Syndros
Syndros (dronabinol) oral solution is a cannabinoid that contains a lab-made form of delta-9-tetrahydrocannabinol (THC). It's FDA-approved to help improve appetite in adults with acquired immunodeficiency syndrome (AIDS) who have severe weight loss. It's also used to prevent nausea and vomiting from chemotherapy in adults. This medication is taken by mouth, typically multiple times a day. Syndros (dronabinol) is a Schedule II controlled substance because it carries a warning for the risk of misuse and dependence. Side effects of this medication include stomach pain, confusion, and sleepiness.
What is Syndros (dronabinol)?
What is Syndros (dronabinol) used for?
Improve appetite in adults who have severe weight loss from acquired immunodeficiency syndrome (AIDS)
Nausea and vomiting from chemotherapy in adults
How Syndros (dronabinol) works
Syndros (dronabinol) is a cannabinoid. It's a synthetic (man-made) form of tetrahydrocannabinol (THC), which is an ingredient found in marijuana. Syndros (dronabinol) 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 Syndros (dronabinol)?
Syndros (dronabinol) 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 Syndros (dronabinol). Tell your healthcare team if you have any mental health conditions. They might consider a different medication for you. Or, they might lower your dose of Syndros (dronabinol) and monitor you more closely for worsening symptoms during treatment.
Additionally, Syndros (dronabinol) can 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 Syndros (dronabinol) affects you.
Seizures
Risk factors: History of seizures
Syndros (dronabinol) might raise your risk of seizures. If you've had a seizure before, discuss with your prescriber to see whether Syndros (dronabinol) is right for you. If you experience a seizure, stop taking this medication and get medical attention 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
Syndros (dronabinol) 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 prescriber if you get lightheaded, dizzy, tired, weak, headache, changes in vision, chest pain, or short of breath.
Risk of misuse or dependence
Risk factors: History of substance misuse or alcohol dependence
Syndros (dronabinol) is a controlled (schedule II) medication because it has a risk of misuse and dependence. Let your healthcare team know if you've had any problems in the past with substance dependence, including with marijuana or alcohol. They talk with you about the risks and benefits of taking Syndros (dronabinol). If needed, they might recommend other options for your condition.
Worsening nausea, vomiting, or stomach pain
Although rare, Syndros (dronabinol) can have the opposite effect and lead to more nausea, vomiting, and stomach pain. Let your prescriber know if it seems like Syndros (dronabinol) is making your symptoms worse. They might need to lower your dose or stop the medication.
Risk of serious interactions
Don't take Syndros (dronabinol) with or within 2 weeks of disulfiram or metronidazole. Because Syndros (dronabinol) contains alcohol, taking it with these medications can trigger a disulfiram-like reaction and cause symptoms like stomach cramps, nausea, vomiting, and flushing. Before you start treatment, ask your healthcare team to help you check for interactions.
What are the side effects of Syndros (dronabinol)?
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
- Weakness
- Fast heartbeat
- Flushing
- Memory loss
- Anxiety or nervousness
- Poor coordination
- Confusion
- Depersonalization (feeling disconnected from your own body and mind)
- Hallucination (seeing or hearing things that aren't there)
Serious Side Effects
- Seizures
- Worsening mental symptoms (e.g., depression, mania, schizophrenia)
Source: DailyMed
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Heart palpitations—rapid, pounding, or irregular heartbeat
- Increase in blood pressure
- Low blood pressure—dizziness, feeling faint or lightheaded, blurry vision
- Mood and behavior changes—anxiety, nervousness, confusion, hallucinations, irritability, hostility, thoughts of suicide or self-harm, worsening mood, feelings of depression
- Seizures
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
Pros and cons of Syndros (dronabinol)
Pros
Works well to improve appetite and help with nausea and vomiting caused by chemotherapy
Oral solution; good option for people who can't swallow pills
Can be given through a feeding tube
Cons
Contains alcohol
Risk for dependence
Can cause confusion and dizziness
Pharmacist tips for Syndros (dronabinol)
If you're taking Syndros (dronabinol) for the treatment of anorexia and weight loss, take your dose at least an hour before lunch and dinner.
If you're taking Syndros (dronabinol) for nausea and vomiting from chemotherapy, take your dose on an empty stomach (at least 30 minutes before eating) before chemotherapy and then with or without food after chemotherapy.
Make sure to drink a full glass of water (6 to 8 ounces) right after taking your Syndros (dronabinol) dose.
Make sure you know how to prepare and administer a dose of Syndros (dronabinol) to avoid accidentally wasting the medication or take the wrong dose. Read the instructions for use and ask a member of your care team if you have any questions.
Always use the syringe that comes with the medication. It'll help with getting an accurate (correct) dose every time. Don't use household spoons to measure out your dose because they aren't accurate and can cause you to take the wrong dose.
Take Syndros (dronabinol) exactly as prescribed. Don't change your dose or suddenly stop taking the medication without talking to your prescriber first. Doing so can cause withdrawal symptoms, such as hot flashes, sweating, and diarrhea. If you want to stop Syndros (dronabinol), ask your prescriber if it's safe to do so.
Syndros (dronabinol) can cause sleepiness, dizziness, and confusion. Don't drive or do anything that requires concentration and focus until you know how this medication affects you. Also, let your care team know if you're taking other medications that cause sleepiness, such as antihistamines and muscle relaxers.
Syndros (dronabinol) can cause sudden low blood pressure when you get up too quickly. Make sure to 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. Try to hold onto something as you're getting up.
Syndros (dronabinol) contains alcohol, which can cause a bad reaction (e.g., stomach cramps, nausea, vomiting) with metronidazole (Flagyl) and disulfiram (Antabuse). Let your care team know if you've recently taken either of these medications, or if you're prescribed one in the future.
Store unopened bottles of Syndros (dronabinol) in the refrigerator. Store opened bottles at room temperature for up to 42 days (6 weeks).
Frequently asked questions about Syndros (dronabinol)
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Syndros (dronabinol) dosage forms
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 5mg/ml | 30 ml | $4796.21 | $159.87 |
Typical dosing for Syndros (dronabinol)
Each 1 mL of Syndros contains 5 mg of dronabinol.
Improve appetite in people with (AIDS): The typical starting dose is 2.1 mg by mouth twice a day, taken 1 hour before lunch and dinner. Your prescriber will adjust your dose as needed.
Nausea and vomiting from chemotherapy: Your oncologist will calculate the dose based on your body surface area (BSA), which is based on your height and weight. The typical starting dose is 4.2 mg/m2 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 daily, with or without food.
Your dose might differ if you're an older adult.
How much does Syndros (dronabinol) cost?
Syndros (dronabinol) contraindications
Allergy or sensitivity to alcohol
Currently take or have taken medications that interact with alcohol, such as metronidazole (Flagyl) or disulfiram (Antabuse), in the last 14 days
What are alternatives to Syndros (dronabinol)?
Improve appetite in adults who have severe weight loss from acquired immunodeficiency syndrome (AIDS)
Nausea and vomiting from chemotherapy in adults
Low appetite, cachexia (wasting), or unexplained significant weight loss in adults with acquired immunodeficiency syndrome (AIDS)
Anorexia and weight loss in adults with acquired immunodeficiency syndrome (AIDS)
Nausea and vomiting from anticancer medications in adults
What is the latest news about Syndros (dronabinol)?
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References
Best studies we foundBenuvia Operations, LLC. (2024). Syndros- dronabinol solution [package insert]. DailyMed.
Brafford May, M., et al. (2016). Dronabinol for chemotherapy-induced nausea and vomiting unresponsive to antiemetics. Cancer Management and Research.
HIV.gov. (2023). What are HIV and AIDS?
O’Donnell, B., et al. (2023). Dronabinol. StatPearls.
U.S. Drug Enforcement Administration and U.S. Department of Justice. (2017). Schedules of controlled substances: Placement of FDA-Approved products of oral solutions containing dronabinol [(-)-delta-9-trans-tetrahydrocannabinol (delta-9-THC)] in schedule II. Federal Register.
Vorvick, L, J. (2023). Pain medications - narcotics. Medline Plus.
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