• CAM-summaries
  • Alternative medical systems
  • Biologically-based practices
    • Boswellia
    • Cannabinoids
      • What are Cannabinoids?
      • How well do Cannabinoids work?
      • Are Cannabinoids safe?
      • Cannabinoids conclusions
    • Essiac
    • Galavit
    • Laetrile
    • Shark cartilage
    • Ukrain
    • Black cohosh
  • Diet & nutrition
  • Energy medicine
  • Manipulative & body-based practices
  • Mind-body medicine
• CAM systematic reviews
• CAM and the law
• Prevalence of CAM use

Cannabinoids

Cannabinoids have been isolated from Cannabis sativa and Cannabis indica plants (hemp). This summary deals with dronabinol and nabilone, two pure cannabinoid products for medical use that are usually administered orally.

Medical cannabinoids are claimed to alleviate nausea and vomiting in chemo-/radiotherapy and in palliative care. Additionally, they are recommended for the treatment of anorexia and cachexia in patients with advanced cancer and for the control of chronic tumour pain. The pharmacokinetics of cannabinoids have been intensively investigated and cannabinoid effects in humans have been linked to their agonist activity at two cannabinoid receptors. Available clinical evidence is diverse for the alleged indications. While the use of cannabinoids against anorexia-cachexia-syndrome in advanced cancer is not supported by the evidence of randomised controlled trials, the antiemetic efficacy in chemotherapy-induced nausea/vomiting has been established in a systematic review. Several RCTs also indicate a mild analgesic effect of cannabinoids in cancer patients. However, dose-limitating central nervous and cardiovascular adverse effects were frequently observed in clinical studies.

Considering the availability of well-investigated and established medications for chemotherapy-induced nausea and chronic pain, a first-line use of medical cannabinoids is not recommended. Medical cannabinoids might be beneficial in individual cases as adjuncts to other antiemetic or analgesic medication when standard treatment fails in symptom control. Potential hazards and toxicities should be kept in mind.