Cesamet® (nabilone) is a therapeutic option for treating patients with chemotherapy-induced nausea and vomiting (CINV) who have failed to respond adequately to conventional antiemetic treatments.¹

Key Facts About CINV:

• Everyone reacts to CINV differently. But you don’t have to suffer alone. Your doctor can prescribe medications, including Cesamet, that can help you treat and possibly even prevent the onset of CINV.
• To prevent CINV, your doctor may prescribe an antiemetic drug before you start chemotherapy treatment, during your treatment, or for as long as the chemotherapy could cause nausea and vomiting.²
• Because each chemotherapy drug reacts differently in each person, there is no one antiemetic drug that controls CINV 100% of the time.²

What is CINV?

Unfortunately, 70% to 80% of patients receiving chemotherapy experience treatment-related nausea and vomiting. There are different types of nausea and vomiting that can be caused by chemotherapy treatment. They may or may not occur together and can be experienced during different times of your chemotherapy treatment.²

• Nausea is an unpleasant feeling in the back of the throat and stomach that may or may not result in vomiting.²
• Vomiting is sometimes referred to as “throwing up.” It is a forceful contraction that causes the contents of the stomach to come up through the mouth.²

Why Does Chemotherapy Induce Nausea and Vomiting?²

Each person experiences CINV for different reasons, including:

• The types and dosage level of chemotherapy drugs
• When and how often the chemotherapy drug is administered
• How the chemotherapy drugs are given [intravenously (into the vein), by mouth, etc.]
• Each person’s individual reaction to the type of chemotherapy they are given

What Should I Do if My Chemotherapy is Causing CINV?

If you are experiencing nausea and vomiting, please speak with your doctor about antiemetic treatment options. You may need to try a number of these medications until you find out which one works best for you.³

How Does Cesamet Help Reduce CINV?

Cesamet is one of the medications that are available to help you with the nausea and vomiting that can be a side effect of chemotherapy. Cesamet is in a class of medications called cannabinoids that work in the brain’s vomiting center. Cesamet, through omnineuromodulation, activates the cannabinoid receptors known as CB1 receptors, throughout the central nervous system. By activating CB1 receptors, Cesamet may help to decrease nausea and vomiting.³

How is Cesamet Prescribed and How Often Do I Need to Take it?

• Cesamet has a long duration of action – 8 to 12 hours – which allows for less frequent dosing.^4-6
• The usual dosage for Cesamet is 1 or 2 mg twice a day, administered orally.¹
• Starting with the lowest dose (1 mg) and increasing the dosage slowly has been reported to lessen side effects.
• Cesamet may be administered 2 or 3 times daily during the entire course of each cycle of chemotherapy and, if needed, for 48 hours after the last dose of each cycle of chemotherapy.¹

Do I Need to Take Cesamet with Food?

You may take Cesamet with or without food. Clinical data suggests that the intake of food does not significantly affect either the rate or extent of absorption.¹

What should I expect when I Take Cesamet and is Cesamet Safe?¹

• Cesamet, a synthetic cannabinoid, is contraindicated in any patient with a history of hypersensitivity to any cannabinoid.
• The most commonly encountered events were drowsiness, vertigo, dry mouth, euphoria (feeling “high”), ataxia, headache, and concentration difficulties.
• Cesamet should not be taken with alcohol, sedatives, hypnotics, or other psychoactive substances because these substances can potentiate the central nervous system effects of nabilone.

Talk to your doctor today to find out if Cesamet could help treat your CINV.

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Important Safety Information¹

Cesamet, a synthetic cannabinoid similar to the active ingredient found in naturally occurring Cannabis sativa L. [Marijuana; delta-9-tetrahydrocannabinol (delta-9-THC)], is contraindicated in any patient who has a history of hypersensitivity to any cannabinoid. Patients receiving treatment with Cesamet should be specifically warned not to drive, operate machinery, or engage in any hazardous activity while receiving Cesamet. During controlled clinical trials of Cesamet, virtually all patients experienced at least one adverse reaction. The most commonly encountered events were drowsiness, vertigo, dry mouth, euphoria (feeling “high”), ataxia, headache, and concentration difficulties. Cesamet should not be taken with alcohol, sedatives, hypnotics, or other psychoactive substances because these substances can potentiate the central nervous system (CNS) effects of nabilone. Since Cesamet can elevate supine and standing heart rates and cause postural hypotension, it should be used with caution in the elderly, and in patients with hypertension or heart disease. Cesamet should also be used with caution in patients with current or previous psychiatric disorders, (including manic depressive illness, depression, and schizophrenia) as the symptoms of these disease states may be unmasked by the use of cannabinoids. Cesamet should be used with caution in individuals receiving concomitant therapy with sedatives, hypnotics, or other psychoactive drugs because of the potential for additive or synergistic CNS effects. Cesamet should be used with caution in patients with a history of substance abuse, including alcohol abuse or dependence and marijuana use, since Cesamet contains a similar active compound to marijuana. Cesamet should be used with caution in pregnant patients, nursing mothers, or pediatric patients because it has not been studied in these patient populations.

For complete prescribing details, please see full prescribing information.
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References

1. Cesamet® [package insert]. Valeant Pharmaceuticals International; 2006.
2. National Comprehensive Cancer Network. Nausea and vomiting. Treatment guidelines for patients with cancer. 2006;3:5-31.
3. Managing Chemotherapy Side Effects for Dummies. John Wiley & Sons, Inc.; 2006.
4. Data on File: Protocols 9, 20 and 28. Valeant Pharmaceuticals International.
5. Lemberger L, Rowe H. Clinical pharmacology of nabilone, a cannabinol derivative. Clin Pharmacol Ther. 1975;18(6):720-726.
6. Einhorn LH, Nagy C, Furnas B, et al. Nabilone: An effective antiemetic in patients receiving cancer chemotherapy. J Clin Pharmacol. 1981;21(suppl):64-69.