Chemotherapy-Induced Nausea and Vomiting
Nausea and vomiting caused by cancer chemotherapy. The 2017 NASEM consensus report found conclusive or substantial evidence that oral cannabinoids are effective antiemetics in adults receiving chemotherapy.
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Reviewed by Laura H. Meyer
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What it is
Nausea and vomiting are common side effects of cytotoxic chemotherapy. Severity and duration vary by regimen, dose, and individual patient factors.
Cannabis and cannabis-derived therapies
Two oral synthetic cannabinoids (dronabinol and nabilone) are FDA-approved for chemotherapy-induced nausea and vomiting that has not responded to conventional antiemetic therapy. The 2017 NASEM consensus report concluded that there is substantial evidence supporting their effectiveness in adults.
Frequently asked questions
What is CINV?
CINV stands for chemotherapy-induced nausea and vomiting. A common adverse effect of cancer chemotherapy, particularly regimens involving cisplatin, anthracyclines, or high-dose alkylating agents. Severity ranges from mild to disabling.
How do cannabinoids compare to standard antiemetics like ondansetron?
In trials predating the modern 5-HT3 antagonist class (ondansetron, granisetron), cannabinoids were more effective than the available antiemetics. With modern combination antiemetic protocols, cannabinoids are typically reserved as add-on therapy for patients with breakthrough nausea not controlled by first-line regimens.
Is dronabinol the same as cannabis?
Dronabinol is synthetic delta-9-THC. Chemically identical to the THC molecule found in cannabis, but produced pharmaceutically. It is FDA-approved as Marinol for chemotherapy nausea and for AIDS-associated anorexia. Plant cannabis contains THC plus dozens of other cannabinoids and terpenes; dronabinol contains only THC.
When during chemotherapy should antiemetic cannabinoids be used?
Per dronabinol prescribing information, the first dose is typically given 1–3 hours before chemotherapy, with subsequent doses every 2–4 hours after. Patients should follow oncologist guidance and the FDA label for any prescribed cannabinoid antiemetic.
Sources
- NASEM: The Health Effects of Cannabis and Cannabinoids (2017)accessed May 14, 2026
“Conclusive or substantial evidence that oral cannabinoids are effective antiemetics in the treatment of chemotherapy-induced nausea and vomiting.”
- NIH NCCIH: Cannabis (Marijuana) and Cannabinoidsaccessed May 14, 2026