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Review: cannabinoids control chemotherapy-induced nausea and vomiting but increase the risk of side effects

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 QUESTION: In patients with chemotherapy-induced sickness, what are the antiemetic efficacy and adverse effects of cannabinoids?

Data sources

Full publications of studies were identified by searching Medline (from 1966), EMBASE/Excerpta Medica (from 1982), and the Cochrane Library (2000, Issue 3) with the terms cannabinoids, cannabis, nabilone, tetrahydrocannabinol (THC), THC, marihuana, marijuana, levonantradol, dronabinol, randomized, and human. Bibliographies of relevant studies were checked.

Study selection

Studies were selected if they were randomised controlled trials (RCTs) comparing the antiemetic efficacy of cannabis with any other antiemetic agent or placebo in patients having chemotherapy.

Data extraction

Data were extracted on study quality, patients, interventions and regimens, and outcomes.

Main results

30 RCTs (1366 patients) published between 1975 and 1997 met the selection criteria. The mean number of patients per study was 46 (range 8 to 139 patients). 16 studies examined oral nabilone, 13 examined oral dronabinol, and 1 examined intramuscular levonantradol. The active control groups were administered prochlorperazine (12 studies), metoclopramide (4 studies), chlorpromazine (2 studies), thiethylperazine (1 study), …

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  • Sources of funding: Swiss National Science Foundation and Royal College of Nursing Institute.

  • For correspondence: Dr M R Tramèr, Division d'Anesthésiologie, Département Anesthésiologie, Pharmacologie Clinique et Soins Intensif de Chirurgie, Hôpitaux Universitaries, CH-1211 Geneva 14, Switzerland. Martin.Tramer{at}