# Cannabinoids for chemotherapy nausea (dronabinol, nabilone, medical cannabis)

Source: https://onco.cc/technologies/cannabinoids-nausea/  
OnCo record `cannabinoids-nausea` (Technology). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Two synthetic cannabinoid tablets, dronabinol and nabilone, have been approved for chemotherapy nausea since 1985 and can help when standard anti-sickness drugs fail. Modern antiemetics work better for most people, and evidence for herbal cannabis or vaped products is thin.

## Summary

Dronabinol (synthetic THC) and nabilone were approved by the FDA in 1985 for chemotherapy-induced nausea and vomiting refractory to conventional antiemetics. Trials from that era showed superiority over placebo and prochlorperazine, at the price of dizziness, dysphoria and sedation; there are no adequate head-to-head trials against 5-HT3 antagonists, NK1 antagonists or olanzapine, which are now first-line. ASCO and MASCC/ESMO antiemetic guidelines list FDA-approved cannabinoids as an option for breakthrough or refractory nausea. A 2024 randomised trial from Australia found an oral THC:CBD extract added to standard antiemetics reduced refractory nausea, a signal the 2024 ASCO cannabis guideline cites while noting the evidence for herbal cannabis remains limited. Smoked or vaped cannabis has not been adequately tested and carries respiratory and psychoactive risks. Cannabinoids can also cause cannabinoid hyperemesis with heavy chronic use.

## Fields

- Kind: Technology
- Status: approved
- Last checked: 2026-09-10
- Tags: complementary; supportive-care; evidence:moderate
- Principle: THC activates CB1 receptors in the dorsal vagal complex and area postrema, suppressing emetic signalling; CBD may act via 5-HT1A.
- Since: 1985
- Strengths: Approved drugs with randomised evidence versus placebo; Option for refractory nausea; Addressed in ASCO and MASCC guidance
- Limitations: Not compared with modern antiemetics; Psychoactive side effects, especially in older adults; Herbal and vaped products under-studied

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Nabilone
- ASCO guideline: cannabis and cannabinoids in adults with cancer (JCO 2024): https://doi.org/10.1200/JCO.23.02596
- NCI PDQ: Cannabis and cannabinoids: https://www.cancer.gov/about-cancer/treatment/cam/hp/cannabis-pdq

## Connected records

- fronts: [Chemotherapy](https://onco.cc/fronts/chemotherapy/), [Supportive Care & Survivorship](https://onco.cc/fronts/supportive-care/)
- technologies: [Antiemetics for chemotherapy-induced nausea and vomiting](https://onco.cc/technologies/antiemetic-therapy/), [Cannabis and cannabinoids for pain, appetite and cancer control](https://onco.cc/technologies/cannabinoids-pain-appetite/), [Evidence-based integrative oncology](https://onco.cc/technologies/integrative-oncology/)
- bottlenecks: [Toxicity and quality of life are undervalued](https://onco.cc/bottlenecks/b-toxicity-qol/)
- key papers: [Cannabis and Cannabinoids in Adults With Cancer: ASCO Guideline](https://onco.cc/key-papers/paper-braun-j-clin-oncol/)
- roadmaps: [Chemotherapy roadmap: mustard gas → curative combinations → the warhead inside smarter drugs](https://onco.cc/roadmaps/chemotherapy-roadmap/)

---
JSON: https://onco.cc/api/v1/entities/cannabinoids-nausea.json