Cannabidiol (CBD) for Treatment of Nausea and Vomiting

One area of medicine where the use of cannabinoids cannot be argued is in the treatment of nausea and vomiting induced by cancer drugs (Chemotherapy). Even though there are some newer potent pharmaceutical agents to treat this condition, the newer agents are prohibitively expensive. Nausea and vomiting may occur from many causes but in most cases it is readily treatable with conventional medications. One cause of nausea and vomiting that is quite difficult to treat is that which occurs after use of potent anticancer drugs. Almost all cancer drugs induce violent retching spells and nausea which can last for hours or even days. To treat chemotherapy-induced nausea and vomiting, one usually requires multiple medications, which not only increases cost but also increases the risk of adverse effects.

Recently there has been significant clinical and laboratory evidence that chemotherapy-induced nausea and vomiting may be decreased by cannabinoids. The cannabis plant has been used for centuries for treatment of nausea and vomiting. However, because there were only anecdotal reports, it was argued that this was just chance event. However, in the last three decades, many clinical and laboratory studies have shown the cannabinoids have potent anti-emetic properties.

The first cannabinoid agonist, nabilone (Cesamet), was licensed and approved in 1985 for treatment of nausea and vomiting by chemotherapy. Soon after, this was followed by approval of the synthetic cannabinoid, dronabinol (Marinol) . Since then, both these agents have been widely used for treatment of cancer patients who develop moderate to severe nausea and vomiting. Over the years, several clinical trials have compared the effectiveness of the cannabinoids to other conventional anti-emetic drugs and found that the cannabinoid were equally as effective as the latest anti-emetic agents.

Newer studies indicate that the cannabinoids may be also effective in treating the more difficult symptoms of nausea and vomiting in children. One study showed that cannabinoid use in children with nausea and vomiting was safe and only produced irritability as a side effect.

Today cannabinoids for treatment of nausea and vomiting following chemotherapy are available in various formulations; such as the oral pill, sublingual dosing or inhalation. However, many patients have a preference for smoking marijuana over the synthetic cannabinoids that are given orally. The reasons for preferring smoked marijuana are said to be 1) titration is easy- you smoke until the desired effect is achieved 2) there may be difficulty swallowing pills when one has nausea and 3) the smoked product works faster than the oral pill.

Although most marijuana users claim that the smoked marijuana is more effective in reducing nausea compared to the oral cannabinoids, there have been no control studies to validate this claim. Until more studies are available, individuals who have nausea and vomiting from chemotherapy can legally get a prescription for the synthetic cannabinoids from any physician.

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