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

Nausea, vomiting, and loss of appetite (anorexia) are common symptoms in many pathological conditions affecting the normal function of the upper gastrointestinal tract.¹ Nausea and vomiting are particularly common side effects of chemotherapy (chemotherapy-induced nausea and vomiting – CINV),² radiotherapy (radiotherapy-induced nausea and vomiting – RINV),³ or anesthesia during surgery (post-operative nausea and vomiting – PONV).^4,5 Pharmacological treatment of nausea and vomiting usually ranges from conventional antiemetics such as antihistamines, benzodiazepines, and dopamine antagonists, to more recently approved antiemetics such as 5HT3 antagonists or NK1-receptor antagonists.⁶ Cannabis and its chemical compound cannabinoids, by acting on cell membrane receptors and altering neurotransmitter release, can relieve nausea, vomiting, and improve appetite.⁷ Nabilone, a synthetic cannabinoid, has been used to treat nausea and vomiting, loss of appetite, has side effects such as hallucination, drowsiness, depression, dysphoria, vertigo, dry mouth and lack of muscle coordination.^8,9 This Rapid Response report aims to review the clinical effectiveness of nabilone for the treatment of nausea, vomiting, or anorexia. Guidelines associated with the use of nabilone for the treatment of nausea, vomiting, or anorexia will also be examined. This is an update and upgrade of two previous CADTH reports examining the clinical effectiveness and guidelines pertaining to the use of nabilone for the treatment of nausea and vomiting, or anorexia in adults and adolescents.^10,11