Details
| Stereochemistry | RACEMIC |
| Molecular Formula | C24H36O3 |
| Molecular Weight | 372.5408 |
| Optical Activity | ( + / - ) |
| Defined Stereocenters | 2 / 2 |
| E/Z Centers | 0 |
| Charge | 0 |
SHOW SMILES / InChI
SMILES
CCCCCCC(C)(C)C1=CC(O)=C2[C@@H]3CC(=O)CC[C@H]3C(C)(C)OC2=C1
InChI
InChIKey=GECBBEABIDMGGL-RTBURBONSA-N
InChI=1S/C24H36O3/c1-6-7-8-9-12-23(2,3)16-13-20(26)22-18-15-17(25)10-11-19(18)24(4,5)27-21(22)14-16/h13-14,18-19,26H,6-12,15H2,1-5H3/t18-,19-/m1/s1
Nabilone is a synthetic cannabinoid approved under the brand name cesamet for treatment of severe nausea and vomiting associated with cancer chemotherapy. Nabilone is an orally active which, like other cannabinoids, has complex effects on the central nervous system (CNS). It has been suggested that the antiemetic effect of nabilone is caused by interaction with the cannabinoid receptor system, i.e. the CB (1) receptor, which has been discovered in neural tissues.
Originator
Approval Year
Targets
| Primary Target | Pharmacology | Condition | Potency |
|---|---|---|---|
Target ID: CHEMBL218 Sources: https://www.ncbi.nlm.nih.gov/pubmed/8981483 |
8.29 null [pKi] |
Conditions
| Condition | Modality | Targets | Highest Phase | Product |
|---|---|---|---|---|
| Palliative | CESAMET Approved UseCesamet capsules are indicated for the treatment of the nausea and vomiting associated with cancer chemotherapy in patients who have failed to respond adequately to conventional antiemetic treatments. This restriction is required because a substantial proportion of any group of patients treated with Cesamet can be expected to experience disturbing psychotomimetic reactions not observed with other antiemetic agents. Because of its potential to alter the mental state, Cesamet is intended for use under circumstances that permit close supervision of the patient by a responsible individual particularly during initial use of Cesamet and during dose adjustments. Cesamet contains nabilone, which is controlled in Schedule II of the Controlled Substances Act. Schedule II substances have a high potential for abuse. Prescriptions for Cesamet should be limited to the amount necessary for a single cycle of chemotherapy (i.e., a few days). Cesamet capsules are not intended to be used on as needed basis or as a first antiemetic product prescribed for a patient. As with all controlled drugs, prescribers should monitor patients receiving nabilone for signs of excessive use, abuse and misuse. Patients who may be at increased risk for substance abuse include those with a personal or family history of substance abuse (including drug or alcohol abuse) or mental illness. Launch Date1985 |
AUC
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
345 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/872500 |
2 mg single, oral dose: 2 mg route of administration: Oral experiment type: SINGLE co-administered: |
NABILONE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
|
90 ng × h/mL EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/872500 |
0.5 mg single, intravenous dose: 0.5 mg route of administration: Intravenous experiment type: SINGLE co-administered: |
NABILONE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
T1/2
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
2 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/872500 |
2 mg single, oral dose: 2 mg route of administration: Oral experiment type: SINGLE co-administered: |
NABILONE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
|
1.7 h EXPERIMENT https://pubmed.ncbi.nlm.nih.gov/872500 |
0.5 mg single, intravenous dose: 0.5 mg route of administration: Intravenous experiment type: SINGLE co-administered: |
NABILONE plasma | Homo sapiens population: HEALTHY age: ADULT sex: MALE food status: FASTED |
Overview
| CYP3A4 | CYP2C9 | CYP2D6 | hERG |
|---|---|---|---|
OverviewOther
| Other Inhibitor | Other Substrate | Other Inducer |
|---|---|---|
Drug as perpetrator
| Target | Modality | Activity | Metabolite | Clinical evidence |
|---|---|---|---|---|
Page: 3.0 |
moderate [IC50 >10 uM] | |||
Page: 3.0 |
moderate [IC50 >10 uM] | |||
Page: 2.0 |
no | |||
Page: 2.0 |
no | |||
Page: 2.0 |
no | |||
Page: 2.0 |
no | |||
Page: 2.0 |
weak [IC50 >50 uM] | |||
Page: 2.0 |
weak [IC50 >50 uM] |
Drug as victim
| Target | Modality | Activity | Metabolite | Clinical evidence |
|---|---|---|---|---|
| yes |
PubMed
| Title | Date | PubMed |
|---|---|---|
| Nabilone produces marked impairments to cognitive function and changes in subjective state in healthy volunteers. | 2010-11 |
|
| Using cannabinoids in pain and palliative care. | 2010-10 |
|
| Substitution profile of the cannabinoid agonist nabilone in human subjects discriminating δ9-tetrahydrocannabinol. | 2010-09-15 |
|
| Treatment of Irritability in Huntington's Disease. | 2010-09 |
|
| Functional role of cannabinoid receptors in urinary bladder. | 2010-06-11 |
|
| Chemoenzymatic synthesis and cannabinoid activity of a new diazabicyclic amide of phenylacetylricinoleic acid. | 2010-06-01 |
|
| A randomized, double-blinded, crossover pilot study assessing the effect of nabilone on spasticity in persons with spinal cord injury. | 2010-05 |
|
| Cannabinoid-mediated modulation of neuropathic pain and microglial accumulation in a model of murine type I diabetic peripheral neuropathic pain. | 2010-03-17 |
|
| New approaches in the management of spasticity in multiple sclerosis patients: role of cannabinoids. | 2010-03-03 |
|
| The abuse potential of the synthetic cannabinoid nabilone. | 2010-03 |
|
| The effects of nabilone on sleep in fibromyalgia: results of a randomized controlled trial. | 2010-02-01 |
|
| Examining the roles of cannabinoids in pain and other therapeutic indications: a review. | 2010-01 |
|
| Pharmacology and toxicology of Cannabis derivatives and endocannabinoid agonists. | 2010-01 |
|
| Receptors and channels targeted by synthetic cannabinoid receptor agonists and antagonists. | 2010 |
|
| Optimizing emetic control in children receiving antineoplastic therapy: beyond the guidelines. | 2010 |
|
| Use of granisetron transdermal system in the prevention of chemotherapy-induced nausea and vomiting: a review. | 2009-12-16 |
|
| Analgesia in conjunction with normalisation of thermal sensation following deep brain stimulation for central post-stroke pain. | 2009-12-15 |
|
| Whole plant cannabis extracts in the treatment of spasticity in multiple sclerosis: a systematic review. | 2009-12-04 |
|
| A treatment algorithm for neuropathic pain: an update. | 2009-12 |
|
| Different forms of glycine- and GABA(A)-receptor mediated inhibitory synaptic transmission in mouse superficial and deep dorsal horn neurons. | 2009-11-18 |
|
| A pilot study using nabilone for symptomatic treatment in Huntington's disease. | 2009-11-15 |
|
| Regulation of synthetic cannabinoids. | 2009-11-07 |
|
| Cannabinoids as pharmacotherapies for neuropathic pain: from the bench to the bedside. | 2009-10 |
|
| Fungal biotransformation of cannabinoids: potential for new effective drugs. | 2009-03 |
|
| Cannabinoids, endocannabinoids, and related analogs in inflammation. | 2009-03 |
|
| Management of postoperative nausea and vomiting: focus on palonosetron. | 2009-02 |
|
| Central side-effects of therapies based on CB1 cannabinoid receptor agonists and antagonists: focus on anxiety and depression. | 2009-02 |
|
| Emerging strategies for exploiting cannabinoid receptor agonists as medicines. | 2009-02 |
|
| Tetrahydrocannabinol (Delta 9-THC) Treatment in Chronic Central Neuropathic Pain and Fibromyalgia Patients: Results of a Multicenter Survey. | 2009 |
|
| Identification of candidate genes affecting Delta9-tetrahydrocannabinol biosynthesis in Cannabis sativa. | 2009 |
|
| The use of a synthetic cannabinoid in the management of treatment-resistant nightmares in posttraumatic stress disorder (PTSD). | 2009 |
|
| Therapeutic use of Cannabis sativa on chemotherapy-induced nausea and vomiting among cancer patients: systematic review and meta-analysis. | 2008-09 |
|
| Current approaches to the treatment of Parkinson's disease. | 2008-08 |
|
| Nabilone for the treatment of paraneoplastic night sweats: a report of four cases. | 2008-07 |
|
| Are cannabinoids a new treatment option for pain in patients with fibromyalgia? | 2008-07 |
|
| [What sense in cannabinoid use as regulated by Italian DM 18/04/07? Pharmacological and legal considerations]. | 2008-06 |
|
| Chemotherapy-induced nausea and vomiting. | 2008-04-09 |
|
| Analgesic and antihyperalgesic effects of nabilone on experimental heat pain. | 2008-04 |
|
| Adjunctive nabilone in cancer pain and symptom management: a prospective observational study using propensity scoring. | 2008-03 |
|
| A review of nabilone in the treatment of chemotherapy-induced nausea and vomiting. | 2008-02 |
|
| Cannabinoids in the management of difficult to treat pain. | 2008-02 |
|
| Comparison of analgesic effects and patient tolerability of nabilone and dihydrocodeine for chronic neuropathic pain: randomised, crossover, double blind study. | 2008-01-26 |
|
| Chemotherapy-and cancer-related nausea and vomiting. | 2008-01 |
|
| [Cannabinoids in medicine]. | 2008 |
|
| Cannabinoid CB1 and CB2 receptor ligand specificity and the development of CB2-selective agonists. | 2008 |
|
| Cannabinoids in health and disease. | 2007 |
|
| A randomized trial of oral nabilone and prochlorperazine compared to intravenous metoclopramide and dexamethasone in the treatment of nausea and vomiting induced by chemotherapy regimens containing cisplatin or cisplatin analogues. | 1988-04 |
|
| Antiemetic efficacy of nabilone and dexamethasone: a randomized study of patients with lung cancer receiving chemotherapy. | 1987-08 |
|
| Nabilone: an effective antiemetic in patients receiving cancer chemotherapy. | 1981-08-01 |
|
| Superiority of nabilone over prochlorperazine as an antiemetic in patients receiving cancer chemotherapy. | 1979-06-07 |
Sample Use Guides
The usual adult dosage is 1 or 2 mg b.i.d. On the day of chemotherapy, the initial dose should be given 1 to 3 hours before the chemotherapeutic agent is administered. To minimize side effects, it is recommended that the lower starting dose be used and that the dose be increased as necessary. A dose of 1 or 2 mg the night before may be useful. The maximum recommended daily dose is 6 mg given in divided doses t.i.d. Cesamet (nabilone) 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.
Route of Administration:
Oral
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| Classification Tree | Code System | Code | ||
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NCI_THESAURUS |
C267
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LIVERTOX |
NBK547865
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NDF-RT |
N0000008010
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DEA NO. |
7379
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NDF-RT |
N0000175782
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WHO-VATC |
QA04AD11
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EU-Orphan Drug |
Nabilone
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WHO-ATC |
A04AD11
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5284592
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51022-71-0
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m7697
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CHEMBL2218896
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100000084425
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SUB09104MIG
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C011941
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2N4O9L084N
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DTXSID8023341
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31447
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DB00486
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3930
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2N4O9L084N
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C1171
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1862
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NABILONE
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ACTIVE MOIETY
METABOLITE (PARENT)