Nabilone, a synthetic CB1 and CB2 receptor agonist, is also approved in the US for the treatment of chemotherapy-related nausea and vomiting. Studies of 0.5- to 1-mg doses of nabilone in patients with MS have not been robust, but the drug may have an effect in patients with fibromyalgia, said Dr. Maloni. A meta-analysis suggested that nabilone and dronabinol were associated with statistically significant differences in pain intensity.
Cannabis May Be an Alternative to Opioids
Physicians need guidance on prescribing cannabis for their patients, said Dr. Maloni. “Cannabis in an oral or buccal spray is safe, tolerable, and effective,” she added. The drug could provide an alternative to opioids and should be considered as a treatment for pain in MS when other accepted options have failed. Patients should be fully informed about their treatment, which should take place in the context of an ongoing relationship with their physician.
—Erik Greb
Senior Associate Editor