Nabilone, Cesamet®

• Cesamet®

1. Synthetic cannabinoid

• Capsule: 1 mg

• Anti-emetic
• Appetite inducer in HIV patients
• Pain killer

• Can be administered 1 to 2 mg up to three times daily

Amphetamines, cocaine, other sympathomimetic agents

1. Additive hypertension,
2. Tachycardia
3. Possibly cardiotoxicity

Atropine, scopolamine, antihistamines, other anticholinergic agents

1. Additive or super-additive tachycardia,
2. Drowsiness

Amitriptyline, amoxapine, desipramine, other TCAs

1. Additive tachycardia
2. Hypertension
3. Drowsiness

Barbiturates, benzodiazepines, ethanol, lithium, opioids, buspirone, antihistamines, muscle relaxants, other CNS depressants

1. Additive
2. Drowsiness
3. CNS depression

Antipyrine, barbiturates

1. Decreased clearance of these agents, presumably via competitive inhibition of metabolism

Theophylline

1. Increased theophylline metabolism reported with smoking of marijuana;
2. effect similar to that following smoking tobacco

Opioids

1. Cross-tolerance and mutual potentiation

1. Naltrexone
   1. Oral THC effects were enhanced by opioid receptor blockade.
2. Alcohol:
   1. Increase in the positive subjective mood effects of smoked marijuana

Blood and Hematopoietic

1. Leukopenia

Cardiovascular

1. Hypotension
2. Tachycardia

Eye and Ear

1. Visual disturbances

Gastrointestinal

1. Dry mouth
2. Nausea
3. Vomiting
4. Constipation

Nervous System:

1. Hallucinations
2. CNS depression
3. CNS stimulation,

1. Ataxia
2. Stupor
3. Vertigo
4. Convulsion
5. Circumoral paresthesia

Psychiatric:

1. Somnolence
2. Confusion
3. Euphoria
4. Depression
5. Dysphoria
6. Depersonalization
7. Anxiety
8. Psychosis
9. Emotional lability

Miscellaneous and Ill:

1. Dizziness
2. Headache
3. Insomnia
4. Abnormal thinking
5. Chest pain
6. Lack of effect
7. Face edema

1. The effects of Cesamet may persist for a variable and unpredictable period of time following its oral administration. Adverse psychiatric reactions can persist for 48 to 72 hours following cessation of treatment.
2. Cesamet has  the  potential  to  affect  the  CNS,  which  might  manifest  itself  in dizziness, drowsiness, euphoria “high”, ataxia, anxiety, disorientation, depression, hallucinations and psychosis.
3. Cesamet can cause tachycardia and orthostatic hypotension.
4. Because of individual variation in response and tolerance to the effects of Cesamet, patients should remain under supervision of a responsible adult especially during initial use of Cesamet and during dose adjustments.
5. Patients receiving  treatment  with  Cesamet  should  be  specifically  warned  not  to drive,  operate  machinery,  or  engage  in  any  hazardous  activity  while  receiving Cesamet.