What is Nabilone and When is it Used on the NHS?

If you've heard the term nabilone and wondered what it is and whether you can get it on the NHS, you're not alone. This synthetic cannabinoid medicine has a specific role in UK healthcare, but accessing it can be complicated. This guide breaks down what nabilone is, what changed in 2018 around its legal status, NHS misuse of drugs regulations 2001 access rules, specialist prescribing guidelines, and why the NHS remains cautious about cannabis-based medicines overall.

What is Nabilone?

Nabilone is a man-made medicine designed to work like some components of cannabis, called cannabinoids. Unlike cannabis flower or herbal extracts, nabilone is a fully licensed pharmaceutical with a defined ingredient and dose.

It's primarily used to treat nausea and vomiting caused by chemotherapy when other anti-sickness medicines have not worked well. The UK’s National Institute for Health and Care Excellence (NICE) generally recommends it as a third-line treatment for this purpose.

You can find more about nabilone’s uses and patient experiences on sites like releaf.co.uk, which explains cannabinoid medicines in clear language.

2018 Rescheduling: What Changed?

Before 2018, all cannabinoid medicines including nabilone were classed as controlled substances with stricter restrictions under UK law. In November 2018, new legislation reclassified some cannabis-based medicines to facilitate prescribing by specialist doctors.

For nabilone specifically:

• It remains a prescription-only medicine (POM) but was rescheduled from Schedule 1 to Schedule 2 of the Misuse of Drugs Regulations, meaning it is recognised as having medical value and can be legally prescribed for medical use.
• This rescheduling allowed doctors in the UK to prescribe nabilone without needing Home Office licenses, but it still requires careful record keeping and falls under various controlled drug regulations.

In plain English: before 2018, prescribing any cannabinoid was legal but complicated and tightly controlled; after 2018, nabilone became easier for specialists to prescribe, but it still isn't a casual prescription.

NHS Funding vs Legal Prescribing: What's the Difference?

This is a key point that often causes confusion. Just because a medicine is legal to prescribe doesn't mean the NHS will automatically pay for it.

Legal to Prescribe Funded by NHS Medicines that are approved and licensed can be prescribed by the right specialists under UK law. Nabilone is legal to prescribe by specialists in the UK. NHS funding/cost coverage depends on NICE guidance or local Clinical Commissioning Group (CCG) policies. Nabilone is available on the NHS for specific uses, such as chemo-induced nausea, but can be restricted locally.

In reality, reaching a specialist doctor willing to prescribe nabilone is the first hurdle. Patients sometimes try private clinics listed on medicalcannabis.co.uk to access cannabinoid treatment earlier, but private prescriptions usually do not come with NHS funding.

Who Can Prescribe Nabilone on the NHS? Specialist-Only Rules

Nabilone is tightly controlled and cannot be prescribed by just any doctor or GP. UK guidance states that only certain specialist consultants can initiate treatment.

• Specialists in oncology or palliative care are most commonly authorised to prescribe nabilone for chemotherapy-induced nausea and vomiting.
• Initiation of nabilone usually occurs after standard antiemetic treatments fail.
• Continuing prescriptions may involve shared care agreements between hospital specialists and GPs once the treatment is stabilised.

This means your GP cannot start nabilone on their own – you would need a referral to a specialist clinic. Such rules ensure careful patient selection and monitoring due to side effects like dizziness and drowsiness.

Unlicensed Cannabis-Based Medicines and NHS Caution

Nabilone is a licensed medicine, which means it has passed regulatory safety and efficacy checks. However, many cannabis-based treatments available today—such as CBD oils or herbal extracts—are unlicensed in the UK.

The NHS remains cautious about prescribing unlicensed cannabis-based medicines. This caution is due to:

1. Lack of strong clinical trial evidence to prove consistent benefits for most conditions beyond chemotherapy nausea.
2. Issues with quality control and dosing accuracy in products without pharmaceutical licensing.
3. Legal and regulatory concerns, including complex prescribing rules and monitoring requirements.

Because of this, UK NHS clinicians generally avoid prescribing unlicensed cannabis products and instead may recommend participation in clinical trials, or refer to specialist centres where access pathways exist.

Patients exploring options can find private clinics that offer these medicines via directories like medicalcannabis.co.uk, but such treatments usually require private funding.

The Bottom Line: When is Nabilone Used on the NHS?

• Main use: Treating nausea and vomiting caused by chemotherapy when standard treatments fail.
• Access: Only prescribed by specialist doctors, often in oncology or palliative care settings.
• Funding: Available on the NHS but subject to local availability and prescribing policies. It is not routinely prescribed for other conditions due to limited evidence.
• 2018 rescheduling: Made legal prescribing easier but did not change NHS funding or routine clinical guidelines significantly.

If you think nabilone might help you with chemotherapy side effects, the best route is to discuss this with your oncology or palliative care team. They can assess whether it is appropriate and navigate NHS pathways.

Additional Resources

• releaf.co.uk – Easy-to-understand cannabinoid medicine explanations
• medicalcannabis.co.uk – Clinic directory and comparison site for cannabis-based medicines

Price Note

No specific NHS prices for nabilone are commonly published in the open sources scraped recently. If prices are mentioned in future official or credible publications, quoting them exactly and providing full attribution is best practice.

In Brief: What Patients Should Know

Nabilone is a doctor-only prescribed medicine on the NHS used mainly to help with severe chemo sickness when other medicines don’t work. Since 2018, it became easier for recognized specialists to prescribe, but it still isn’t widely available beyond very specific cases. Unlicensed cannabis products remain a different story, mostly outside NHS routine use.