There Are Many Risk Factors for CINV

There are many risk factors for CINV, but the type of chemotherapy being given is the main risk factor. Some types of chemotherapy are more likely to cause CINV than others. Even though they may cause CINV, these chemotherapies are still used because they can be very effective in treating cancer. If your health care provider has chosen one of these treatments for you, (s)he believed it was the best choice based on your specific situation. The cancer treatments listed below are some of the treatments that are very likely to cause CINV1:

  • AC (doxorubicin or epirubicin with cyclophosphamide)
  • Carmustine >250 mg/m2
  • Cisplatin ≥50 mg/m2
  • Cyclophosphamide >1500 mg/m2
  • Dacarbazine
  • Mechlorethamine
  • Streptozocin

Other cancer drugs are less likely to cause CINV by themselves. However, when these drugs are given together (known as combination therapy) they may become more likely to cause nausea or vomiting.1

Other Risk Factors

In addition to the type of cancer therapy being given, many other factors contribute to a person's risk of CINV.

  • Chemotherapy-related risk factors1-3
    • A high dose and/or a high dose given in a short time
    • Treatment given over multiple days
    • How quickly it is given
    • How it is given (for example, by mouth)
  • Other risk factors1,4
    • Female
    • Age <50 years
    • History of CINV
    • History of low alcohol use
    • High anxiety or depression
    • History of nausea/vomiting with pregnancy and motion sickness
    • Low ability to perform daily activities
  • A few other factors may affect your risk for CINV, such as certain medical procedures you may have had, medications you may be taking, and/or medical conditions you may have.1,4,5

If you have questions about your risk of CINV, talk to your health care provider.

Please see Full Prescribing Information and see below for important risk information.

Reference:

  1. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology. Antiemesis. Ver 4, 2009. Available at: http://www.nccn.org/professionals/physician_gls/f_guidelines.asp#supportive. Accessed March 2, 2010.
  2. Hesketh PJ. Chemotherapy-induced nausea and vomiting. N Engl J Med. 2008;358:2482-2494.
  3. Blanchard EM, Hesketh PJ. Nausea and vomiting. In: DeVita VT Jr, Lawrence TS, Rosenberg SA, eds. Cancer: Principles and Practice of Oncology. 8th ed. Philadelphia: Lippincott, Williams and Wilkins; 2008:2639-2646.
  4. Lohr I. Chemotherapy-Induced Nausea and Vomiting. Cancer J. 2008;14:85-89.
  5. Berger AM, Clark-Snow RA. Adverse effects of treatment. In: DeVita VJ Jr et al. Cancer: Principles and Practice of Oncology. 6th ed. Philadelphia: Lippincott, Williams and Wilkins; 2001:2869-2880.

Cesamet Indication

  • Cesamet is a medicine for nausea and vomiting caused by cancer chemotherapy. It is used when other drugs have not been able to control these symptoms. The scientific name of Cesamet is nabilone.
  • Doctors prescribe other drugs first because Cesamet can affect your mental state. Other nausea and vomiting drugs usually do not have this kind of side effect.
  • Cesamet can affect your mental state, so you should take it around an adult you trust. This is most important when you first take Cesamet and if your doctor changes your dose.
  • Cesamet can be abused, so there are laws about how doctors can prescribe it. Prescriptions for Cesamet should last for just a few days.
  • Your doctor might watch you for signs of abusing Cesamet. If you or a family member has ever abused drugs or had a mental illness, you might have a higher risk of abusing Cesamet.
  • Only take Cesamet when your doctor told you to. It should not be the first drug you take for nausea and vomiting.

Cesamet Important Risk Information

  • Do not take Cesamet if you are allergic to any of its ingredients or any other cannabinoids.
  • The effects of Cesamet last longer in some people than others. Mental side effects could last for 2 or 3 days after you stop taking it.
  • Cesamet works in your brain. You might feel dizzy, sleepy, "high", uncoordinated, anxious, confused, or depressed while taking Cesamet. You might also hear or see things that are not real.
  • Cesamet can make your heart race or blood pressure drop. Ask your doctor about this if you are older or have high blood pressure or heart disease.
  • Cesamet affects people differently. You should take Cesamet around an adult you trust. This is most important when you first take Cesamet or if your doctor changes your dose.
  • Do not drive, use machines, or do other activities that could be dangerous until you know how Cesamet affects you.
  • Do not drink alcohol, take sleeping pills, or take other medicines that affect your brain while you are taking Cesamet. If you do, the side effects of Cesamet could be worse.
  • Talk to your doctor if you have ever had depression, schizophrenia, bipolar disorder, or another mental disorder. Cesamet could bring out the symptoms of these illnesses.
  • Cesamet is similar to marijuana. Tell your doctor if you ever abused or were dependent on alcohol or marijuana.
  • Cesamet has not been studied in pregnant women, nursing mothers, or children. These patients should be careful when taking Cesamet.
  • Cesamet can change heart rhythms. The effects of these changes in heart rhythms are not known.
  • In scientific studies, most patients who took Cesamet had at least one side effect. The most common side effects were sleepiness, dizziness, dry mouth, a "high" feeling, an uncoordinated feeling, a headache, and problems concentrating.

Cesamet Important Risk Information

  • Do not take Cesamet if you are allergic to any of its ingredients or any other cannabinoids.
  • The effects of Cesamet last longer in some people than others. Mental side effects could last for 2 or 3 days after you stop taking it.
  • Cesamet works in your brain. You might feel dizzy, sleepy, "high", uncoordinated, anxious, confused, or depressed while taking Cesamet. You might also hear or see things that are not real.
  • Cesamet can make your heart race or blood pressure drop. Ask your doctor about this if you are older or have high blood pressure or heart disease.
  • Cesamet affects people differently. You should take Cesamet around an adult you trust. This is most important when you first take Cesamet or if your doctor changes your dose.
  • Do not drive, use machines, or do other activities that could be dangerous until you know how Cesamet affects you.
  • Do not drink alcohol, take sleeping pills, or take other medicines that affect your brain while you are taking Cesamet. If you do, the side effects of Cesamet could be worse.
  • Talk to your doctor if you have ever had depression, schizophrenia, bipolar disorder, or another mental disorder. Cesamet could bring out the symptoms of these illnesses.
  • Cesamet is similar to marijuana. Tell your doctor if you ever abused or were dependent on alcohol or marijuana.
  • Cesamet has not been studied in pregnant women, nursing mothers, or children. These patients should be careful when taking Cesamet.
  • Cesamet can change heart rhythms. The effects of these changes in heart rhythms are not known.
  • In scientific studies, most patients who took Cesamet had at least one side effect. The most common side effects were sleepiness, dizziness, dry mouth, a "high" feeling, an uncoordinated feeling, a headache, and problems concentrating.

Cesamet Indication

  • Cesamet is a medicine for nausea and vomiting caused by cancer chemotherapy. It is used when other drugs have not been able to control these symptoms. The scientific name of Cesamet is nabilone.
  • Doctors prescribe other drugs first because Cesamet can affect your mental state. Other nausea and vomiting drugs usually do not have this kind of side effect.
  • Cesamet can affect your mental state, so you should take it around an adult you trust. This is most important when you first take Cesamet and if your doctor changes your dose.
  • Cesamet can be abused, so there are laws about how doctors can prescribe it. Prescriptions for Cesamet should last for just a few days.
  • Your doctor might watch you for signs of abusing Cesamet. If you or a family member has ever abused drugs or had a mental illness, you might have a higher risk of abusing Cesamet.
  • Only take Cesamet when your doctor told you to. It should not be the first drug you take for nausea and vomiting.