Clinical Reprint Review
The following reprint overviews are provided for additional information on the efficacy of Cesamet:

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.

Reducing Chemotherapy-Induced Nausea and Vomiting in Cancer Patients¹

Nabilone Significantly Reduces Severity of Nausea Compared with Prochlorperazine¹

Nabilone Significantly Reduces Frequency of Vomiting Compared to Prochlorperazine¹

Herman TS, Einhorn LH, Jones SE, et al. Superiority of nabilone over prochlorperazine as an antiemetic in patients receiving cancer chemotherapy. N Engl J Med. 1979;300(23):1295-1297.

Nabilone vs. Prochlorperazine in Patients with Severe Chemotherapy-Induced Nausea and Vomiting²

Nabilone is Superior to Prochlorperazine in Patients with Severe Chemotherapy-Induced Nausea and Vomiting²

Important Safety Information³

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. 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.
2. Herman TS, Einhorn LH, Jones SE, et al. Superiority of nabilone over prochlorperazine as an antiemetic in patients receiving cancer chemotherapy. N Engl J Med. 1979;300(23):1295-1297.
3. Cesamet® [package insert]. Valeant Pharmaceuticals International; 2006.

Maida.V. The use of cannabinoids in the supportive care of cancer patients. Oncologistics. 2006; (second quarter): 63-67.

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CESAMET REFERENCES

Cesamet® [package insert]. Valeant Pharmaceuticals International; 2006.

Croxford JL. Therapeutic potential of cannabinoids in CNS disease. CNS Drugs. 2003;17(3):179-202.

Data on File: Protocols 9, 20 and 28. Valeant Pharmaceuticals International.

Diana MA, Marty A. Endocannabinoid-mediated short-term synaptic plasticity: depolarization-induced suppression of inhibition (DSI) and depolarization-induced suppression of excitation (DSE). Br J Pharmacol. 2004;142(1):9-19. Epub 2004 Apr 20.

Dodds LJ. The control of cancer chemotherapy-induced nausea and vomiting. J Clin Hosp Pharm. 1985;10(2):143-166.

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.

Freund TF, Katona I, Piomelli D. Role of endogenous cannabinoids in synaptic signaling. Physiol Rev. 2003;83(3):1017-1066.

Grunberg SM. Advances in the management of nausea and vomiting induced by non-cisplatin containing chemotherapeutic regimens. Blood Rev. 1989;3(4):216-221.

Herman TS, Einhorn LH, Jones SE, et al. Superiority of nabilone over prochlorperazine as an antiemetic in patients receiving cancer chemotherapy. N Engl J Med. 1979;300(23):1295-1297.

Hornby PJ. Central neurocircuitry associated with emesis. Am J Med. 2001;111(suppl 8A):106-112.

Howlett AC, Barth F, Bonner TI, et al. International union of pharmacology. XXVII. Classification of cannabinoid receptors. Pharmacol Rev. 2002;54(2): 161-202.

Howlett AC, Breivogel CS, Childers SR, et al. Cannabinoid physiology and pharmacology: 30 years of progress. Neuropharmacology. 2004;47
(suppl 1):345-358.

Kalant H. Medicinal use of cannabis: history and current status. Pain Res Manag. 2001;6(2):80-91.

Lemberger L, Rowe H. Clinical pharmacology of nabilone, a cannabinol derivative. Clin Pharmacol Ther. 1975;18(6):720-726.

MARINOL^® [package insert]. Solvay Pharmaceuticals, Inc; 2003.

Martin BR. Cellular effects of cannabinoids. Pharmacol Rev. 1986;38(1):45-74.

Martin BR, Wiley JL. Mechanism of action of cannabinoids: how it may lead to treatment of cachexia, emesis, and pain. J Support Oncol. 2004;2(4):305-314; discussion 314-316.

National Comprehensive Cancer Network. Antiemesis. Clinical practice guidelines in oncology. 2006;1:AE-1-REF-7.

National Comprehensive Cancer Network. Nausea and vomiting. Treatment guidelines for patients with cancer. 2006;3:5-31.

Piomelli D. The molecular logic of endocannabinoid signalling. Nat Rev Neurosci. 2003;4(11):873-884.

Poli-Bigelli S, Rodrigues-Pereira J, Carides AD, et al. Addition of the neurokinin 1 receptor antagonist aprepitant to standard antiemetic therapy improves control of chemotherapy-induced nausea and vomiting. Results from a randomized, double-blind, placebo-controlled trial in Latin America. Cancer. 2003;97(12):3090-3098.

Schlicker E, Kathmann M. Modulation of transmitter release via presynaptic cannabinoid receptors. Trends Pharmacol Sci. 2001;22(11):565-572.

Tramer MR, Carroll D, Campbell FA, et al. Cannabinoids for control of chemotherapy induced nausea and vomiting: quantitative systematic review. Br Med J. 2001;323:1-8.

Turgeon J, Bartolucci G. Cannabinoids in the treatment of chronic pain. Continuing Education in Neurology & Psychiatry. 2003;2(2):1-8.

Ward A, Holmes B. Nabilone. A preliminary review of its pharmacological properties and therapeutic use. Drugs. 1985;30(2):127-144.

Wiser W, Berger A. Practical management of chemotherapy-induced nausea and vomiting. Oncology. 2005;19(5):637-645.

RESOURCE LINKS

Canadian Consortium for the Investigation of Cannabinoids eNewsletter

This electronic newsletter consists of a summary of published research on cannabis and cannabinoids from the international literature. Once a month, published abstracts identified during the preceding month will be collected and made available here. We have attempted to categorize the abstracts into broad subheadings of interest to physicians and basic scientists; in some cases abstracts may appear twice, as they may be of relevance to different areas. The information is provided for educational and research purposes only.

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