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dronabinol (Marinol)
Tradename: Marinol. DEA-controlled substance: class 3. (delta-9-tetrahydrocannabinol)
Indications:
1) control of nausea/vomiting associated with cancer chemotherapy
2) treatment of anorexia in patients with AIDS
3) treatment of Alzheimer's disease ? [5]
Dosage:
1) chemotherapy-induced nausea:
a) 5 mg/m1 1-3 hours prior to chemotherapy, the
b) 5 mg/m2 every 2-4 hours after chemotherapy up to 6 doses/day
c) maximum dose: 15 mg/m2: increase in 2.5 mg/m2 increments
2) AIDS anorexia: 2.5 mg PO BID
3) elderly: start 2.5 mg QHS
Tabs: 2.5, 5, 10 mg.
Pharmacokinetics:
1) metabolized in liver
2) primary psychoactive metabolite is 11-OH-THC
3) primary urinary metabolite is 11-nor-delta-9-tetrahydro- cannabinol-9-carxoxylic acid
Adverse effects:
1) common (> 10%)
- drowsiness, dizziness, detachment, anxiety, difficulty concentrating, mood disorder
2) less common (1-10%)
- orthostatic hypotension, tachycardia, ataxia, depression, headache, vertigo, hallucinations, memory lapse, xerostomia, paresthesia, weakness
3) uncommon (< 1%)
- syncope, nightmares, speech disorder, diarrhea, diarrhea, myalgia, tinnitus, diaphoresis
4) some question about lowering of seizure threshold [4]
Drug interactions:
- weak inhibitor of cyt P450s CYP3A4, CYP1A2, CYP2C9, & CYP2C19
Laboratory:
1) specimen: plasma (heparin, EDTA)
2) methods: GLC, GC-MS, HPLC-MS, RIA, EIA, TLC, FIA
Mechanism of action:
- central sympathomimetic activity [6]
- putative cannabinoid receptor agonist
Interactions
drug adverse effects of psychotropic agents
General
anti-emetic
tetrahydrocannabinol; delta-9-tetrahydrocannabinol; THC
Properties
MISC-INFO: elimination route LIVER
1/2life 25-36 HOURS
protein-binding 94-99%
pregnancy-category C
safety in lactation -
Database Correlations
PUBCHEM correlations
References
- The Pharmacological Basis of Therapeutics, 9th ed.
Gilman et al, eds. Permagon Press/McGraw Hill, 1996
- Kaiser Permanente Northern California Regional Drug
Formulary, 1998
- Clinical Guide to Laboratory Tests, 3rd ed. Teitz ed.,
W.B. Saunders, 1995
- Prescriber's Letter 12(6):32 2005
New Drug: Sativex (Delta-9-tetrahydrocannabinol and Cannabidiol)
Detail-Document#: 210605
(subscription needed) http://www.prescribersletter.com
- Associated Press Oct 6, 2006
- HIGHLIGHTS OF PRESCRIBING INFORMATION
MARINOL (dronabinol) capsules, for oral use, CIII
https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/018651s029lbl.pdf