What Is Marinol and How It Relates to Medical Marijuana Use
While reaching for nationwide legitimate therapeutic approval, marijuana-products still carry the heavy burden of their many pros and cons. Over three decades, the authorities argued about the medical uses of cannabis while the pharmaceutical companies offered a solution — a synthetic cannabinoid.
Here, we will appraise that solution by answering the question: what is Marinol and how does it work?
We will dive deep into the drug’s composition, and restate the evidence for its therapeutic use. Furthermore, we will delineate the THC dilemma that synthetic cannabinoids carry and evaluate the drug’s long-term effectiveness.
What’s more, we will compare the effects of this drug with other marijuana-derived products, such as CBD oil, and emphasize the therapeutic differences.
Hopefully, by the end of this article, you will know whether it is applicable or harmful in your particular situation.
So, let’s dive right in!
What Is Marinol?
Marinol is a prescription-only drug, used for the treatment of digestive problems associated with immunodeficiencies and cancer therapy. It is an FDA-approved, Schedule III drug.
Its main active substance is dronabinol — a synthetic cannabinoid. What’s more, Marinol is sold in capsules.
In other words, Marinol is not a cannabis-derived drug, but it could be considered cannabis-like.
Dronabinol is a synthetic compound created to mimic the structure and clinical effectiveness of delta-9-tetrahydrocannabinol (THC) — a cannabinoid compound found in cannabis plants. It acts via the endocannabinoid system, and as such, it affects various parts of the immune and nervous systems.
Simply put, with Marinol, THC effects are pure and are more accurately delivered.
As previously mentioned, dronabinol expresses psychoactive THC effects. Therefore, its use was restricted, and its distribution heavily controlled. Since its introduction in 1985, dronabinol had been rescheduled two times within the official Drug Enforcement Schedule.
The first time, after the registration of the drug, officials marked dronabinol as a Schedule I substance, declaring it highly addictive, adverse reaction-imposing, and with low medical potential.
The following year, due to the recorded effectiveness, the DEA relocated Marinol to Schedule II, which provided a significant boost to prescription-rates during that period. After a while, the accumulated evidence regarding the drug’s effectiveness fueled the initiative for yet another rescheduling.
It’s worth pointing out that, officially, marijuana is still considered a Schedule I substance.
Dronabinol vs THC
Chemically, there is no difference between these two substances. THC is naturally found in cannabis plants, and dronabinol is artificially created based on its structure.
Given that it resembles its chemical constitution, dronabinol acts on both CB1 and CB2 receptors of the endocannabinoid system as well. Its physiological and psychotropic effects are fully engaged, without the natural support of other cannabis-based chemicals.
Inactive Marinol Ingredients
Besides the main acting dronabinol, each Marinol gelatine capsule contains additional substances that add to its pharmacological potency. These are glycerin, titanium dioxide, and iron compounds, all supporting its chemical stability. The main solvent used in this drug is sesame oil.
In other words, Marinol capsules are not just THC pills, they contain additional pharmacologically inactive ingredients to aid its physiological efficacy.
What Is Marinol Prescribed For?
The inspiration for dronabinol came from clinical experience, which repeatedly recorded the benefits of marijuana for nausea. Thus, Marinol was initially introduced and registered as anti-nausea medicine, or an antiemetic.
However, due to its psychoactive effects, this drug is treated somewhat differently than other prescription nausea medicine and is reserved for only the worst of cases.
Today, Marinol is clinically approved and officially prescribed for the treatment of:
- Loss of appetite (anorexia) in people with Acquired Immune Deficiency Syndrome (AIDS) who have lost weight. This appetite suppression is also called cachexia or Wasting Syndrome.
- Nausea and vomiting caused by anti-cancer medicine (chemotherapy) in people with a low response rate to conventional medication for nausea.
What Is Marinol Used For, Additionally?
Off-label uses of Marinol are not officially recognized but are clinically supported and show some therapeutic promise. Given its THC-mimicking effects, this drug has the potential to treat glaucoma and even obstructive sleep apnea.
The use of Marinol for pain proved to be mildly effective in managing chronic pain and muscle spasms associated with multiple sclerosis.
Some studies also confirm that Marinol could be used successfully for pain relief and as a behavioral aid in patients with Alzheimer’s disease.
Compared to Marinol, marijuana studies show greater potential in the treatment of pain-related conditions.
On the other hand, a limited pain study found the data on Marinol to be inconclusive when it comes to treating neuropathic pain following an injury.
How Are Marinol Pills Used?
There are three available doses of Marinol capsules: 2.5mg, 5mg, and 10mg. Each dosage is administered according to the severity of the symptoms and the overall physiological state of the patient.
It takes 30 minutes for the drug to express its effects, which can last up to 20 hours.
Treatment of AIDS-Related Anorexia
To avoid any unwanted side effects of Marinol on the elderly, the initial starting doses should be introduced only in the evening.
For adults, the initial starting dose is 2.5mg, taken twice a day. If it’s well-tolerated, the dose can be increased to two doses of 5mg. Still, the maximum dose of Marinol is 10mg, taken twice daily.
Treatment of Chemotherapy-Related Nausea
In cancer patients, Marinol is administered 1–3 hours before the treatment, and if necessary, once again every four hours after the procedure. The initial dose is 5mg, and it can be repeated up to 4–6 times per day if needed.
Also, the first dose is used at least 30 minutes before the first meal, whereas subsequent treatments do not depend on food intake.
Marinol vs Marijuana: The Therapeutic Outlook
Although inherently similar, medical marijuana and cannabis-based drugs tend to act differently.
Besides THC, cannabis contains a variety of other chemicals, such as cannabidiol (CBD), terpenes, flavonoids, and essential oils. When consumed and absorbed together, they synergize with one another, revealing their full therapeutic potential.
Given that it is still illegal in the US (on a federal level), there is no way of obtaining marijuana prescriptions. You can, however, get a cannabis recommendation from a licensed physician who works in a country/state that legalized cannabis. Medical cannabis is usually consumed by smoking or in the form of pills (supplements).
Unlike marijuana-based THC pills, Marinol is a registered drug, meaning, every licensed doctor can prescribe it.
Pros of Marijuana
No matter how controversial it might seem, medical marijuana can offer certain benefits compared to Marinol.
The advantages of medical marijuana include:
- Better dosing control. Initial doses of Marinol can be too potent for some people, and medical cannabis has more comfortable dose-adjusting properties.
- Broader spectrum of effects. Cannabis contains other beneficial chemicals, such as CBD, that contribute to its overall effects.
- Better tolerability. The side effects of marijuana can be diminished by choosing the right cannabis strain.
What is Marinol intended for, then? Well, it’s primarily used for the official medical indications and nothing more. On the other hand, marijuana can be helpful for treating:
- Alzheimer’s disease
- Chronic pain
- Appetite loss and nausea
- Crohn’s disease
- Multiple sclerosis
- Muscle spasms
The fact is, these cannabis-uses are predominantly empirical and are not supported by substantial quantified data, which is the case with Marinol.
In terms of effectiveness, marijuana pills have approximately the same onset time as Marinol capsules.
According to the official evidence, only 10–20% of dronabinol is systemically effective, due to the metabolic effects of the liver. When inhaled as weed, the effects of THC are expressed more quickly.
Marinol vs CBD
Both THC and CBD are the principal cannabinoids of the marijuana plant. In recent years, CBD has gained academic attention due to its newly found therapeutic potential.
CBD is proven to be useful for:
- Chronic pain
- Cancer problems
- Anxiety disorders
- Irritable bowel syndrome
- Heart problems
- Insulin resistance
There are numerous CBD-infused products on the market today, and they all vary in terms of the extraction method used, quality control, and the pharmacological type of the product in question.
The main advantage of CBD is that it doesn’t provide neurological side effects consistent with THC.
Marinol Side Effects
Given that it delivers an exact amount of dronabinol with every dose, side effects are more likely to appear in the long-term, as opposed to dose-adjustable medical marijuana products.
An interesting fact is that cannabis traits that describe the “marijuana high” are declared as side effects of dronabinol.
The most common side effects include:
- Out-of-body experience
- Cognitive decline
- Stomach pain (accompanied by nausea)
- Elevated heartbeat
- Irritability and restlessness
Compared to weed, Marinol is officially recognized as having a low dependency profile, and as such, is not regarded a heavily addictive substance.
Marinol Side Effects in the Elderly
The elderly usually have a number of conditions, such as cardiovascular and neurological diseases — hence why they tend to use more medications. As a result, they are more susceptible to adverse THC effects.
Most commonly they develop neurological symptoms, such as dizziness, confusion, and irritability. Additionally, Marinol can significantly lower blood pressure and interfere with blood pressure medication. This can cause loss of balance, falls, and fractures, as well as an occasional arrhythmia-episode.
These patients are to be monitored closely and, according to recommendations, the best way to treat them is to administer their doses in the evening, thus avoiding most of the unwanted side effects.
Will Marinol Test Positive for THC?
Seeing how the drug’s main active substance, both structurally and pharmacologically, resembles THC, the drug test will show a positive result.
How long does it take to pass a drug test? Well, it depends on the metabolic profile of the patient. Similarly to marijuana, dronabinol can stay in the bloodstream for up to two months, lying dormant in fat tissue, or even hair follicles.
The Bottom Line
The topic of Marinol is yet another “natural vs. man-made” medicine discussion, with appealing arguments on both sides.
Although Marinol sounds a lot like “marijuana,” it is not to be confused with the herb, neither chemically nor pharmacologically.
Also, despite its main component resembling THC, it has a state-of-the-art substance delivery mechanism that provides your body with calculated doses of cannabinoid stimulation. Officially it’s prescribed only for nausea and appetite suppression in patients with AIDS or cancer.
Recreationally, what is Marinol suitable for? Well, it’s nothing like weed. It’s extremely potent and could slam-dunk you with a single dose. It’s prescription-only and pricey, too. All things considered, Marinol is a drug, and like any other drug, it should be used with caution. All the patient-instruction rules apply.
Does Marinol have THC or CBD?
Marinol contains synthetic THC, called dronabinol. It is a complete structural twin of the THC molecule.
These two differ only in the optical properties of the compound, which doesn’t impact the pharmacological properties whatsoever. Drug tests will show positive for THC when Marinol is taken but show no signs of CBD, not even in trace amounts.
What is the active ingredient in Marinol?
The main active ingredient in Marinol is dronabinol, a synthetic version of THC.
It acts on the very same receptors as THC and expresses both physiological and psychoactive properties. Therefore, it is considered a controlled substance, and it can be obtained only through a prescription.
Does Marinol show up on a drug test?
The main active compound in Marinol has the same basic structure as THC, and as such, it shows up both on the laboratory tox screens and on routine drug tests. If you’re using Marinol, be sure to notify the person that’s doing your drug test.
What states is Marinol legal in?
Marinol is FDA-approved for the treatment of chemotherapy-induced nausea and AIDS-related wasting syndrome, and as such, is legal in all 50 states. Pharmacies stock up on Marinol regularly and dispense the drug to patients with prescriptions.
Does Marinol help with pain?
There are studies that confirm the benefits of Marinol for neuropathic pain, associated with multiple sclerosis and other degenerative diseases.
However, the data on its wider analgesic uses is still inconclusive. Off-label uses of Marinol include treating pain usually associated with fibromyalgia and diabetic polyneuropathy.
How much does Marinol cost?
The price of the drug depends on its potency.
A pack of 60 capsules with 2.5mg, 5mg, and 10mg doses costs approximately $693, $1,432, and $2,623, respectively. Compared to medical marijuana, Marinol is significantly more expensive.