Nabilone

Nabilone is a fully synthetic cannabinoid structural analog of Δ9-THC marketed as Cesamet. Originally developed by Eli Lilly, nabilone received initial FDA approval on December 26, 1985 for chemotherapy-induced nausea and vomiting refractory to conventional antiemetics; Lilly discontinued U.S. marketing in 1989, and Valeant Pharmaceuticals (now Bausch Health) obtained renewed FDA marketing approval on May 15, 2006. Nabilone is a Schedule II controlled substance under the CSA (21 CFR 1308.12). Each capsule contains 1 mg of nabilone; typical dosing is 1–2 mg twice daily, up to 6 mg/day. Nabilone differs pharmacokinetically from dronabinol in having a longer terminal half-life of identified and unidentified metabolites (≈35 hours) supporting twice-daily dosing, and is often described as more potent on a per-milligram basis than Δ9-THC. It is used off-label in some jurisdictions for chronic pain and MS-related spasticity. → See also: Dronabinol, CINV.