moertel C. G., O'Fallon J. R., Rubin J., Creagan E. T., O'Connell M. J., Schutt A. J., Schwartau N. W. Delta-9-tetrahydrocannabinol as an antiemetic for patients receiving cancer chemotherapy. A comparison with prochlorperazine and a placebo. Ann Intern Med. 1979 Dec;91(6):825–830. doi: 10.7326/0003-4819-91-6-825. [DOI] [PubMed] [Google Scholar]
- Gralla R. J., Itri L. M., Pisko S. E., Squillante A. E., Kelsen D. P., Braun D. W., Jr, Bordin L. A., Braun T. J., Young C. W. Antiemetic efficacy of high-dose metoclopramide: randomized trials with placebo and prochlorperazine in patients with chemotherapy-induced nausea and vomiting. N Engl J Med. 1981 Oct 15;305(16):905–909. doi: 10.1056/NEJM198110153051601. [DOI] [PubMed] [Google Scholar]
- Herman T. S., Einhorn L. H., Jones S. E., Nagy C., Chester A. B., Dean J. C., Furnas B., Williams S. D., Leigh S. A., Dorr R. T. Superiority of nabilone over prochlorperazine as an antiemetic in patients receiving cancer chemotherapy. N Engl J Med. 1979 Jun 7;300(23):1295–1297. doi: 10.1056/NEJM197906073002302. [DOI] [PubMed] [Google Scholar]
- Laszlo J., Lucas V. S., Jr Emesis as a critical problem in chemotherapy. N Engl J Med. 1981 Oct 15;305(16):948–949. doi: 10.1056/NEJM198110153051609. [DOI] [PubMed] [Google Scholar]
- Laszlo J. Tetrahydrocannabinol: from pot to prescription? Ann Intern Med. 1979 Dec;91(6):916–918. doi: 10.7326/0003-4819-91-6-916. [DOI] [PubMed] [Google Scholar]
- Lemberger L., Rowe H. Clinical pharmacology of nabilone, a cannabinol derivative. Clin Pharmacol Ther. 1975 Dec;18(6):720–726. doi: 10.1002/cpt1975186720. [DOI] [PubMed] [Google Scholar]
- Sallan S. E., Zinberg N. E., Frei E., 3rd Antiemetic effect of delta-9-tetrahydrocannabinol in patients receiving cancer chemotherapy. N Engl J Med. 1975 Oct 16;293(16):795–797. doi: 10.1056/NEJM197510162931603. [DOI] [PubMed] [Google Scholar]
- Steele N., Gralla R. J., Braun D. W., Jr, Young C. W. Double-blind comparison of the antiemetic effects of nabilone and prochlorperazine on chemotherapy-induced emesis. Cancer Treat Rep. 1980 Feb-Mar;64(2-3):219–224. [PubMed] [Google Scholar]
- Trounce J. R. Antiemetics and cytotoxic drugs. Br Med J (Clin Res Ed) 1983 Jan 29;286(6362):327–329. doi: 10.1136/bmj.286.6362.327. [DOI] [PMC free article] [PubMed] [Google Scholar]