Marinol vs. Cannabis: What’s the Difference?

Marinol (dronabinol) is an FDA-approved medication. It’s taken to increase appetite and reduce nausea in people with certain health conditions. It contains a synthetic (lab-made) form of an active ingredient found in cannabis. But currently, cannabis isn’t FDA approved for medical use.

FDA-approval status isn’t the only difference between these two substances. Knowing how Marinol and cannabis compare will help you decide if either one is right for your treatment plan.

What is Marinol?

As mentioned, Marinol is a medication that reduces nausea and stimulates appetite. It’s specifically approved for people with AIDS or going through chemotherapy treatment. But it’s also being studied for obstructive sleep apnea and chronic pain.

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Marinol’s active ingredient, dronabinol, is a synthetic form of delta-9-tetrahydrocannabinol (THC). THC is one of the active ingredients found in cannabis. Marinol is a schedule III controlled substance, which means it has a potential for misuse and dependence. 

How do you take Marinol?

Marinol comes in an oral capsule and oral solution (under the brand name Syndros). The capsules are also available as a lower-cost generic, dronabinol. The following doses are available:

It takes about 30 minutes to 1 hour for Marinol to work, and the peak effects happen around 2 to 4 hours after you take it. The psychoactive effects typically last around 4 to 6 hours, but the effects on appetite may last 24 hours or longer after you take it. It’s also best to keep Marinol in the refrigerator. 

If you’re living with AIDS and taking Marinol to increase your appetite, you’ll take it twice a day, an hour before lunch and dinner. 

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For chemotherapy-induced nausea and vomiting, you’ll take one dose 1 to 3 hours before your chemotherapy treatment. You’ll then continue with one dose every 2 to 4 hours as needed. The average dose is 5 mg, but can range from 2.5 mg to 10 mg based on your response.

For nausea from chemotherapy, the dose may be based on your body surface area. Your healthcare provider will help determine the best dose for you.

Good to know: Marinol capsules contain sesame oil, and Syndros solution contains alcohol. These ingredients may not be ideal for people with allergies or intolerance to these ingredients.

What are the differences between Marinol and cannabis?

There are several differences between Marinol and cannabis.

• Marinol is synthetic, but cannabis is not. Dronabinol is a lab-made compound. Cannabis is a natural plant.

• Marinol and cannabis don’t contain the same active ingredients. Marinol contains one ingredient — dronabinol. Cannabis contains over 100 active ingredients, called cannabinoids. Each cannabinoid has different effects. And cannabis also contains terpenes and flavonoids that can also have effects on the body. Marinol has the same formulation each time you take it. But since cannabis is a plant, it won’t be exactly the same each time it grows.

• Marinol is federally legal, but cannabis is not. Even though many states have passed laws to legalize cannabis, it’s still illegal at the federal level. Marinol is an FDA-approved prescription medication, so it’s a legal medication in the U.S. This means your prescription insurance (if applicable) may cover Marinol. But you’ll have to pay for cannabis yourself — insurance can’t cover something that’s not federally legal.

• Marinol and cannabis are available in different forms. Marinol is only available as an oral capsule or solution. Cannabis comes in oral, sublingual, topical, and inhaled dosage forms. Additionally, Marinol is only available in three different doses. Cannabis products can contain a wide variety of ingredients and dosages.

• Marinol and cannabis don’t have the same effects. Each cannabinoid in cannabis has different effects on the body. This is how cannabis products may help with many different medical conditions, depending on what’s in them. And some cannabinoids work to balance each other out. For example, CBD can help lower the psychoactive effect of THC. Marinol only contains dronabinol. So it doesn’t have the same effects as the full cannabis plant.

Why do people use medical cannabis?

Medical cannabis is used for a wide variety of medical conditions. But keep in mind that most of these aren’t well-studied. Most medical cannabis uses are based on people’s experiences, not clinical research. Many people turn to cannabis when traditional medications aren’t working for their symptoms.

The best scientific evidence exists for medical cannabis to treat:

• Certain types of seizures

• Chemotherapy-induced nausea and vomiting

• Chronic pain

• Symptoms of multiple sclerosis

Additional areas of interest for medical cannabis include:

• Opioid use disorder

• Anxiety

• Inflammatory bowel disease

• Post-traumatic stress disorder

• Sleep problems

• Alzheimer’s disease

• Huntington’s disease

• Parkinson’s disease

• Traumatic brain or spine injury

Good to know: There isn’t really a difference between “medical cannabis” and “cannabis.” Medical cannabis usually refers to cannabis purchased through a state-regulated medical cannabis program. But the cannabis plants used to make medical cannabis products are the same as those grown for adult-use or illicit purposes. It’s best to obtain medical cannabis through a regulated program to make sure it’s been tested and is free of contaminants like pesticides or heavy metals.

Do Marinol and cannabis work for pain?

Probably, but we don’t know for sure.

Marinol (dronabinol) has been studied for the following conditions:

• Post-surgical pain

• Nerve-related pain

• Chronic non-cancer pain

Marinol was not found effective for post-surgical pain in women after a hysterectomy procedure. However, it did show some benefit for people with nerve pain from multiple sclerosis. It also improved pain and muscle spasms due to spinal cord injury. Marinol seems to be effective for chronic pain symptoms, but more research is needed.

Cannabis may also be an effective treatment for chronic pain, including nerve pain, arthritis, and headaches. It may also help reduce opioid use and help people stop taking opioids.

At this time, neither Marinol or cannabis is FDA approved for pain. But clinical studies are underway to gain more information.  

Do they work for appetite and nausea?

Both cannabis and Marinol help reduce nausea and increase appetite. In fact, THC is one of the only anti-nausea treatments that also increases appetite. This can have meaningful benefits for people who are struggling to maintain a healthy weight due to nausea or appetite changes.

Some people find that Marinol takes too long to work and find it hard to balance side effects since there are limited dosing options available. Marinol’s side effects are also often intense, since it only contains THC. Inhaled cannabis works much faster, and people have more control over its effects since they can choose how much they consume. Cannabis also contains other cannabinoids that can help reduce THC’s intensity. But inhaled cannabis also has risks, including possible lung damage.

Regardless, most healthcare providers prefer to try traditional nausea medications, like ondansetron (Zofran), first. But if these options don’t work for you, a cannabis-based medication could be an option.

What other medications contain cannabinoids?

There are currently two other FDA-approved cannabinoid-based medications available in the U.S.:

• Cesamet (nabilone). A synthetic form of THC for chemotherapy-induced nausea and vomiting that hasn’t responded to other treatments.

• Epidiolex (cannabidiol). A prescription form of high-dose CBD oil made from cannabis plants. Epidiolex treats two forms of severe childhood epilepsy: Dravet syndrome and Lennox-Gastaut syndrome. It doesn’t contain any THC.

The maker of Epidiolex is currently seeking FDA approval for another cannabis medication — Sativex (nabiximols). Sativex is an oral spray that contains both THC and CBD. A review found moderate evidence that it may help with symptoms of spasticity, muscle cramps, and pain in people with multiple sclerosis.

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Written by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

Reviewed by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

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