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Syndros
Syndros (generic name: dronabinol) is an oral solution containing a synthetic form of delta-9-tetrahydrocannabinol (THC), the active component found in cannabis. It is used to treat nausea and vomiting caused by chemotherapy in patients who have not responded to other treatments, as well as appetite loss (anorexia) associated with weight loss in AIDS patients.
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Frequently Asked Questions
How long does it take for Syndros to work?
Syndros generally begins to work within 30 minutes to 1 hour after administration. The peak effects are usually felt within 2 to 4 hours.
Can I drive while taking Syndros?
No, it is not recommended to drive or operate heavy machinery while taking Syndros, as it can cause drowsiness, dizziness, and impair coordination.
Can Syndros be used long-term?
Syndros is typically used for the short-term management of nausea and vomiting or appetite stimulation. If long-term use is required, regular monitoring for side effects, including mental health effects and potential abuse, is necessary.
What should I do if I miss a dose?
If you miss a dose of Syndros, take it as soon as you remember, unless it is close to the time of your next dose. Do not double the dose to make up for the missed one.
Is Syndros addictive?
Syndros has the potential for abuse and dependence, particularly in patients with a history of substance use disorders. It should be used with caution and under close supervision.
Comprehensive Drug Guide
How Does Syndros Work?
Dronabinol works by mimicking the effects of natural cannabinoids found in the brain, specifically binding to cannabinoid receptors (CB1) in the central nervous system. By doing so, it helps to stimulate appetite and reduce nausea and vomiting, making it particularly effective for patients undergoing chemotherapy or those with AIDS-related anorexia.
Common Dosages
- 5 mg/mL dronabinol
Typical Dosing
- For chemotherapy-induced nausea and vomiting (CINV): The usual starting dose is 2.5 mg taken 1 to 3 hours before chemotherapy, followed by 2.5 mg every 2 to 4 hours after chemotherapy, for a maximum of 4 to 6 doses per day.
- For AIDS-related anorexia: The starting dose is 2.5 mg taken twice daily, before lunch and dinner. The dose may be increased to 2.5 mg to 20 mg daily depending on the patient’s response.
Typical Dosing
FDA Approved Indications
- Treatment of nausea and vomiting associated with chemotherapy in patients who have not responded adequately to conventional antiemetic treatments.
- Treatment of anorexia associated with weight loss in patients with AIDS.
Who Shouldn't Take Syndros?
- Known hypersensitivity to dronabinol or any component of the formulation.
- Patients with a history of substance abuse or psychiatric disorders, particularly schizophrenia, should use it with caution due to the risk of exacerbating symptoms.
Advice From The Pharmacist
- Take Syndros with food, as taking it on an empty stomach can cause increased side effects.
- Use the included calibrated syringe to measure the dose accurately, and mix it with a small amount of water if necessary.
- Store Syndros in the refrigerator to prevent degradation of the solution. Do not freeze.
- Avoid alcohol and other CNS depressants while taking Syndros, as the combination can increase sedation and dizziness.
- Monitor for changes in mood or behavior, as Syndros can cause mood alterations, hallucinations, or even worsening of psychiatric symptoms in vulnerable patients.
Side Effects of Syndros
Common Side Effects
- Drowsiness
- Dizziness
- Euphoria
- Nausea
- Vomiting
- Stomach pain
Uncommon/Severe Side Effects
- Mental/mood changes, such as paranoia, hallucinations, or confusion.
- Severe dizziness or fainting, especially when standing up too quickly (postural hypotension).
- Seizures: In rare cases, Syndros has been associated with seizure activity.
- Heart rate abnormalities: Syndros can cause tachycardia or palpitations, particularly in those with pre-existing heart conditions.
Risks and Warnings of Syndros
- Psychiatric Effects: Syndros can cause euphoria, confusion, or paranoia, especially in higher doses or in patients with a history of psychiatric disorders. It is important to monitor for changes in behavior or mental state, especially in patients with a history of schizophrenia or depression.
- CNS Depression: Dronabinol can cause central nervous system (CNS) depression, which can lead to sedation, drowsiness, and decreased motor skills. Patients should avoid operating heavy machinery or driving while on Syndros.
- Substance Abuse Potential: As a Schedule II controlled substance, Syndros has a potential for abuse, particularly in patients with a history of substance abuse. Prescribers should monitor patients closely for signs of misuse.
Interactions with Syndros
Common Drug Interactions
- CNS depressants: Syndros should be used cautiously with other CNS depressants (e.g., alcohol, benzodiazepines, opioids) as it may increase the risk of drowsiness, sedation, and respiratory depression.
- Anticholinergic drugs: Drugs with anticholinergic effects (e.g., antihistamines, tricyclic antidepressants) can increase the risk of tachycardia and confusion when used with Syndros.
- Warfarin: Dronabinol may increase the anticoagulant effects of warfarin, leading to a higher risk of bleeding.
Alternatives to Syndros
- Marinol (Dronabinol capsules): A capsule form of dronabinol, used for similar indications as Syndros.
- Cesamet (Nabilone): Another synthetic cannabinoid used for the treatment of chemotherapy-induced nausea and vomiting.
- Megace (Megestrol acetate): A medication used to stimulate appetite in patients with AIDS or cancer-related cachexia.
