Marinol is used for appettite support. MARINOL (dronabinol) Capsules is indicated for the treatment of: 1.anorexia associated with weight loss in patients with AIDS; and
2.nausea and vomiting associated with cancer chemotherapy in patients who have failed to respond adequately to conventional antiemetic treatments.
Dronabinol (Marinol) has been studied in both HIV and oncology patients, and is particularly useful for patients with both anorexia and nausea. Some patients respond best to round-the-clock (2.5-10 mg 3 times per day) dosing. Other patients do best with bedtime dosing, as some patients become “stoned”/sedated on daytime dronabinol. It is not a drug that substitutes for conventional anti-emetics given for chemotherapy and is, therefore, not a Part D Medicare drug.
There are phase III and phase II studies of this agent, although it is FDA approved only for nausea/vomiting. One recent clinical trial conducted by the North Central Cancer Treatment Group (NCCTG) evaluated both Marinol® and megestrol acetate oral suspension (which is FDA approved) for improving appetite and weight gain in late-stage cancer patients with anorexia. The study involved 469 late-stage cancer patients with an ongoing problem of anorexia and/or weight loss. Patients were divided into three groups: one group received Marinol®, another group received megestrol acetate, and a final group received both agents. Patients received a fixed dose of Marinol® in this trial of only 5 milligrams per day. The results indicated that improved appetite and weight gain were reported in 73% of patients taking megestrol acetate, 47% of patients taking Marinol® and 70% in the combination group. Side effects were comparable between the groups; however, 18% of men receiving megestrol acetate experienced impotence, compared with 14% in the combination group and only 4% in the Marinol® group.
Jatoi Am Windschitl H, Loprinzi C, et al. Dronabinol versus megestrol acetate versus combination therapy for cancer-associated anorexia: a North Central Cancer Treatment Group Study. Journal of Clinical Oncology. 2002;20:567-573.
Walsh D, Nelson KA, Mahmoud FA. Established and potential therapeutic applications of cannabinoids in oncology. Support Care Cancer. 2003;11(3):137-43.
Mantovani, G., Maccio, A., Madeddu, C., Serpe, R. and others. (2010). Randomized phase III clinical trial of five different arms of treatment in 332 patients with cancer cachexia. Oncologist. 15: 200-211.
Mechoulam R. Non-psychotropic plant cannabinoids: new therapeutic opportunities from an ancient herb. Trends Pharmacol Sci. 2009 Dec;30(12):609.
Prescribng Information, 2014
Wolters Kluwer Health, Inc. Dronabinol, Facts and Comparisons 4.0 [online]. Available at: www.factsandcomparisons.com.