In a randomized, double-blind, crossover trial,
nabilone was compared to
prochlorperazine for control of
cancer chemotherapy-induced
emesis in 30 children 3.5 to 17.8 years of age. All subjects received two consecutive identical cycles of
chemotherapy with the trial
antiemetics given in accordance to a
body weight-based dosage schedule beginning eight to 12 hours before treatment. The overall rate of improvement of retching and
emesis was 70% during the
nabilone and 30% during the
prochlorperazine treatment cycles (P = .003, chi 2 test). On completion of the trial, 66% of the children stated that they preferred
nabilone, 17% preferred
prochlorperazine, and 17% had no preference (P = .015, chi 2 test). Major side effects (
dizziness, drowsiness, and mood alteration) were more common (11% v 3%) during the
nabilone treatment cycles. CNS side effects appeared to be dose related and were most likely to occur when the
nabilone dosage exceeded 60 micrograms/kg/d, but individual tolerance to
nabilone varied considerably. Lower dosages of
nabilone were associated with equivalent efficacy and no major side effects.
Nabilone appears to be a safe, effective, and well-tolerated
antiemetic drug for children receiving
cancer chemotherapy. Although major side effects may occur at higher dosages,
nabilone is preferable to
prochlorperazine because of improved efficacy.