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US: Synthetic Cannabis Gets FDA OK

genengnews.com

Tuesday 16 May 2006

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Valeant Pharmaceuticals Receives FDA Marketing Approval for Cannabinoid
Cesamet(TM) (CII)

Valeant Pharmaceuticals International (NYSE:VRX) today announced that
the U.S. Food and Drug Administration (FDA) has given marketing approval
for Cesamet (CII) (nabilone) oral capsules. Cesamet is used to treat
nausea and vomiting associated with cancer chemotherapy in patients who
have failed to respond adequately to conventional anti-emetic treatments.

"There is still a significant unmet need in treating one of the most
feared and severe consequences of life-saving cancer therapies," said
Timothy C. Tyson, Valeant's president and chief executive officer. "With
the approval of Cesamet, Valeant is proud to offer a solution that will
help alleviate one of the most common side effects of chemotherapy."

Cesamet is a synthetic cannabinoid that is thought to act as an
omnineuromodulator - interacting with the cannabinoid receptor, CB1,
which is present throughout the nervous system. This receptor is
involved in regulating nausea and vomiting. Because of this
omnineuromodulation, the mechanism of action for Cesamet is
significantly different from conventional anti-emetics. Cesamet has a
long duration of action, which allows for less frequent dosing,
typically twice daily.

Valeant acquired Cesamet from Eli Lilly & Company in 2004 and currently
sells Cesamet in Canada, where the product has an 86 percent share of
the cannabinoid market, according to IMS Compuscript data from February
2006. Last year, Valeant entered into an agreement with Par
Pharmaceutical Companies, Inc. (NYSE:PRX) to promote Cesamet in the
United States. Valeant anticipates launch of Cesamet in the next several
weeks following approval.

"In my practice, Cesamet has been used successfully to treat patients
with chemotherapy-induced nausea and vomiting," said Paul Daeninck,
M.D., assistant professor, Department of Oncology at the University of
Manitoba in Winnipeg, Canada. "We have found that it offers long-acting
chemotherapy-induced nausea and vomiting relief in a well-tolerated and
convenient twice-a-day regimen."

The American Cancer Society estimates that there will be nearly 1.4
million new cancer cases in 2006. Approximately 70 to 80 percent of all
patients receiving chemotherapy experience chemotherapy-induced nausea
and vomiting (CINV). Although the use of anti-emetic agents decreases
the incidence and severity of CINV, symptoms continue to occur in 40 to
60 percent of patients.

"There is a need for cannabinoids, such as Cesamet, for patients who
have exhausted conventional treatments but are still coping with the
debilitating side effects of chemotherapy," said Neal Slatkin, M.D.,
DABPM and director, Department of Supportive Care, Pain and Palliative
Medicine at City of Hope. "CINV dramatically impacts cancer patients'
quality of life and can result in patients refusing courses of
chemotherapy, which minimizes chances for the best possible outcome."

Cesamet Clinical Trial Overview

Cesamet was evaluated for its effectiveness and safety in the treatment
of nausea and vomiting induced by cancer chemotherapy in patients
receiving a wide variety of chemotherapy regimens, including low-dose
cisplatin (20 mg/m2) in both placebo-controlled and active controlled
(prochlorperazine) trials. Efficacy and safety results were derived from
eleven (11) well-controlled anti-emetic, double-blind, crossover studies
with optional continuation into Cesamet open-label therapy. Either
prochlorperazine or placebo was used as the comparator. The
prochlorperazine-controlled studies consisted of two (2) flexible-dose,
crossover studies (143 patients of which 112 were evaluable for
efficacy) and three (3) fixed-dose, crossover studies (126 patients of
which 73 patients were evaluable for efficacy). The placebo-controlled
studies were six (6) fixed-dose, crossover studies (199 patients of
which 129 were evaluable for efficacy). The crossover studies comprised
two (2) cycles of cancer treatment, Cesamet in one (1) cycle and control
drug in the other. The order of cycles for each patient was randomized.
The most frequent dose regimen of nabilone was 2 mg BID (twice-a-day),
except in the two (2) flexible-dose studies, where Cesamet daily doses
of over 4 mg were frequent. Efficacy was evaluated by comparing the
number of vomits and the severity of nausea.

All statistical comparisons significantly favored nabilone, with the
exception of one (1) prochlorperazine-controlled flexible-dose study.
However, even in this study, nabilone had a lower overall average
frequency of vomits and a lower average severity of nausea score than
prochlorperazine.

Important Safety Information

Cesamet, a synthetic cannabinoid similar to the active ingredient found
in naturally occurring Cannabis sativa L (marijuana; delta-9-THC), is
contraindicated in any patient who has a history of hypersensitivity to
any cannabinoid. Patients receiving treatment with Cesamet should be
specifically warned not to drive, operate machinery, or engage in any
hazardous activity while taking Cesamet. During controlled clinical
trials of Cesamet, virtually all patients experienced at least one
adverse reaction. The most commonly encountered events were drowsiness,
vertigo, dry mouth, euphoria (feeling "high"), ataxia, headache, and
concentration difficulties. Cesamet should not be taken with alcohol,
sedatives, hypnotics, or other psychoactive substances because these
substances can potentiate the central nervous system effects of
nabilone. Since Cesamet can elevate supine and standing heart rates and
cause postural hypotension, it should be used with caution in the
elderly, and in patients with hypertension or heart disease. Cesamet
should also be used with caution in patients with current or previous
psychiatric disorders (including manic depressive illness, depression
and schizophrenia), as the symptoms of these disease states may be
unmasked by the use of cannabinoids. Caution must be used when
administering Cesamet in combination with any CNS depressant.

Cesamet should be used with caution in patients with a history of
substance abuse, including alcohol abuse or dependence and marijuana
use, since Cesamet is similar to the active ingredient found in
naturally occurring marijuana. Cesamet should be used with caution in
pregnant patients, nursing mothers, or pediatric patients because it has
not been studied in these patient populations. For product-related
questions, call Valeant Pharmaceuticals International at 1-877-361-2719.

About Valeant

Valeant Pharmaceuticals International (NYSE:VRX) is a global,
science-based specialty pharmaceutical company that develops,
manufactures and markets products primarily in the areas of neurology,
infectious disease and dermatology. More information about Valeant can
be found at www.valeant.com.

Cesamet is a trademark of Valeant Pharmaceuticals International or its
related companies. All other trademarks are the trademarks or the
registered trademarks of their respective owners.

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