Table 1.
Summary of therapeutic options in the management of cannabinoid hyperemesis syndrome
Agent | Indication and dosing | Clinical outcome |
IV Sodium chloride 0.9% | Hydration 1-2 L bolus and then 150-200 mL/h infusion for 24 to 48 hours |
Demonstrated symptom improvement in case reports4,18 |
Morphine | Pain 4 mg IV as needed |
Demonstrated pain control in case reports18 |
Acetaminophen | Headache 650 mg as needed |
Demonstrated headache relief in case reports18 |
Lorazepam | Nausea/vomiting 1 mg IV x 1 OR 1 mg IV every 4 h as needed |
Demonstrated symptom improvement in case reports18,19 |
Chlorpromazine | Hiccups 25 mg IV every 4 h as needed |
Demonstrated symptom improvement in case reports18 |
Note: CHS = cannabinoid hyperemesis syndrome; h = hour; IV = intravenous.