From the FDA Drug Label
2.1 Anorexia Associated with Weight Loss in Adult Patients with AIDS Starting Dosage The recommended adult starting dosage of dronabinol capsules is 2.5 mg orally twice daily, one hour before lunch and dinner.
2.2 Nausea and Vomiting Associated with Cancer Chemotherapy in Adult Patients Who Failed Conventional Antiemetics Starting Dosage The recommended starting dosage of dronabinol capsules is 5 mg/m2, orally administered 1 to 3 hours prior to the administration of chemotherapy and then every 2 to 4 hours after chemotherapy, for a total of 4 to 6 doses per day.
The recommended dose and frequency of Marinol (dronabinol) varies depending on the indication:
- For anorexia associated with weight loss in adult patients with AIDS:
- Starting dose: 2.5 mg orally twice daily
- Maximum dose: 10 mg twice daily
- For nausea and vomiting associated with cancer chemotherapy in adult patients who failed conventional antiemetics:
- Starting dose: 5 mg/m2 orally 1 to 3 hours prior to chemotherapy
- Frequency: every 2 to 4 hours after chemotherapy, for a total of 4 to 6 doses per day
- Maximum dose: 15 mg/m2 per dose for 4 to 6 doses per day 1
From the Research
Marinol (dronabinol) should be started at a dose of 2.5 mg taken twice daily, once before lunch and once before dinner, as this initial dosing allows patients to adjust to the medication's effects while minimizing side effects like dizziness and confusion. For patients who tolerate this well but need better symptom control, the dose can be gradually increased to 5 mg twice daily, and in some cases up to 10 mg twice daily 2. The maximum recommended daily dose is generally 20 mg divided throughout the day. Marinol should be taken with food to reduce stomach upset and enhance absorption. Patients should avoid alcohol and other CNS depressants while using Marinol, as these can intensify its sedative effects. Elderly patients or those with liver disease typically require lower starting doses. Marinol works by activating cannabinoid receptors in the brain, which helps reduce nausea and vomiting in chemotherapy patients and stimulates appetite in patients with AIDS-related weight loss. Effects typically begin within 30-60 minutes and can last 4-6 hours, which is why twice-daily dosing is common.
Some key points to consider when prescribing Marinol include:
- Starting with a low dose and gradually increasing as needed to minimize side effects
- Taking the medication with food to reduce stomach upset
- Avoiding alcohol and other CNS depressants
- Monitoring for sedative effects, especially in elderly patients or those with liver disease
- Considering the patient's individual needs and adjusting the dose accordingly, as some patients may require higher or lower doses than others 3.
It's also important to note that while Marinol is effective in reducing nausea and vomiting, it may not be suitable for all patients, and alternative treatments may be necessary in some cases 4, 5, 6.