Nabilone
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| Image:Nabilone.png | |
| Nabilone
| |
| Systematic (IUPAC) name | |
| (6aR,10aR)-1-hydroxy-6,6-dimethyl-3-(2-methyloctan-2-yl)-
-7,8,10,10a-tetrahydro-6H-benzo[c]chromen-9(6aH)-one | |
| Identifiers | |
| CAS number | |
| ATC code | A04 |
| PubChem | |
| DrugBank | |
| Chemical data | |
| Formula | C24H36O3 |
| Mol. mass | 372.541 g/mol |
| Pharmacokinetic data | |
| Bioavailability | 20% after first-pass by the liver |
| Protein binding | similar to THC (+/-97%) |
| Metabolism | ? |
| Half life | 2 hours, with metabolites around 35 hours. |
| Excretion | ? |
| Therapeutic considerations | |
| Pregnancy cat. |
NA |
| Legal status | |
| Routes | Oral form (PO)- capsule |
Nabilone is a synthetic cannabinoid with therapeutic use as an antiemetic and as an adjunct analgesic for neuropathic pain. It is a synthetic cannabinoid, which mimics the main ingredient of marijuana (THC) but it has more predictable side effects and causes no or minimal euphoria. Nabilone is not derived from the cannabis plant as is dronabinol.
In Canada, the United States, the United Kingdom and Mexico, nabilone is marketed as Cesamet. It was approved in 1985 by the United States FDA for treatment of chemotherapy-induced nausea and vomiting that has not responded to conventional antiemetics. Though it was approved by the FDA in 1985, the drug only began marketing in the United States in 2006. It is also approved for use in treatment of anorexia and weight loss in patients with AIDS.
Although it doesn't have the official indication (except in Mexico), nabilone is widely used as an adjunct therapy for chronic pain management. Numerous trials and case studies have demonstrated various benefits for condition such as fibromyalgia and multiple sclerosis [citation needed].
Nabilone is a racemic mixture consisting of the (S,S) and the (R,R) isomers ("trans").
Clinical trials
The main settings that have seen published clinical trials of nabilone include movement disorders such as Parkinson's syndrome, chronic pain, dystonia and spasticity neurological disorders, fibromyalgia, multiple sclerosis, and the nausea of cancer chemotherapy.
A study comparing nabilone with metoclopramide, conducted before the development of modern 5-HT3 inhibitor anti-emetics such as ondansetron, revealed that patients taking cisplatin chemotherapy preferred metoclopramide, while patients taking carboplatin chemotherapy preferred nabilone to control nausea and vomiting. [1] Another study compared nabilone alone to nabilone with dexamethasone. The study found that the combination worked better than the single medication. [1] An older study revealed that nabilone was more effective than prochlorperazine in controlling nausea, though in this study, only 9% of nabilone patients had complete resolution of symptoms. [1] A follow-up to this study revealed similar findings. [1]
References
Antiemetics and antinauseants (A04) | |
|---|---|
| Serotonin (5-HT3) antagonists | Ondansetron • Granisetron • Tropisetron • Dolasetron • Palonosetron |
| Other | Scopolamine • Cerium oxalate • Chlorobutanol • Metopimazine • Cannabinoids (Dronabinol, Nabilone) • NK1 receptor antagonist (Aprepitant, Fosaprepitant) |
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Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
