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Treatment of anorexia associated with weight loss in AIDS patients and N/V associated with cancer chemotherapy in patients who have failed to respond adequately to conventional antiemetic treatments.
Adults: Individualize dose. Appetite Stimulation: Initial: 2.5mg bid before lunch and supper. Titrate: Reduce dose to 2.5mg qpm or qhs if 5mg/day dose is intolerable. Max: 20mg/day in divided doses. Antiemetic: Initial: 5mg/m2 1-3 hrs before chemotherapy, then q2-4h after chemotherapy, for a total of 4-6 doses/day. Titrate: May increase dose by 2.5mg/m2 increments. Max: 15mg/m2/dose.
Pediatrics: Antiemetic: Initial: 5mg/m2 1-3 hrs before chemotherapy, then q2-4h after chemotherapy, for a total of 4-6 doses/day. Titrate: May increase dose by 2.5mg/m2 increments. Max: 15mg/m2/dose.
Cap: 2.5mg, 5mg, 10mg
Sesame oil hypersensitivity.
May impair mental/physical abilities. Seizure and seizure-like activity reported; d/c immediately if seizures develop. Caution with history of seizure disorders, substance abuse, and cardiac disorders due to occasional hypotension, possible HTN, syncope, or tachycardia. Caution in patients with mania, depression, or schizophrenia; exacerbation of these illnesses may occur. Caution in elderly (particularly those with dementia), pregnancy, nursing, and pediatrics.
Abdominal pain, N/V, dizziness, euphoria, paranoid reaction, somnolence, abnormal thinking.
May displace highly protein-bound drugs; dose requirement changes may be needed. Additive or synergistic CNS effects with sedatives, hypnotics, or other psychoactive drugs. Additive HTN, tachycardia, and possible cardiotoxicity with sympathomimetics (eg, amphetamines, cocaine). Additive or super-additive tachycardia, and drowsiness with anticholinergics (eg, atropine, scopolamine, antihistamines). Additive tachycardia, HTN, and drowsiness with TCAs (eg, amitriptyline, amoxapine, desipramine). Additive drowsiness and CNS depression with CNS depressants (eg, barbiturates, benzodiazepines, ethanol, lithium, opioids, buspirone, antihistamines, muscle relaxants). May result in hypomanic reaction with disulfiram and fluoxetine in patients who smoked marijuana. May decrease clearance of antipyrine and barbiturates. May increase theophylline metabolism in patients who smoked marijuana/tobacco.
Category C, not for use in nursing.
Cannabinoid; has complex effects on the CNS, including central sympathomimetic activity.
Absorption: Administration of variable doses resulted in different pharmacokinetic parameters. Distribution: Vd=10L/kg; plasma protein binding (97%); found in breast milk. Metabolism: Liver via microsomal hydroxylation; 11-OH-delta-9-THC (active metabolite). Elimination: Urine (10-15%), bile/feces (50%, <5% unchanged); T1/2=25-36 hrs.
Assess for history of hypersensitivity to the drug and sesame oil, history of seizure disorders, substance abuse (including alcohol abuse/dependence), cardiac disorders, mania, depression, schizophrenia, pregnancy/nursing status, hepatic/renal impairment, and possible drug interactions.
Monitor for psychiatric illness exacerbation, abdominal pain, N/V, dizziness, euphoria, paranoid reaction, somnolence, abnormal thinking, hypotension or HTN, syncope, tachycardia, for psychological and physiological dependence, and other adverse reactions.
Inform about additive CNS depression effect if taken concomitantly with alcohol or other CNS depressants (eg, benzodiazepines, barbiturates). Advise to use caution while performing hazardous tasks (eg, operating machinery/driving) until effect is well-tolerated. Inform of mood changes and other behavioral effects that may occur during therapy. Advise that patients must be under constant supervision of a responsible adult during initial use and following dosage adjustments. Instruct to immediately report to physician any adverse effects and notify if pregnant or breastfeeding.
8-15°C (46-59°F). Protect from freezing.