dronabinol
Dronabinol (also known by its brand name, Marinol) is a medication used to treat nausea and vomiting from anticancer medications. It's also approved as an appetite stimulant for people with acquired immunodeficiency syndrome (AIDS). Dronabinol (Marinol) is available as a lower-cost, generic capsule. It's a controlled substance because it carries a warning for the risk of abuse and misuse. Some side effects of dronabinol (Marinol) include dizziness, sleepiness, and stomach pain.
What is Dronabinol (Marinol)?
What is Dronabinol (Marinol) used for?
Anorexia and weight loss in adults with acquired immunodeficiency syndrome (AIDS)
Nausea and vomiting from anticancer medications in adults
How Dronabinol (Marinol) works
Dronabinol (Marinol) is a cannabinoid. It's a synthetic (man-made) form of tetrahydrocannabinol (THC), which is an ingredient found in marijuana. Dronabinol (Marinol) works by attaching to cannabinoid receptors in nerve cells to help with nausea and vomiting and improve appetite.
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What are the risks and warnings for Dronabinol (Marinol)?
Dronabinol (Marinol) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Mental health side effects
Risk factors: Older adults | History of mental health conditions | Taking other medications that cause sleepiness, dizziness, or confusion | Drinking alcohol
People with certain mental health conditions, like mania, depression, or schizophrenia, might have worsening symptoms while taking dronabinol (Marinol). Make sure your provider knows about all of your medical conditions before starting dronabinol (Marinol). Additionally, the medication can also make you dizzy, sleepy, and affect your ability to concentrate. Don't drive, operate heavy machinery, or do any activity where you have to focus until you know how dronabinol (Marinol) affects you.
Seizures
Risk factors: History of seizures
Dronabinol (Marinol) might raise your risk of seizures. If you've had a seizure before, discuss with your provider to see whether dronabinol (Marinol) is right for you. If you experience a seizure, stop taking this medication and contact your provider right away.
Heart and blood pressure changes
Risk factors: History of heart problems | Taking other medications that have similar effects on the heart and blood pressure
Dronabinol (Marinol) can raise or lower your blood pressure, raise your heart rate, and cause you to feel faint. Your risk is higher if you have a history of heart problems or if you're also taking other medications that affect your heart rate or blood pressure (e.g., stimulants, tricyclic antidepressants like amitriptyline, etc.).
Always make sure to move slowly from a lying down position to a sitting position, and then stand up slowly to allow your body to adjust to possible changes in blood pressure. If you fall and hit your head, get medical help right away. Contact your provider if you get lightheaded, dizzy, tired, weak, headache, changes in vision, chest pain, or short of breath.
Risk of misuse
Risk factors: History of substance misuse or alcohol dependence
Dronabinol (Marinol) is a controlled (schedule III) medication because it has a risk of misuse and dependence. Misuse is when a medication is used for non-medical reasons to bring out desirable physical or emotional effects, such as euphoria (extreme happiness). Dependence can occur when you take a medication for a certain period of time and you start to rely on it to function normally. With dependence, if you stop taking the medication suddenly, you can experience bothersome withdrawal symptoms (e.g., diarrhea, hiccups, cough, low appetite, sweating, runny nose). Your provider will monitor your dose and slowly lower it before completely stopping the medication, if needed.
Worsening nausea, vomiting, or stomach pain
Although rare, dronabinol (Marinol) can have the opposite effect and lead to more nausea, vomiting, and stomach pain. Let your provider know if it seems like dronabinol (Marinol) is making your symptoms worse. They might need to lower your dose or stop the medication.
What are the side effects of Dronabinol (Marinol)?
Common Side Effects
- Dizziness (3-10%)
- Euphoria (3-10%)
- Paranoia (intense anxiety or fearful thoughts; 3-10%)
- Sleepiness (3-10%)
- Abnormal thinking (3-10%)
- Stomach pain (3-10%)
- Nausea and vomiting (3-10%)
Other Side Effects
- Confusion
- Coordination problems
- Slurred speech
- Anxiety or nervousness
- Fast heartbeat
- Flushing
- Hallucination (seeing or hearing things that aren't there)
- Memory loss
- Lack of energy
Serious Side Effects
- Seizures
- Worsening mental symptoms (e.g., depression, mania, schizophrenia)
- Changes in blood pressure
Source: DailyMed
The following side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Less common
Changes in mood
confusion
delusions
fast or pounding heartbeat
feelings of unreality
loss of memory
mental depression
nervousness or anxiety
problems with memory
seeing, hearing, or feeling things that are not there
Rare
Blurred vision
chills
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
sweating
unusual tiredness or weakness
Incidence not known
Fainting
feeling of warmth
hives or rash
redness of the face, neck, arms, and occasionally, upper chest
seizures
sores in the mouth
swelling of the lips
tightness in the throat
trouble sleeping
Get emergency help immediately if any of the following symptoms of overdose occur:
Symptoms of overdose
Being forgetful
change in how fast you think time is passing
change in your sense of smell, taste, sight, sound, or touch
decrease in motor coordination
drowsiness (severe)
dryness of the mouth (severe)
false sense of well-being
feeling sluggish
panic reaction
problems in urinating
redness of the eyes
seizures
slurred speech
unusual drowsiness or dullness
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Clumsiness or unsteadiness
dizziness
drowsiness
false sense of well-being
trouble with thinking
vomiting
Less common or rare
Abdominal or stomach pain
flushing of the face
lack or loss of strength
restlessness
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Dronabinol (Marinol)
Pros
Works well to improve appetite and help with nausea and vomiting caused by chemotherapy
Available as a lower-cost, generic
Dosage can be adjusted by your provider, if needed
Cons
Has a risk for addiction, misuse, and dependence
Needs to be stored in the refrigerator
Can affect your ability to think clearly
Pharmacist tips for Dronabinol (Marinol)
You might feel dizzy, sleepy, or confused when you start taking dronabinol (Marinol), and when the dose is raised. This should get better over time as you continue taking the medication.
Dronabinol (Marinol) can cause dizziness and low blood pressure, especially when you get up too quickly. Slowly move from a lying down position to a sitting position, and then stand up slowly to allow your body to adjust to possible changes in blood pressure.
Dronabinol (Marinol) interacts with a lot of commonly used medications. Make sure to tell your provider about all the medications you're taking before starting dronabinol (Marinol) to make sure it's safe.
Avoid alcohol while taking dronabinol (Marinol) because this can worsen side effects (e.g., sleepiness, dizziness) as well lower your appetite or worsen your nausea and vomiting.
Take dronabinol (Marinol) exactly as prescribed. Don't change your dose or suddenly stop taking the medication without talking to your provider first. Doing so can cause withdrawal symptoms (e.g., irritability, trouble sleeping, restlessness, diarrhea, sweating). If you want to stop dronabinol (Marinol), ask your provider if it's safe to do so.
Store dronabinol (Marinol) capsules in the refrigerator in the container they come in from the pharmacy. Don't store at room temperature or in the freezer.
Dronabinol (Marinol) shouldn't be taken by pregnant females because of the risk of harm to unborn babies. If you're pregnant or thinking of becoming pregnant, let your provider.
Frequently asked questions about Dronabinol (Marinol)
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Dronabinol (Marinol) dosage forms
Typical dosing for Dronabinol (Marinol)
Anorexia and weight loss from AIDS: The typical starting dose is 2.5 mg by mouth twice daily, taken 1 hour before lunch and dinner.
Nausea and vomiting from cancer medications: Your provider will calculate your dose based on your height and weight. Typically, you'll take the first dose by mouth on an empty stomach, 1 to 3 hours before chemotherapy. After chemotherapy, you'll continue to take a dose by mouth every 2 to 4 hours for up to 4 to 6 doses, with or without food.
Your dose might differ if you're an older adult.
Interactions between Dronabinol (Marinol) and other drugs
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
How much does Dronabinol (Marinol) cost?
Dronabinol (Marinol) contraindications
Allergy to sesame oil
What are alternatives to Dronabinol (Marinol)?
Anorexia and weight loss in adults with acquired immunodeficiency syndrome (AIDS)
Nausea and vomiting from anticancer medications in adults
Low appetite, cachexia (wasting), or unexplained significant weight loss in adults with acquired immunodeficiency syndrome (AIDS)
Add-on treatment due to protein loss from long-term corticosteroid use
Bone pain from osteoporosis
What is the latest news about Dronabinol (Marinol)?
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References
Best studies we foundHIV.gov. (2023). What are HIV and AIDS?
Kulig, K. (2017). Interpretation of workplace tests for cannabinoids. Journal of Medical Toxicology.
May, M.B., et al. (2016). Dronabinol for chemotherapy-induced nausea and vomiting unresponsive to antiemetics. Cancer Management and Research.
Narang, S., et al. (2008). Efficacy of dronabinol as an adjuvant treatment for chronic pain patients on opioid therapy. The Journal of Pain.
Ng, T., et al. (2023). Tetrahydrocannabinol (THC). StatPearls.
O’Donnell, B., et al. (2023). Dronabinol. StatPearls.
Rhodes Pharmaceuticals L.P. (2023). Dronabinol capsule [package insert]. DailyMed.
Schimrigk, S., et al. (2017). Dronabinol is a safe long-term treatment option for neuropathic pain patients. European Neurology.
Schneider-Smith, E., et al. (2020). Matched pilot study examining cannabis-based dronabinol for acute pain following traumatic injury. Trauma Surgery & Acute Care Open.
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