Cesamet (Nabilone) at a glance: schedule, half-life, and class
- Generic name
- Nabilone
- Brand names
- Cesamet
- Drug class
- Synthetic cannabinoid; CB1 and CB2 receptor agonist
- US legal status
- Schedule II, prescription only
- Approved uses
- Chemotherapy-induced nausea and vomiting not responding to conventional antiemetics
- Forms
- 1 mg capsules
- Onset
- 60 to 90 minutes
- Half-life
- About 2 hours; metabolites about 35 hours
Cesamet uses: what nabilone is prescribed for
Nabilone treats nausea and vomiting from cancer chemotherapy when standard antiemetics have not worked. It is related to dronabinol (synthetic THC) but is a different molecule.[1]
It is sometimes used off-label for chronic pain or sleep, particularly in Canada, where it has long been available.
Cesamet dosage: how nabilone is usually prescribed
The figures below come from the FDA-approved label and describe how prescribers typically use nabilone. They are not personal dosing advice. A prescriber sets the dose for each person and adjusts it over time.[1]
| Product | Typical adult dose | Notes from the label |
|---|---|---|
| Adults | 1 or 2 mg twice a day | First dose 1 to 3 hours before chemotherapy |
| Maximum | 6 mg a day in 3 divided doses | May continue up to 48 hours after each cycle |
| Older adults | Lower doses | More sensitive to dizziness and confusion |
Cesamet (nabilone) side effects and risks
Common side effects include drowsiness, dizziness, dry mouth, euphoria, and trouble concentrating.[1]
Psychiatric effects: anxiety, confusion, depression, and hallucinations, particularly in people with a history of mental illness.[1]
Heart and blood pressure: fast heartbeat and low blood pressure on standing.
Cesamet interactions: what not to mix with nabilone
Choose what it would be combined with:
| Combined with | What happens | Label guidance |
|---|---|---|
| Alcohol, benzodiazepines, opioids, sleep medicines | Additive sedation and impairment | Avoid or use caution |
| Stimulants and anticholinergics | Fast heartbeat | Monitor |
| Other cannabis products | Stronger psychoactive effects | Avoid |
This is not a full list. A pharmacist can check a complete medication list, including supplements and over-the-counter products.[1]
Cesamet overdose: signs of nabilone overdose and what to do
Overdose can cause extreme drowsiness, confusion, hallucinations, anxiety, fast heartbeat, and low blood pressure.[1]
If someone is having a dangerous reaction
- Call 911 for a seizure, chest pain, a very high temperature, trouble breathing, unresponsiveness, or if the person may harm themselves or others.
- Move them to a quiet, safe place away from roads, water, heights, and crowds. Stay with them and speak calmly.
- Do not leave the person alone and do not give them other drugs or alcohol to calm them down.
- If they become unresponsive, place them on their side and give naloxone in case opioids are involved.
Cesamet withdrawal timeline: how long nabilone withdrawal lasts
Short courses during chemotherapy rarely cause dependence. Long-term use can cause cannabis-like withdrawal when stopped.[1]
- Days 1 to 3Possible symptomsIrritability, insomnia, and restlessness.
- Days 3 to 7PeakLow mood, sweating, and appetite changes.
- 1 to 2 weeksResolvesSymptoms fade.
How to get prescribed Cesamet (nabilone) legally in the US
In the United States, nabilone is a Schedule II controlled substance. The only legal way to get it is with a prescription from a clinician registered with the Drug Enforcement Administration (DEA), filled by a licensed pharmacy. Depending on state law, that can be a physician, nurse practitioner, or physician assistant.[2]
- Refills: Schedule II prescriptions cannot be refilled. A prescriber can issue several prescriptions at once, each dated with the earliest fill date, for up to a 90-day supply.[3]
- Telehealth: federal flexibilities let DEA-registered clinicians prescribe Schedule II to V medicines after a telemedicine visit, without a prior in-person exam, through December 31, 2026. A permanent DEA rule was under final review in late 2026. State rules can be stricter.[4]
- Monitoring: prescribers and pharmacists in most states check a prescription drug monitoring program, a database of controlled-substance prescriptions, before prescribing or dispensing.
- Pharmacies: a legitimate pharmacy always requires a valid prescription, has a licensed pharmacist available, and is licensed in the state it ships to. The FDA's BeSafeRx tool and the NABP's safe pharmacy list help confirm a pharmacy is real.[5][6]
- Cost: cesamet is brand-name and costly, and pharmacies may need to order it.
Traveling: keep the medicine in its original pharmacy container and carry a copy of the prescription. Check the rules of the destination country before travel, because many countries restrict controlled medicines or require a permit.
Can you order Cesamet (nabilone) online legally?
Yes, but only with a valid prescription and only from a pharmacy licensed in your state. Many licensed pharmacies, including mail-order pharmacies run by insurers, fill nabilone prescriptions online and ship them. Buying nabilone from a website that does not require a prescription is illegal, and the product is often fake.[5][7]
- See a licensed clinicianA clinician evaluates you in person or by telemedicine and decides whether nabilone is appropriate.
- The prescription goes to a pharmacyPrescriptions are usually sent electronically, straight from the prescriber to the pharmacy you choose.
- The pharmacy checks and fills itA pharmacist verifies the prescription and your identity, then dispenses the medicine in person or by mail.
Signs that an online seller is illegal:
- It sells nabilone with no prescription, or after only a short online questionnaire.
- It takes orders through social media, messaging apps, or email.
- It asks for payment in cryptocurrency, gift cards, or money transfers.
- It has no US street address, no state pharmacy license, and no pharmacist to speak to.
- Its prices are far below those of ordinary pharmacies, or it ships from another country.
The FDA's BeSafeRx tool links to each state's license lookup, and the National Association of Boards of Pharmacy lists verified online pharmacies.[5][6]
Cesamet price: how much does Cesamet (nabilone) cost without insurance?
Cesamet is brand-name and costly, and pharmacies may need to order it.
What you pay depends on the strength, the number of doses, your insurance plan, and the pharmacy. Cash prices for the same prescription can differ several times over between pharmacies in the same town, so check current prices before you fill it.
Ways to pay less, legally:
- Ask the prescriber whether a generic nabilone is available. FDA-approved generics work the same way as the brand and usually cost much less.
- Compare cash prices between pharmacies before you fill the prescription.
- Use a free prescription discount card, such as GoodRx or SingleCare, when you pay cash. These cards cannot be combined with insurance on the same fill.
- For brand-name medicines, check the manufacturer's savings program or patient assistance program.
- Check your insurer's mail-order pharmacy, which may charge a lower copay.
Warning: A price far below what licensed pharmacies charge, especially with no prescription required, is a strong sign of an illegal seller and counterfeit medicine.[5]
Is Cesamet legal? Nabilone legal status in other countries
| Country | Status |
|---|---|
| Canada | Prescription only; widely used |
| United Kingdom | Prescription-only medicine; controlled drug |
| International | Not under UN control |
Laws change and differ in detail. Check current rules before carrying any controlled medicine across a border.[8]
Common questions about Cesamet (nabilone)
Is Cesamet (nabilone) the same as THC?
No. It is a synthetic molecule that acts on the same cannabinoid receptors as THC.
Is Cesamet (nabilone) the same as dronabinol?
No. Dronabinol is synthetic THC; nabilone is a related but different compound.
Does Cesamet (nabilone) show up on a drug test?
Standard THC tests may not detect it, but specific tests can.
Can Cesamet (nabilone) be used for pain?
Only off-label; evidence is limited.
Is Cesamet (nabilone) addictive?
It has misuse potential and is Schedule II.
Can you buy Cesamet (nabilone) without a prescription?
No. Cesamet (nabilone) is a Schedule II controlled substance in the US, so it is illegal to buy or possess it without a valid prescription. Websites and social media sellers that offer it without one are not legal pharmacies, and the FDA warns that products sold this way are often counterfeit, contaminated, or the wrong strength. The legal route is a visit with a licensed clinician, in person or by telehealth, and a prescription filled at a state-licensed pharmacy. The FDA's BeSafeRx tool and the NABP's safe pharmacy list help confirm an online pharmacy is real.
Sources
- Cesamet (nabilone) prescription information. DailyMed, US National Library of Medicine.
- Controlled Substance Schedules. DEA Diversion Control Division.
- 21 CFR 1306.12, Refilling prescriptions; issuance of multiple prescriptions (Schedule II). Electronic Code of Federal Regulations.
- Prescribing controlled substances via telehealth. US Department of Health and Human Services.
- BeSafeRx: Your Source for Online Pharmacy Information. US Food and Drug Administration.
- Safe Pharmacy. National Association of Boards of Pharmacy.
- One Pill Can Kill. US Drug Enforcement Administration.
- International drug control conventions. United Nations Office on Drugs and Crime.
