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Nabilone for the Management of Pain.

Abstract

Nabilone, a synthetic cannabinoid, is approved in many countries including, but not limited to, Canada, the United States, Mexico, and the United Kingdom for the treatment of severe nausea and vomiting associated with chemotherapy. Clinical evidence is emerging for its use in managing pain conditions with different etiologies. We review the efficacy and safety of nabilone for various types of pain as well as its abuse potential, precautions and contraindications, and drug interactions; summarize pertinent clinical practice guidelines; and provide recommendations for dosing, monitoring, and patient education. Citations involving nabilone were identified through systematic reviews evaluating cannabinoids for pain. A systematic search (updated July 23, 2015) of the Ovid MEDLINE, EMBASE, PubMed, and Cochrane Library databases was performed. Eight randomized controlled trials, two prospective cohort trials, and one retrospective chart review were retrieved. Cancer pain, chronic noncancer pain, neuropathic pain, fibromyalgia, and pain associated with spasticity were the pain conditions evaluated. Nabilone was most commonly used as adjunctive therapy and led to small but significant reductions in pain. The most common adverse drug reactions included euphoria, drowsiness, and dizziness. Nabilone was rarely associated with severe adverse drug reactions requiring drug discontinuation, and the likelihood of abuse was thought to be low. Although the optimal role of nabilone in the management of pain is yet to be determined, certain clinical practice guidelines consider nabilone as a third-line agent.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Pharmacy Department, The Ottawa Hospital, Ottawa, Ontario, Canada.

    Pharmacy Department, The Ottawa Hospital, Ottawa, Ontario, Canada.

    Source

    Pharmacotherapy 36:3 2016 Mar pg 273-86

    MeSH

    Analgesics
    Clinical Trials as Topic
    Disease Management
    Dronabinol
    Humans
    Pain
    Receptor, Cannabinoid, CB1
    Receptor, Cannabinoid, CB2
    Treatment Outcome

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    26923810

    Citation

    Tsang, Corey C., and Mirella G. Giudice. "Nabilone for the Management of Pain." Pharmacotherapy, vol. 36, no. 3, 2016, pp. 273-86.
    Tsang CC, Giudice MG. Nabilone for the Management of Pain. Pharmacotherapy. 2016;36(3):273-86.
    Tsang, C. C., & Giudice, M. G. (2016). Nabilone for the Management of Pain. Pharmacotherapy, 36(3), pp. 273-86. doi:10.1002/phar.1709.
    Tsang CC, Giudice MG. Nabilone for the Management of Pain. Pharmacotherapy. 2016;36(3):273-86. PubMed PMID: 26923810.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Nabilone for the Management of Pain. AU - Tsang,Corey C, AU - Giudice,Mirella G, Y1 - 2016/02/29/ PY - 2016/3/1/entrez PY - 2016/3/1/pubmed PY - 2016/12/17/medline KW - abuse KW - cannabinoids KW - efficacy KW - nabilone KW - pain KW - review KW - safety SP - 273 EP - 86 JF - Pharmacotherapy JO - Pharmacotherapy VL - 36 IS - 3 N2 - Nabilone, a synthetic cannabinoid, is approved in many countries including, but not limited to, Canada, the United States, Mexico, and the United Kingdom for the treatment of severe nausea and vomiting associated with chemotherapy. Clinical evidence is emerging for its use in managing pain conditions with different etiologies. We review the efficacy and safety of nabilone for various types of pain as well as its abuse potential, precautions and contraindications, and drug interactions; summarize pertinent clinical practice guidelines; and provide recommendations for dosing, monitoring, and patient education. Citations involving nabilone were identified through systematic reviews evaluating cannabinoids for pain. A systematic search (updated July 23, 2015) of the Ovid MEDLINE, EMBASE, PubMed, and Cochrane Library databases was performed. Eight randomized controlled trials, two prospective cohort trials, and one retrospective chart review were retrieved. Cancer pain, chronic noncancer pain, neuropathic pain, fibromyalgia, and pain associated with spasticity were the pain conditions evaluated. Nabilone was most commonly used as adjunctive therapy and led to small but significant reductions in pain. The most common adverse drug reactions included euphoria, drowsiness, and dizziness. Nabilone was rarely associated with severe adverse drug reactions requiring drug discontinuation, and the likelihood of abuse was thought to be low. Although the optimal role of nabilone in the management of pain is yet to be determined, certain clinical practice guidelines consider nabilone as a third-line agent. SN - 1875-9114 UR - https://www.unboundmedicine.com/medline/citation/26923810/Nabilone_for_the_Management_of_Pain_ L2 - https://doi.org/10.1002/phar.1709 DB - PRIME DP - Unbound Medicine ER -