Marinol (dronabinol) - HIV/AIDS Drug Information

Marijuana Derivative Used to Stimulate Appetite in Later-Stage HIV Infection

Marinol (dronabinol) 10mg gel capsule. Courtesy Unimed Pharmaceuticals

Marinol (dronabinol) is a prescription drug derived from marijuana that was once commonly prescribed in people with HIV-associated wasting syndrome. While its uses are similar to those of medical marijuana, Marinol is legal in all 5U.S. states.

Marinol is most frequently prescribed to relieve the nausea and vomiting associated with chemotherapy. But it also approved for use as an appetite stimulant for HIV-positive people with severe weight loss.

Additionally, when used to relieve the symptoms of nausea or vomiting, Marinol can be prescribed when more standard anti-nauseal drugs such as Compazine, Zofran or Vistaril are ineffective.

The use of Marinol has gone down significant since the drug first used in HIV patients in the late 1980s. At that time, the likelihood of HIV-related death was still high, and Marinol was often seen the only means to address HIV-associated wasting.

Today, because of more effective antiretroviral therapies, even those with later-stage disease have the ability to restore their immune function. In doing so, issues related to appetite and weight loss often tend to improve with the use of stimulants.

How is Marinol Similar to Marijuana?

More and more states are voting to allow marijuana to treat the symptoms of glaucoma, nausea, vomiting, and poor appetite. Despite its greater social acceptance, medical marijuana is still considered illegal by the U.S. federal government.

In states where medical marijuana is illegal, Marinol can be use legal alternative, the drug of when contains a synthetic version of the active ingredient in marijuana called tetrahydrocannabinol (THC).

Some people report experiencing a high similar to that of marijuana; others don't. The effect appears largely dependent on such factors as dosage, frequency of use, and the overall length of time you have been using the drug.

How is Marinol Used in HIV-Positive Patients?

Marinol is typically prescribed when other medications have not been effective. Weight loss is a common problem, particularly in late-stage infection, which can caused by opportunistic infections, concurrent non-HIV-related infection, or, in the case of HIV wasting, the virus itself.

Marinol is manufactured in 2.5mg (white), 5mg (dark brown) and 10mg (orange) capsules. The capsules should be stored in the refrigerator to prevent them from becoming soft and gummy when warm. They should not, however, be allowed to freeze.

Marinol is typically prescribed in doses of 2.5mg twice daily to a maximum dose of 10mg twice daily; before lunch and dinner. In people who cannot tolerate the drug because of side effects, a dose of 2.5mg at bedtime may be used.

Capsules should be swallowed whole and never crushed, chewed or bitten.

Are There Side Effects from Marinol?

The most common side effects associated with Marinol use are:

  • Feeling "high"
  • Drowsiness
  • Confusion
  • An exaggerated sense of well-being
  • Headache
  • Dry mouth
  • Confusion
  • Mental status changes

Marinol Treatment Considerations

Marinol should be avoided if you have a known allergy to marijuana or sesame oil (another component contained in the drug capsule). Notify your provider if you have a history of alcohol or substance abuse. It is also advised that you avoid operating heavy machinery or power tools while taking Marinol.

Marinol should be used with caution in the following individuals:

  • Persons diagnosed with clinical depression, schizophrenia, bipolar disorder, or any other psychiatric condition.
  • Persons being treated with sedatives, hypnotics or other psychoactive drugs due to the additive effects of combined drug use.
  • Pregnant patients and nursing mothers due to unknown effects of the drug on the baby.

Marinol is typically avoided in children and adolescents.

Sources:

U.S. Food and Drug Administration (FDA). "Marinol (dronabinole) capsules." Rockville, Maryland; September 2004.

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