Dronabinol (Delta-9-Tetrahydrocannabinol, Delta-9-THC)(droe nab’ i nol)
Marinol
PREGNANCY CATEGORY C
CONTROLLED SUBSTANCE C-III
Drug Classes
Antiemetic
Appetite stimulant
Therapeutic Actions
Principal psychoactive substance in marijuana; has complex CNS effects; mechanism of action as antiemetic is not understood.
Indications
Treatment of nausea and vomiting associated with cancer chemotherapy in patients who have failed to respond adequately to conventional antiemetic treatment (should be used only under close supervision by a responsible individual because of potential to alter the mental state)
Treatment of anorexia associated with weight loss in patients with AIDS for appetite stimulation
Contraindications and Cautions
Contraindicated with allergy to dronabinol or sesame oil vehicle in capsules, nausea and vomiting arising from any cause other than cancer chemotherapy, lactation.
Use cautiously with hypertension; heart disease; manic, depressive, schizophrenic patients (dronabinol may unmask symptoms of these disease states); pregnancy; history of substance abuse; seizures.
Available Forms
Capsules—2.5, 5, 10 mg
Dosages
Adults and pediatric patients
Antiemetic: Initially, 5 mg/m2 PO 1–3 hr prior to the administration of chemotherapy. Repeat dose every 2–4 hr after chemotherapy is given, for a total of four to six doses per day. If the 5 mg/m2 dose is ineffective and there are no significant side effects, increase dose by 2.5 mg/m2 increments to a maximum of 15 mg/m2 per dose.
Appetite stimulation: Initially, give 2.5 mg PO bid before lunch and supper. May reduce dose to 2.5 mg/day as a single evening or bedtime dose; up to 10 mg PO bid (not recommended for pediatric use).
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