Characterization of Dronabinol Usage in a Pediatric Oncology Population

Elder, Joshua J.; Knoderer, Holly

doi:10.5863/1551-6776-20.6.462

Cited by 23 publications

(18 citation statements)

References 12 publications

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“…Remarkably, even relatively high doses of THC were well tolerated and even improved concentration according to the patient’s report. This observation of good tolerance of CBM is completely in line with reports of good tolerance in studies of CBM treatment as a prevention of vomiting due to antineoplastic treatment [10, 11] and CBM treatment of treatment-resistant spasticity [12] in pediatric populations. However, based on the short-term treatment in this single case, no statement can be made about long-term (side) effects of cannabis and THC in children and adolescents with TS.…”

Section: Discussion/conclusionsupporting

confidence: 73%

Vaporized Cannabis Is Effective and Well-Tolerated in an Adolescent with Tourette Syndrome

Szejko

Jakubovski

Fremer

et al. 2019

Med Cannabis Cannabinoids

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We present the case of a 12-year-old boy diagnosed with Tourette syndrome, who was successfully treated with a combination of vaporized medicinal cannabis and oral pure tetrahydrocannabinol (THC). Due to severe motor tics resulting in insomnia, the parents – both of whom were medical doctors – decided to initiate treatment with 0.02 g vaporized cannabis (Bedrocan with a THC content of 22% and a cannabidiol content of 1%; corresponding to a dose equivalent to 4.4 mg THC) without prior consultation of a Tourette expert. This treatment resulted – according to the parents’ report – in an immediate and nearly complete remission of the tics. Due to a further increase in tics, the parents therefore decided to implement a regular treatment with a combination of vaporized medicinal cannabis (up to 0.1 g cannabis per day, varieties Bedrocan and Amnesia Haze, corresponding to 22 mg THC/day) plus orally administered oil-based THC drops (maximum daily dose = 12.5 mg THC) resulting in a marked tic reduction. During a visit in our clinic, we were able to observe the reported beneficial effects 30 min after vaporization of 0.15 g cannabis (Amnesia Haze, equivalent to 33 mg THC; in addition, 7 mg oral THC were taken at home 6 h before the visit): tics, premonitory urges, and overall impairment significantly improved according to self-ratings, parent and clinician questionnaires. Importantly, no adverse events were reported. From this single case study, it is suggested that cannabis-based medicines and their combination (such as oral THC plus vaporized medicinal cannabis) are effective and safe in the treatment of severe tics in minors with TS. However, long-term follow-up is needed to confirm the beneficial treatment effects. We want to emphasize that in this boy treatment with cannabis was initiated by the parents before a consultation in our clinic has taken place. In our opinion, treatment with cannabis-based medicine in children should be regarded as a last-line treatment, when well-established treatments have failed to improve tics.

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Section: Discussion/conclusionsupporting

confidence: 73%

Vaporized Cannabis Is Effective and Well-Tolerated in an Adolescent with Tourette Syndrome

Szejko

Jakubovski

Fremer

et al. 2019

Med Cannabis Cannabinoids

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“…A recent systematic review of the use of medical cannabinoids in children and adolescents identified five studies that evaluated the use of medical cannabinoids (nabilone: two studies; dronabinol: one study; Δ 9 THC: one study; Δ 8 THC : one study) for CINV control . The authors concluded that cannabinoids are more effective at controlling vomiting than placebo in children receiving chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of nabilone for acute chemotherapy‐induced vomiting prophylaxis in pediatric patients: A multicenter, retrospective review

Polito

MacDonald

Romanick

et al. 2018

Pediatric Blood & Cancer

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“…Dronabinol and nabilone, synthetic forms of THC, have been FDA‐approved since 1985 for use in patients with chemotherapy‐induced nausea and vomiting (Table ). Dronabinol was also approved in 1992 for management of anorexia associated with HIV/AIDS 1 and is routinely prescribed as an antiemetic and appetite stimulant in children with cancer . Formerly available exclusively in capsule formulation, a dronabinol solution, Syndros TM , has recently been approved .…”

Section: Cannabinoid Pharmaceuticalsmentioning

confidence: 99%

“…Although FDA‐approved synthetic THC analogs may yield symptom relief for pediatric patients with cancer, they carry many dose‐limiting side effects . Furthermore, these pharmaceuticals have poor oral bioavailability.…”

Section: Cannabinoid Pharmaceuticalsmentioning

confidence: 99%

“…Dronabinol was also approved in 1992 for management of anorexia associated with HIV/AIDS 1 and is routinely prescribed as an antiemetic and appetite stimulant in children with cancer. 45 Formerly available exclusively in capsule formulation, a dronabinol solution, Syndros TM , has recently been approved. 46 Nabilone is available in capsules; its off-label use in children has been described in older studies, but its efficacy and safety in pediatrics are not well defined.…”

Section: Cannabinoid Pharmaceuticalsmentioning

confidence: 99%

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Medical marijuana in pediatric oncology: A review of the evidence and implications for practice

Ananth

Reed-Weston

Wolfe

2017

Pediatric Blood & Cancer

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Medical marijuana (MM) has become increasingly legal at the state level and accessible to children with serious illness. Pediatric patients with cancer may be particularly receptive to MM, given purported benefits in managing cancer-related symptoms. In this review, we examine the evidence for MM as a supportive care agent in pediatric oncology. We describe the current legal status of MM, mechanism of action, common formulations, and potential benefits versus risks for pediatric oncology patients. We offer suggestions for how providers might approach MM requests. Throughout, we comment on avenues for future investigation on this growing trend in supportive care.

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Characterization of Dronabinol Usage in a Pediatric Oncology Population

Abstract: Dronabinol appears to be a viable option as an adjuvant antiemetic in pediatric CINV, but a prospective trial using patients as their own controls is necessary to truly define dronabinol's place in therapy.

Cited by 23 publications

References 12 publications

Vaporized Cannabis Is Effective and Well-Tolerated in an Adolescent with Tourette Syndrome

Vaporized Cannabis Is Effective and Well-Tolerated in an Adolescent with Tourette Syndrome

Safety and efficacy of nabilone for acute chemotherapy‐induced vomiting prophylaxis in pediatric patients: A multicenter, retrospective review

Medical marijuana in pediatric oncology: A review of the evidence and implications for practice

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