Side effects of marinol

Contents

Marinol

WARNINGS

Included as part of the “PRECAUTIONS” Section

PRECAUTIONS

Neuropsychiatric Adverse Reactions

Psychiatric Adverse Reactions

Dronabinol has been reported to exacerbate mania, depression, or schizophrenia. Significant CNS symptoms followed oral doses of 0.4 mg/kg (28 mg per 70 kg patient) of MARINOL in antiemetic studies.

Prior to initiating treatment with MARINOL, screen patients for a history of these illnesses. Avoid use in patients with a psychiatric history or, if the drug cannot be avoided, monitor patients for new or worsening psychiatric symptoms during treatment. Also, avoid concomitant use with other drugs that are associated with similar psychiatric effects.

Cognitive Adverse Reactions

Use of MARINOL has been associated with cognitive impairment and altered mental state. Reduce the dose of MARINOL or discontinue use of MARINOL if signs or symptoms of cognitive impairment develop. Elderly patients may be more sensitive to the neurological and psychoactive effects of MARINOL .

Hazardous Activities

MARINOL can cause and may impair the mental and/or physical abilities required for the performance of hazardous tasks such as driving a motor vehicle or operating machinery. Concomitant use of other drugs that cause dizziness, confusion, sedation, or somnolence such as CNS depressants may increase this effect (e.g., barbiturates, benzodiazepines, ethanol, lithium, opioids, buspirone, scopolamine, antihistamines, tricyclic antidepressants, other anticholinergic agents, muscle relaxants). Inform patients not to operate motor vehicles or other dangerous machinery until they are reasonably certain that MARINOL does not affect them adversely.

Hemodynamic Instability

Patients may experience occasional hypotension, possible hypertension, syncope, or tachycardia while taking MARINOL . Patients with cardiac disorders may be at higher risk. Avoid concomitant use of other drugs that are also associated with similar cardiac effects (e.g., amphetamines, other sympathomimetic agents, atropine, amoxapine, scopolamine, antihistamines, other anticholinergic agents, amitriptyline, desipramine, other tricyclic antidepressants). Monitor patients for changes in blood pressure, heart rate, and syncope after initiating or increasing the dosage of MARINOL.

Seizures

Seizure and seizure-like activity have been reported in patients receiving dronabinol.

Weigh this potential risk against the benefits before prescribing MARINOL to patients with a history of seizures, including those receiving anti-epileptic medication or with other factors that can lower the seizure threshold. Monitor patients with a history of seizure disorders for worsened seizure control during MARINOL therapy.

If a seizure occurs, advise patients to discontinue MARINOL and contact a healthcare provider immediately.

Multiple Substance Abuse

Patients with a history of substance abuse or dependence, including marijuana or alcohol, may be more likely to abuse MARINOL as well.

Assess each patient’s risk for abuse or misuse prior to prescribing MARINOL and monitor patients with a history of substance abuse during treatment with MARINOL for the development of these behaviors or conditions.

Paradoxical Nausea, Vomiting, Or Abdominal Pain

Nausea, vomiting, or abdominal pain can occur during treatment with synthetic delta-9tetrahydrocannabinol (delta-9-THC), the active ingredient in MARINOL. In some cases, these adverse reactions were severe (e.g., dehydration, electrolyte abnormalities) and required dose reduction or drug discontinuation. Symptoms are similar to cannabinoid hyperemesis syndrome (CHS), which is described as cyclical events of abdominal pain, nausea, and vomiting in chronic, long-term users of delta-9-THC products.

Because patients may not recognize these symptoms as abnormal, it is important to specifically ask patients or their caregivers about the development of worsening of nausea, vomiting, or abdominal pain while being treated with MARINOL. Consider dose reduction or discontinuing MARINOL if a patient develops worsening nausea, vomiting, or abdominal pain while on treatment.

Patient Counseling Information

Advise the patient to read the FDA-approved patient labeling (PATIENT INFORMATION).

Neuropsychiatric Adverse Reactions
  • Advise patients that psychiatric adverse reactions may occur, especially in patients with a past psychiatric history or in those receiving other drugs also associated with psychiatric effects, and to report to their healthcare provider any new or worsening psychiatric symptoms.
  • Advise patients, especially elderly patients, that cognitive impairment or an altered mental state may also occur during treatment with MARINOL and to report to their healthcare provider if they develop signs or symptoms of cognitive impairment.
  • Advise patients not to operate motor vehicles or other dangerous machinery until they are reasonably certain that MARINOL does not affect them adversely. Alert patients to the potential for additive central nervous system depression if MARINOL is used concomitantly with alcohol or other CNS depressants such as benzodiazepines and barbiturates.

Advise patients, especially those with cardiac disorders, to report to their healthcare provider if they experience any signs or symptoms of hemodynamic instability, including hypotension, hypertension, syncope or tachycardia, especially after initiating or increasing the dosage of MARINOL .

Advise patients to discontinue MARINOL and contact a healthcare provider immediately if they experience a seizure .

Inform patients with a history of substance abuse or dependence, including marijuana or alcohol, that they may be more likely to abuse MARINOL. Advise patients to report to their healthcare provider if they develop abuse behaviors or conditions .

Advise patients to report worsening nausea, vomiting or abdominal pain to their healthcare provider .

Advise pregnant women of the potential risk to a fetus and to avoid use of MARINOL during pregnancy .

  • Advise HIV infected women with anorexia associated with weight loss, not to breastfeed.
  • Advise women with nausea and vomiting associated with cancer chemotherapy not to breastfeed during treatment with MARINOL and for 9 days after the last dose .

Nonclinical Toxicology

Carcinogenesis, Mutagenesis, Impairment Of Fertility

In 2-year carcinogenicity studies, there was no evidence of carcinogenicity in rats at doses up to 50 mg/kg/day dronabinol (approximately 20 times the MRHD in AIDS patients on a body surface area basis) or in mice at doses up to 500 mg/kg/day (approximately 100 times the MRHD in AIDS patients on a body surface area basis).

Dronabinol was not genotoxic in the Ames tests, the in vitro chromosomal aberration test in Chinese hamster ovary cells, and the in vivo mouse micronucleus test. However, dronabinol produced a weak positive response in a sister chromatid exchange test in Chinese hamster ovary cells.

In a long-term study (77 days) in rats, oral administration of dronabinol at doses of 30 to 150 mg/m2, equivalent to 2 to 10 times the MRHD of 15 mg/m2/day in AIDS patients or 0.3 to 1.5 times the MRHD of 90 mg/m2/day in cancer patients, reduced ventral prostate, seminal vesicle and epididymal weights and caused a decrease in seminal fluid volume. Decreases in spermatogenesis, number of developing germ cells, and number of Leydig cells in the testis were also observed. However, sperm count, mating success, and testosterone levels were not affected. The significance of these animal findings in humans is not known.

Use In Specific Populations

Pregnancy

Risk Summary

MARINOL, a synthetic cannabinoid, may cause fetal harm. Avoid use of MARINOL in pregnant women. Although there is little published data on the use of synthetic cannabinoids during pregnancy, use of cannabis (e.g., marijuana) during pregnancy has been associated with adverse fetal/neonatal outcomes . Cannabinoids have been found in the umbilical cord blood from pregnant women who smoke cannabis. In animal reproduction studies, no teratogenicity was reported in mice administered dronabinol at up to 30 times the MRHD (maximum recommended human dose) and up to 5 times the MRHD for patients with AIDS and cancer, respectively. Similar findings were reported in pregnant rats administered dronabinol at up to 5 to 20 times the MRHD and 3 times the MRHD for patients with AIDS and cancer, respectively. Decreased maternal weight gain and number of viable pups and increased fetal mortality and early resorptions were observed in both species at doses which induced maternal toxicity. In published studies, offspring of pregnant rats administered delta-9-THC during and after organogenesis have been reported to exhibit neurotoxicity with adverse effects on brain development, including abnormal neuronal connectivity and impairments in cognitive and motor function .

The estimated background risk of major birth defects and miscarriage for the indicated populations are unknown. All pregnancies have a background risk of birth defect, loss, or other adverse outcomes. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2 to 4% and 15 to 20%, respectively.

Clinical Considerations

Fetal/Neonatal Adverse Reactions

Published studies suggest that during pregnancy, the use of cannabis, which includes THC, whether for recreational or medicinal purposes, may increase the risk of adverse fetal/neonatal outcomes including fetal growth restriction, low birth weight, preterm birth, small-for-gestational age, admission to the NICU, and stillbirth. Therefore, use of cannabis during pregnancy should be avoided.

Data

Human Data

Delta-9-THC has been measured in the cord blood of some infants whose mothers reported prenatal use of cannabis, suggesting that dronabinol may cross the placenta to the fetus during pregnancy. The effects of delta-9-THC on the fetus are not known.

Animal Data

Reproduction studies with dronabinol have been performed in mice at 15 to 450 mg/m2, equivalent to 1 to 30 times the MRHD of 15 mg/m2/day in AIDS patients or 0.2 to 5 times the MRHD of 90 mg/m2/day in cancer patients, and in rats at 74 to 295 mg/m2 (equivalent to 5 to 20 times the MRHD of 15 mg/m2/day in AIDS patients or 0.8 to 3 times the MRHD of 90 mg/m2/day in cancer patients). These studies have revealed no evidence of teratogenicity due to dronabinol. At these dosages in mice and rats, dronabinol decreased maternal weight gain and number of viable pups and increased fetal mortality and early resorptions. Such effects were dose dependent and less apparent at lower doses that produced less maternal toxicity.

Review of published literature indicates that the endocannabinoid system plays a role in neurodevelopmental processes such as neurogenesis, migration, and synaptogenesis. Exposure of pregnant rats to delta-9-THC (during and after organogenesis) may modulate these processes to result in abnormal patterns of neuronal connectivity and subsequent cognitive impairments in the offspring. Nonclinical toxicity studies in pregnant rats and newborn pups have shown prenatal exposure to THC that resulted in impairment of motor function, alteration in synaptic activity, and interference in cortical projection of neuron development in the offspring. Prenatal exposure has shown effects on cognitive function such as learning, short-and long-term memory, attention, decreased ability to remember task, and ability to discriminate between novel and same objects. Overall, prenatal exposure to THC has resulted in significant and long-term changes in brain development, cognition, and behavior in rat offspring.

Lactation

For mothers infected with the Human Immunodeficiency Virus (HIV), the Centers for Disease Control and Prevention recommends that HIV-infected mothers not breastfeed their infants to avoid risking postnatal transmission of HIV. Because of the potential for HIV transmission (in HIV-negative infants) and serious adverse reactions in a breastfed infant, instruct mothers not to breastfeed if they are receiving MARINOL.

For mothers with nausea and vomiting associated with cancer chemotherapy, there are limited data on the presence of dronabinol in human milk, the effects on the breastfed infant, or the effects on milk production. The reported effects of inhaled cannabis transferred to the breastfeeding infant have been inconsistent and insufficient to establish causality. Because of the possible adverse effects from MARINOL on the breastfeeding infant, advise women with nausea and vomiting associated with cancer chemotherapy not to breastfeed during treatment with MARINOL and for 9 days after the last dose.

Pediatric Use

The safety and effectiveness of MARINOL have not been established in pediatric patients.

Pediatric patients may be more sensitive to neurological and psychoactive effects of MARINOL .

Geriatric Use

Clinical studies of MARINOL in AIDS and cancer patients did not include the sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects.

Elderly patients may be more sensitive to the neuropsychiatric and postural hypotensive effects of MARINOL .

Elderly patients with dementia are at increased risk for falls as a result of their underlying disease state, which may be exacerbated by the CNS effects of somnolence and dizziness associated with MARINOL . These patients should be monitored closely and placed on fall precautions prior to initiating MARINOL therapy. In antiemetic studies, no difference in efficacy was apparent in patients greater than 55 years of age compared to younger patients.

In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of falls, decreased hepatic, renal, or cardiac function, increased sensitivity to psychoactive effects, and of concomitant disease or other drug therapy .

Effect Of CYP2C9 Polymorphism

Published data suggest that systemic clearance of dronabinol may be reduced and concentrations may be increased in the presence of CYP2C9 genetic polymorphism. Monitoring for potentially increased adverse reactions is recommended in patients known to carry genetic variants associated with diminished CYP2C9 function .

The Dangers of Synthetic Marijuana Drugs Like Marinol (Dronabinol) Are Pretty Scary

Many people choose marijuana because it is seen as one of the most natural drugs available. Whether you are looking to smoke marijuana for recreational purposes or simply seeking an all-natural alternative to traditional pharmaceuticals, it offers one of the most natural treatment experiences achievable in the 21st century.

Considering that marijuana is loved by so many for its natural qualities, you might be surprised to learn that there is such a thing as synthetic marijuana. That’s right; it is possible to buy 100% synthetic marijuana, completely removing one of the drug’s major selling points.

Synthetic marijuana first entered the market back in the early 2000s and was originally created to provide a safer alternative to the real deal.

Synthetic marijuana has come a long way since then, and there are now thought to be over 150 different types of artificial marijuana available across the world.

Synthetic marijuana sounds great, and its ever-growing popularity would lead you to believe that it might just be the answer to your marijuana problems. However, the sad truth is that synthetic marijuana is now considered to be more dangerous than a lot of popular recreational drugs; and definitely more so than real marijuana.

So, what exactly is synthetic marijuana, and why should you be looking to avoid it? Let’s find out.

What Is Synthetic Marijuana?

Synthetic marijuana was not an entirely new concept. When it first flooded the market back in 2000, it had, in fact, been used for a few decades by this point within the medical profession. Forms of synthetic marijuana include Marinol, Epidiolex, and Sativex; the three most commonly used types of synthetic marijuana.

It was often given to patients as part of a blend of medications to treat a whole host of conditions, similar to the reasons that medical marijuana is used today. What changed in 2000 was that synthetic marijuana was suddenly being sold for recreational purposes.

At its core, synthetic marijuana is an artificial chemical which binds to the body’s cannabinoid receptors in the same way that THC found in cannabis plants does.

These chemicals are then sprayed onto herbs and other plant matter, giving the final product a similar appearance to real marijuana. Just like with regular, natural marijuana, this plant matter can be smoked and enjoyed in much the same way as the real deal.

Synthetic marijuana is often sold under a variety of different names in an attempt to make it sound more appealing; the most commonly used names include Bombay Blue, Chaos, and Green Giant. Since 2016, it has become possible to purchase synthetic marijuana in a concentrated liquid form, making it as accessible as CBD oils and vape liquids for those who prefer to avoid smoking.

One of the reasons that synthetic marijuana is so widely used is due to the fact that it does not fall within the same legal limits as marijuana. Synthetic marijuana as a substance is not actually illegal in the USA, meaning even in states where the use of recreational marijuana is still illegal, it is possible to achieve a similar high with the synthetic stuff.

However, the law is not quite so clear cut and, in many cases, synthetic marijuana is not legal to sell. What often makes it illegal are the chemicals used to produce it. The majority of synthetic marijuana manufacturers are based in Asia, where regulations are not quite as strict as Europe and the U.S. This often results in chemicals being used that are illegal in western countries, and which are thought to course a whole host of worrying health complications.

While the consumer will not find themselves facing a five-year prison sentence simply for smoking synthetic marijuana, those selling it can be prosecuted in much the same way they would be for selling other banned foods.

Just like real marijuana, synthetic marijuana works by activating your body’s CB1 and CB2 receptors, resulting in very similar, yet still different effects. Let’s take a closer look at the science behind synthetic marijuana and why its effects can be so dangerous.

The Science Behind Synthetic Marijuana

Synthetic marijuana is designed to replicate the effects of real marijuana; this is done by using artificial THC. One of the main differences between real and synthetic marijuana is that natural marijuana not only contains THC but also all of the other naturally occurring cannabinoids, including CBD.

You might be thinking this is not a problem. After all, you only want the psychoactive effects of marijuana and, since they come primarily from THC, all of the other cannabinoids simply get in the way.

This is, however, not the case, as CBD works to balance out the effects of THC and ensures that your body is able to process the THC in a manageable way. Without all of the other cannabinoids that are found in marijuana, the effects of THC can quickly become overwhelming.

The THC found in synthetic marijuana binds to the CB1 and CB2 receptors in much the same way as regular, natural marijuana. This stimulates the release of dopamine and is the cause of many of the effects associated with the feeling of being high. CB1 and CB2 receptors are also responsible for the way that our bodies manage pain and are why CBD is often recommended as a natural form of pain relief.

THC can have negative side effects, especially when taken in larger quantities, causing anxiety and paranoia. It can also alter your coordination and slightly reduce your fine motor skills, as well as causing you to feel dizzy. Everyone has a slightly different tolerance to THC, and for some people, all it takes is a small dose for the negative effects of taking hold.

While you might have plenty of experience with marijuana and believe your body to have a high THC tolerance, the lack of CBD and unpredictable amount of THC can take even the most experienced users by surprise.

The lack of regulations surrounding the manufacturing of synthetic marijuana often results in inconsistencies and varying quantities of artificial THC being sprayed onto each herb. This only adds to the unpredictable nature of synthetic marijuana as each dose can be drastically different.

As these different compounds break down, they can also activate CB1 receptors, which adds to the effects of the THC and results in dangerous side effects. In the most serious of cases, compounds found in synthetic marijuana can activate receptors that are not normally affected by THC or any of the compounds found in cannabis. When this happens, it can be extremely difficult to predict the effects that are felt.

The National Institute of Drug and Abuse have reported that synthetic marijuana can be up to 200 times stronger than natural marijuana – levels that the human body simply cannot cope with.

Why Is Using Synthetic Marijuana Dangerous?

While synthetic marijuana has been a concern among health care professionals since its rise in popularity back in the early 2000s, it only really came to the media’s attention in 2015. It hit the news after a group of men was taken to Montefiore Hospital for what was at first thought to be a drug-fueled party gone wrong.

While all of those admitted tested positive to having drugs in their system, their symptoms and their uncharacteristic psychosis did not quite match up. Further investigation discovered that the group had actually taken synthetic marijuana and that this had caused their severe reaction, resulting in multiple days spent in hospital and sedation being required.

As a result of unclear regulations, and in some cases a complete lack of regulations altogether, the effects of synthetic marijuana can be extremely unpredictable. The 2015 case is just one example among a long list of incidents that have resulted in hospitalization and even death.

Since 2015, there have been at least 20 deaths linked to the use of synthetic marijuana. Some of the most common side effects include severe anxiety, kidney damage, and, in the most serious of cases, life-altering strokes.

Many countries across the world are responding to the rise in synthetic marijuana, with moves towards making it completely illegal. In Finland, for example, synthetic marijuana is classified as a medical drug and therefore cannot be purchased.

New Zealand has gone one step further, with synthetic marijuana now being categorized as a Class C drug. It could result in either a 3-month prison sentence or a $500 fine.

The Main Problems with Synthetic Marijuana

Unpredictable Levels of THC

The lack of consistency when it comes to synthetic marijuana means that it can be extremely difficult to predict the effects that you will experience when taking synthetic marijuana. Even if you stick to one brand, there is no guarantee that you will experience the same effects every time.

This is, in part, the result of varying regulations governing what can be used during the manufacturing process of synthetic marijuana.

With natural marijuana, most long term users find a few strains that work best with their body and THC tolerance level and tend to stick to them when they need predictable effects. The lack of predictability with synthetic marijuana can be dangerous, with many people accidentally taking a much stronger dosage than they intend to.

Synthetic Marijuana Can Be Extremely Addictive

One of the main things that sets natural marijuana apart from most other recreational drugs is its lack of addictive properties. Studies have shown that synthetic marijuana does not share this trait with its natural counterpart and can actually be highly addictive. This fact is often hidden from the consumer, with many people only becoming aware of its addictive priorities once it is too late.

While those who use natural marijuana can easily stop without having to worry about horrible withdrawal effects, this is not the case for synthetic marijuana users.

The withdrawal effects experienced with synthetic marijuana are known not just to be unpleasant, but also potentially dangerous.

The most commonly experienced effects are an overwhelming sense of depression and, in the most severe of cases, even suicidal thoughts. People have also reported severe muscle pain, insomnia, and general flu-like symptoms that can last for weeks at a time. Going completely cold turkey can result in a loss of cognitive function, the effect of which can have a permanent effect on your health.

Synthetic marijuana is not a drug that you can simply stop taking, in order to allow your body to adjust you need to lower your dosage slowly. This can be extremely difficult given the unpredictability when it comes to the THC content of synthetic marijuana.

Lack of Other Cannabinoids

Synthetic marijuana only contains THC, and even this is synthetically made rather than extracted from cannabis plants. The lack of other naturally occurring cannabinoids means that the majority of the health benefits associated with cannabis is completely lost.

Another huge problem is that CBD, even in low levels, helps to balance out the effects of THC. This helps your body to process the THC and reduces the risk of negative effects being experienced.

While your body might be able to handle a strain with a 20% THC content, it is unlikely to be able to handle synthetic marijuana with a similar THC content due to the lack of other cannabinoids to offset the effects.

For those who are unaware of how cannabinoids work within the body and the exact contents of synthetic marijuana, this can be dangerous and often results in THC induced anxiety attacks.

Extreme Psychoactive Effects

Natural marijuana temporarily alters your mental state and can cause a wide range of psychoactive effects, including a change in the way you perceive your surroundings and your mood. Due to the intensity of synthetic marijuana and the lack of other cannabinoids, these effects are felt much more intensely.

This is thought to be what happened in the 2015 case involving the group of men at Montefiore Hospital. The high levels of synthetic THC are thought to have caused a severe reaction that changed their perception of the world around them and resulted in the violent behavior which led to a number of them having to be sedated for their own safety.

A lot of the positive psychoactive effects of marijuana appear to be lost when it comes to synthetic marijuana, which is possibly due to the lack of balance between the compounds entering your body. The human body’s inability to cope with synthetic marijuana commonly results in the less desirable effects of THC being much more noticeable. This can include sudden changes in mood, trouble sleeping, and a sense of disorientation.

Final Verdict About Synthetic Marijuana

While synthetic marijuana might sound like the perfect alternative to natural marijuana at first, the reality is that, due to its unpredictability, it can all too often result in a very different and potentially dangerous experience than what you would expect. The few benefits, issues of legality, and failing drug tests make it difficult to accept synthetic marijuana as being worth the risks.

While natural marijuana is thought to have an overall positive impact on your health, synthetic marijuana does the exact opposite and can actually have a long term effect on your mental and physical wellbeing. While the initial effects of marijuana and synthetic marijuana can appear the same, the way in which the body processes the two are very different.

With natural marijuana, the body turns it into non-psychoactive substances allowing it to be processed in much the same way other compounds within the body are. With synthetic marijuana, however, the body produces extra psychoactive metabolites which trigger cannabinoid receptors, causing a whole host of unwelcome effects.

With many countries looking to change the law surrounding synthetic marijuana or having already done so, combined with shifting recreational marijuana laws, it looks as though the popularity of synthetic marijuana could start to fall off. For many people, the risks are just too high for the limited rewards that it offers.

Marinol is the brand name for the prescription drug dronabinol. Doctors prescribe the drug to treat nausea and vomiting caused by chemotherapy when other treatments aren’t effective. Doctors also prescribe Marinol to treat appetite and weight loss in people with AIDS.

Marinol is in a class of medications called cannabinoids, which impact the central nervous system. Dronabinol, the active ingredient in Marinol, is synthetic delta-9-tetrahydrocannabinol (THC), the psychoactive component of marijuana. Dronabinol affects the area of the brain responsible for appetite, nausea, and vomiting.

Banner Pharmacaps for AbbVie (formerly Unimed) developed the drug, and the Food and Drug Administration (FDA) first approved Marinol in 1985 to treat nausea and vomiting associated with cancer chemotherapy. In 1992, the FDA extended the approved uses of Marinol to include the treatment of weight loss in people with AIDS.

What Are the Key Things I Need to Know About Marinol?

Dronabinol may be habit-forming. It’s important to take this medication exactly as your doctor prescribes it. Don’t take more than you should at one time or take it more often than prescribed. Take Marinol with caution if you have a history of substance abuse.

Marinol can worsen certain mental illnesses, such as mania, depression, bipolar disorder or schizophrenia.

If you have a heart problem, taking Marinol could cause increased heart rate, decreased blood pressure, and fainting.

It’s also important to understand that Marinol could alter your mood or cause feelings of being “high.” For some people, these side effects can be troubling.

Read the complete FDA warning on Marinol.

Is There Anything Special I Should Discuss With My Doctor Before Taking Marinol?

Marinol may cause side effects and can interfere with many medications. If you have certain medical conditions, use Marinol (dronabinol) with caution. Always tell your doctor if you have allergies to any medication and discuss all the risks and benefits of the drug.

Before taking Marinol, let your doctor know if you have ever used marijuana or other illegal drugs. Also tell your doctor if you are or have ever been a heavy drinker.

Your doctor also needs to know if you’ve ever had any of the following:

  • Heart disease
  • High blood pressure
  • Seizures
  • Dementia
  • A mental illness, such as mania (abnormally excited mood), depression, or schizophrenia (a mental disorder that causes disturbed or strange thinking as well as strong or inappropriate feelings)

Tell your doctor if you have any type of surgery planned, including dental surgery.

Your doctor should also know if you are pregnant, may become pregnant, or are breastfeeding. It’s unknown whether Marinol is safe to take during pregnancy. Nursing women shouldn’t use the drug because it may pass into breast milk.

Although doctors don’t prescribe Marinol for AIDS-related weight loss among children, young people may take it for nausea related to chemotherapy. Because of the effects of the drug on the brain, however, prescribing the drug for children requires extra caution.

Older people may also be more sensitive to the effects of Marinol. Experts recommend that doctors prescribe the drug for older people conservatively, at the lowest effective dose.

Generic Name: dronabinol (droe NAH bih nol)
Brand Names: Marinol, Syndros

Medically reviewed by Sanjai Sinha, MD Last updated on Mar 19, 2019.

  • Overview
  • Side Effects
  • Dosage
  • Professional
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What is Marinol?

Marinol (dronabinol) is a man-made form of cannabis (also known as marijuana).

Marinol is used to treat loss of appetite that causes weight loss in people with AIDS.

Marinol is also used to treat severe nausea and vomiting caused by cancer chemotherapy. It is usually given after medicines to control nausea and vomiting have been tried without success.

Important information

Marinol may cause new or worsening psychosis (unusual thoughts or behavior), especially if you have ever had depression or mental illness.

Marinol can raise or lower blood pressure, especially in older adults or in people with heart problems.

Call your doctor at once if you have new or worsening mood symptoms, changes in behavior, headaches, vision problems, rapid heartbeats, or severe dizziness.

Marinol may be habit-forming and should be used only by the person it was prescribed for. It should never be given to another person, especially someone who has a history of drug addiction or habitual marijuana use. Keep the medication in a secure place where others cannot get to it.

Avoid using other medicines that affect the central nervous system (such as stimulants, diet pills, cold medicine, pain medication, muscle relaxers, and medicine for seizures, depression, anxiety, mental illness, or Parkinson’s disease). These other drugs can add to the effects of Marinol.

Marinol causes effects that will impair your thinking or reactions. Do not drive or do anything that requires you to be awake and alert until the effects wear off.

Before taking this medicine

You should not use Marinol if you are allergic to dronabinol.

You should not take Marinol capsules if you are allergic to sesame oil.

To make sure this medicine is safe for you, tell your doctor if you have ever had:

  • an allergy to any medication;

  • epilepsy or other seizure disorder;

  • heart problems, high or low blood pressure, fainting spells, fast heartbeats;

  • alcoholism or drug addiction; or

  • depression, mental illness, or psychosis.

Older adults may be more sensitive to the effects of this medicine.

It is not known whether dronabinol will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

HIV can be passed to your baby if you are not properly treated during pregnancy. If you have HIV or AIDS, take all of your medicines as directed to control your infection.

Dronabinol can pass into breast milk and may harm a nursing baby. You should not breast-feed while using this medicine, and for at least 9 days after your last dose.

Women with HIV or AIDS should not breast feed a baby. Even if your baby is born without HIV, the virus may be passed to the baby in your breast milk.

Marinol is not approved for use by anyone younger than 18 years old.

How should I take Marinol?

Take Marinol exactly as it was prescribed for you. Follow all directions on your prescription label. Your doctor may occasionally change your dose. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Dronabinol may be habit-forming. Never share Marinol with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it. Tell your doctor if you feel an increased urge to take more or higher doses than prescribed.

Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions.

To stimulate appetite in people with AIDS, Marinol is usually taken 1 hour before lunch and 1 hour before dinner.

To prevent nausea and vomiting caused by chemotherapy:

  • Take your first dose on an empty stomach, at least 30 minutes before eating.

  • After your first dose, you may take Marinol with or without food but take it the same way each time.

  • Marinol is usually given 1 to 3 hours before your chemotherapy treatment, and then every 2 to 4 hours (up to 6 doses per day).

To prevent nausea and vomiting, Marinol is usually given 1 to 3 hours before your chemotherapy treatment, and then every 2 to 4 hours (up to 6 doses per day). Follow your doctor’s instructions.

Marinol may be only part of a complete program of treatment that also includes a special diet. Follow the diet plan created for you by your doctor or nutrition counselor. Get familiar with the list of foods you should eat to help boost your food intake.

Do not crush, chew, break, or open a capsule. Swallow the capsule whole.

Call your doctor if your symptoms do not improve, or if they get worse while using Marinol.

Do not stop using this medicine suddenly after long-term use, or you could have unpleasant withdrawal symptoms. Ask your doctor how to avoid withdrawal symptoms when you stop using this medicine.

Store the capsules in a tightly-closed container in the refrigerator. Do not freeze.

You may also store the capsules at cool room temperature, away from moisture and heat.

Marinol dosing information

Usual Adult Dose for Nausea/Vomiting — Chemotherapy Induced:

Initial: 5 mg/m2, 1 to 3 hours prior to chemotherapy treatment, then every 2 to 4 hours after chemotherapy for a total of 4 to 6 doses per day.

Usual Adult Dose for Anorexia:

Initial: 2.5 mg orally twice daily, before lunch and supper.
Maximum: 20 mg daily, given in 4 divided doses.

Usual Pediatric Dose for Nausea/Vomiting — Chemotherapy Induced:

Initial: 5 mg/m2, 1 to 3 hours prior to chemotherapy treatment, then every 2 to 4 hours after chemotherapy for a total of 4 to 6 doses per day.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include changes in mood, memory problems, little or no urinating, constipation, loss of energy, problems with speech or coordination, or feeling light-headed.

What should I avoid while taking Marinol?

Avoid driving or operating machinery until you know how this medicine will affect you. Dizziness or severe drowsiness can cause falls or other accidents.

Do not use marijuana while taking Marinol.

Do not drink alcohol while taking this medicine.

Marinol side effects

Get emergency medical help if you have signs of an allergic reaction to Marinol: hives, skin rash or burning; mouth sores; warmth, redness, or tingly feeling; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • a seizure;

  • fast or pounding heartbeats;

  • a light-headed feeling, like you might pass out;

  • confusion, trouble sleeping, problems with memory or concentration;

  • unusual changes in mood or behavior;

  • restlessness, feeling nervous or irritable;

  • slurred speech, drowsiness;

  • severe or ongoing nausea, vomiting, or stomach pain; or

  • increased blood pressure – severe headache, blurred vision, pounding in your neck or ears, anxiety, nosebleed.

Common Marinol side effects may include:

  • feeling “high”;

  • dizziness, drowsiness, thinking problems;

  • unusual thoughts or fears;

  • feelings of extreme happiness; or

  • nausea, vomiting, stomach pain.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Marinol?

Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.

Taking Marinol with other drugs that make you sleepy can worsen this effect. Ask your doctor before taking a sleeping pill, narcotic medication, muscle relaxer, or medicine for anxiety, depression, or seizures.

Other drugs may interact with dronabinol, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Marinol only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Copyright 1996-2020 Cerner Multum, Inc. Version: 8.01.

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What Is Marinol And How Does It Differ From Cannabis?

Originally introduced as a Schedule II substance, Marinol has been rescheduled to Schedule III. It is unclear whether, like Sativex, it will be further downgraded. Meanwhile, the plant itself remains a Schedule I drug in the U.S. and throughout most of the world.

Research on THC and cannabinoids in general tends to bear out the above claims and more. Marinol does not contain CBD, which is a much relied upon cannabinoid in the medical community. It also does not contain flavonoids or terpenes. Furthermore, microdosing cannabis is gathering steam as a viable medical practice.

The rise of “whole plant” medication may finally put the use of Marinol to bed. In the meantime, many patients are forced to rely on this drug instead of the real thing. Why? It is covered by insurance where cannabis “bud” is not.

WHAT IS MARINOL?

THC is a chemical molecule like any other. It can be reproduced in a lab. That is what Marinol is – a medicine based on cannabinoid chemistry.

This results in the synthetic cannabinoid dronabinol, which is then dissolved in sesame oil and put into tablets.

WHAT IS IT USED FOR?

Marinol is commonly prescribed for wasting syndrome, nausea and increasingly, chronic pain caused by movement disorders including MS and Dystonia. It is also a Schedule III drug. As such, it is often covered under most western health insurance plans.

In most places, the fight right now is to bring greater awareness to whole plant medication as a more effective and natural alternative to synthetic formulations.

WHY IS THE NATURAL CANNABIS PLANT BETTER?

There are many, many reasons why the whole cannabis plant and its chemical constituents are superior to Marinol.

  1. Patients can control their dosing better. Even the smallest dosage of Marinol – 5mg – is too much for many patients to handle all at once. Taking cannabinoids in others ways is easier and makes for more adjustable dosing. Marinol can send you to the stratosphere. For patients looking to stay fully functional, this is obviously an uncomfortable place to be.
  2. It can upset the stomach. Marinol can actually cause nauseous patients to feel sicker, not better.
  3. It does not contain other cannabinoids. Marinol only contains synthetic THC. CBD, in particular, is known to interact with THC in many beneficial ways. Stripping medicine of this cannabinoid and others completely defeats the purpose.
  4. Medical marijuana contains more efficient medicine. It includes all of the plant’s cannabinoids, plus much more. Aromatic compounds known as terpenes have made a huge splash recently for contributing to the overall medical efficacy of cannabis. Marinol has none of these. It is also missing the flavonoids, which are believed to help the drug work better too.
  5. It has other side effects. Many patients simply cannot tolerate the drug. While marijuana also has side effects, many of these can be ameliorated depending on strain. There is only one strain of Marinol.

One thing is very clear. Given the choice, patients overwhelmingly choose natural forms of cannabis, or failing that, substances made directly from the plant.

SO WHY IS MARINOL STILL BEING USED?

This is a very good question. The answers are mostly political. Marinol has always been used to slow down full plant reform. This is because of the stigma still surrounding cannabis culture. It is also due to the lobbying power of entrenched pharmaceutical companies. In general, the drug industry does not like medical marijuana. It sees weed as a threat.

However, this might be changing. Medical trials, for cancer in particular, are finding something interesting now. Adding marijuana to conventional drugs appears to make both medications work better.

In this kind of environment, drug companies are likely to change their views about cannabis. That is, if they have not already begun patenting a cannabinoid concoction they can then sell to a hungry market.

In the interim, Marinol is one of the few cannabinoid-based medications that is widely available globally.

Even when used medicinally, the plant continues to be prohibited in many parts of the world. That too may be changing, but it is the next big fight ahead. In both Canada and Germany right now, patients are suing insurance companies who refuse to cover the cost of their medication.

HOW DO I GET MY DOCTOR TO SWITCH ME?

If you are one of the lucky patients who has a helpful doctor on this front, the first step is to initiate the conversation.

The first issue is cost.

If that is not an issue depending on where you live, you are in luck.

In the United States, Canada, Israel, Australia and Germany, this is a conversation that is going on daily. The advances made by the movement to reform and legalise cannabis have created this opportunity.

However, there is still a long way to go. In Germany, patients currently face the unappetising “choice” of paying 10 euros for a monthly supply of dronabinol or much more for the real plant.

Most people do not really have a choice to make.

That is why this issue has become so contentious.

CAN DRUG TESTS DETERMINE THE DIFFERENCE?

There is a great deal of debate on this issue. Some people take Marinol to try to cheat drug tests. Sadly, this is not an effective solution. Marijuana has more chemicals in it than Marinol. Drug tests look for the difference. In a pinch, you can always ask to be retested and rely on Marinol for a month. These are the uncomfortable situations patients often find themselves in. However, be aware – this is a tactic of the last resort.

You can, in fact, tell the difference between the two substances in all body fluid tests.

External Resources:

  1. Medical marijuana: Medical necessity versus political agenda https://www.ncbi.nlm.nih.gov

Disclaimer: This content is for educational purposes only. The information provided is derived from research gathered from external sources.

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