PEDIATRICS Vol. 79 No. 6 June 1987, pp. 946-952
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Nabilone Versus Prochlorperazine for Control of Cancer Chemotherapy-Induced Emesis in Children: A Double-Blind, Crossover Trial

Helen S. L. Chan MB, FRCP(C), FAAP1, Junita A. Correia RN1, and Stuart M. MacLeod MD, PhD, FRCP(C)1

1 From the Divisions of Hematology-Oncology and Clinical Pharmacology, Department of Pediatrics and Pharmacology, the Hospital for Sick Children and the University of Toronto, Toronto

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, khgr2 test). On completion of the trial, 66% of the chidren stated that they preferred nabilone, 17% preferred prochlorperazine, and 17% had no preference (P = .015, khgr2 test). Major side effects (dizziness, drowsiness, and mood alteration) were more common (11P % 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 µg/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.

Key Words: nabilone • prochlorperazine • cancer chemotherapy-induced emesis

Submitted on May 28, 1986




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