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Marinol
Marinol, the brand name for dronabinol, is a synthetic form of delta-9-tetrahydrocannabinol (THC), the active ingredient in cannabis. It is used to treat nausea and vomiting associated with chemotherapy, as well as loss of appetite and weight loss in patients with AIDS or those undergoing cancer treatment. Marinol works by stimulating the brain's appetite and nausea control centers, helping to manage symptoms that cannot be controlled by other treatments.
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Frequently Asked Questions
How long does it take for Marinol to start working?
Marinol typically starts working within 30 minutes to 1 hour after taking it, and the effects can last for 4 to 6 hours.
Can Marinol make you feel "high"?
Yes, because Marinol is a synthetic form of THC, it can cause feelings of euphoria or being "high," especially at higher doses. This is why it is important to take the medication as prescribed.
Can Marinol be used long-term?
Marinol can be used long-term for appetite stimulation in patients with AIDS-related weight loss, but it should be closely monitored by a healthcare provider to prevent potential side effects or dependency.
What should I do if I experience hallucinations or severe anxiety after taking Marinol?
If you experience severe psychiatric symptoms such as hallucinations, paranoia, or severe anxiety, stop taking Marinol and contact your healthcare provider immediately.
Is Marinol addictive?
Marinol has the potential for abuse and dependence, although the risk is lower than with marijuana. It is classified as a Schedule III controlled substance, meaning it has moderate potential for addiction or abuse.
Comprehensive Drug Guide
How Does Marinol Work?
Marinol works by mimicking the effects of endogenous cannabinoids in the brain, specifically acting on cannabinoid receptors (CB1) found in areas responsible for nausea, vomiting, and appetite regulation. By stimulating these receptors, dronabinol helps reduce nausea, stimulate appetite, and increase caloric intake in patients who have difficulty maintaining body weight due to illness.
Common Dosages
- 2.5 mg, 5 mg, and 10 mg oral capsules.
The dosing depends on the condition being treated:
- For chemotherapy-induced nausea and vomiting (CINV): The initial dose is 5 mg/m², given 1 to 3 hours before chemotherapy, then every 2 to 4 hours after chemotherapy, for a total of 4 to 6 doses per day.
- For AIDS-related anorexia: The typical starting dose is 2.5 mg twice daily, before lunch and dinner. The dose may be increased depending on the patient's response.
Typical Dosing
- For chemotherapy-induced nausea and vomiting (CINV): The recommended dose is 5 mg/m² orally 1 to 3 hours before chemotherapy, followed by additional doses every 2 to 4 hours after chemotherapy, up to a total of 4 to 6 doses per day. The dose may be adjusted based on the patient's tolerance.
- For AIDS-related anorexia: Start with 2.5 mg twice daily before meals. If tolerated, the dose may be increased to 5 mg twice daily.
Typical Dosing
FDA Approved Indications
- Nausea and vomiting associated with chemotherapy in cancer patients who do not respond to conventional antiemetics.
- Appetite stimulation in patients with AIDS-related anorexia and weight loss.
Who Shouldn't Take Marinol?
- Hypersensitivity to dronabinol, sesame oil, or any of the ingredients in the capsule.
- Allergy to cannabinoids.
- History of severe psychiatric disorders, such as schizophrenia, as Marinol can exacerbate psychiatric symptoms.
Advice From The Pharmacist
- Take Marinol exactly as prescribed, following your doctor’s instructions regarding dosage and timing, especially if using it for chemotherapy-related nausea.
- Do not drive or operate heavy machinery after taking Marinol, as it can cause dizziness or impair your ability to think clearly.
- Avoid alcohol while taking Marinol, as it can increase the risk of side effects like dizziness, confusion, or drowsiness.
- If you miss a dose, take it as soon as you remember, unless it is almost time for the next dose. Do not double up on doses.
Side Effects of Marinol
Common Side Effects
- Drowsiness or dizziness
- Euphoria or feeling "high"
- Nausea
- Abdominal pain
- Confusion
- Mood changes
Uncommon/Severe Side Effects
- Paranoia or hallucinations
- Tachycardia (rapid heartbeat)
- Severe anxiety
- Hypotension (low blood pressure)
- Severe allergic reactions (e.g., rash, difficulty breathing, swelling)
Risks and Warnings of Marinol
- Psychiatric Effects: Marinol can cause changes in mood, including euphoria, paranoia, and hallucinations. Patients with a history of psychiatric disorders should use caution, and healthcare providers should closely monitor for any worsening of symptoms.
- Addiction Potential: While Marinol is considered to have a lower abuse potential than marijuana, it is still a Schedule III controlled substance and may lead to dependency or abuse in some individuals.
- Cardiovascular Effects: Marinol may cause an increase in heart rate (tachycardia) or a decrease in blood pressure (hypotension). Patients with heart conditions should be monitored closely.
Interactions with Marinol
Common Drug Interactions
- CNS depressants: Combining Marinol with central nervous system depressants such as benzodiazepines, alcohol, or opioids can increase the risk of drowsiness, dizziness, or confusion.
- Antidepressants and antipsychotics: Marinol can interact with medications used to treat psychiatric conditions, potentially worsening psychiatric symptoms or increasing the risk of side effects.
- Antihypertensives: Marinol may lower blood pressure, so combining it with medications used to treat high blood pressure may lead to excessive hypotension.
Alternatives to Marinol
- Ondansetron (Zofran): A commonly prescribed antiemetic used to prevent nausea and vomiting caused by chemotherapy or surgery.
- Megestrol acetate (Megace): A medication used to stimulate appetite in patients with cancer or AIDS-related cachexia (wasting).
- Nabilone (Cesamet): A synthetic cannabinoid similar to Marinol, used to treat nausea and vomiting in patients undergoing chemotherapy.
