What are the indications and dosages of Marinol (dronabinol)?

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From the Guidelines

Marinol (dronabinol) is indicated for chemotherapy-induced nausea and vomiting that hasn't responded to conventional antiemetic treatments, and the recommended starting dose is 2.5 mg three times a day, which can be up-titrated to 10 mg three to four times daily as needed 1. The use of Marinol in adults with cancer is supported by the ASCO guideline, which recommends augmenting the antiemetic regimen with dronabinol, nabilone, or a quality-controlled oral 1:1 THC:CBD extract for refractory nausea or vomiting despite optimal prophylaxis 1. Some key points to consider when prescribing Marinol include:

  • Starting dose: 2.5 mg three times a day
  • Dose titration: up to 10 mg three to four times daily as needed
  • Indications: chemotherapy-induced nausea and vomiting, AIDS-related anorexia
  • Mechanism of action: activation of cannabinoid receptors in the brain that regulate nausea and appetite
  • Common side effects: dizziness, drowsiness, confusion, and euphoria
  • Precautions: patients with psychiatric disorders, heart disease, or a history of substance abuse should be carefully monitored while taking this medication 1. It is essential to weigh the benefits and risks of Marinol in the context of individual patient needs and medical history, and to consider alternative treatment options when necessary.

From the FDA Drug Label

Dronabinol capsules are indicated in adults for the treatment of: • anorexia associated with weight loss in patients with Acquired Immune Deficiency Syndrome (AIDS). • nausea and vomiting associated with cancer chemotherapy in patients who have failed to respond adequately to conventional antiemetic treatments.

The recommended adult starting dosage of dronabinol capsules is 2.5 mg orally twice daily, one hour before lunch and dinner.

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 indication of Marinol (dronabinol) is for the treatment of:

  • Anorexia associated with weight loss in patients with AIDS
  • Nausea and vomiting associated with cancer chemotherapy in patients who have failed to respond adequately to conventional antiemetic treatments

The dose of Marinol (dronabinol) is:

  • For anorexia associated with weight loss in adult patients with AIDS:
    • Starting dose: 2.5 mg orally twice daily, one hour before lunch and dinner
    • 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 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
    • Maximum dose: 15 mg/m2 per dose for 4 to 6 doses per day 2 2

From the Research

Indication of Marinol

  • Marinol, also known as dronabinol, is indicated for the treatment of anorexia associated with weight loss in individuals with AIDS 3
  • It is also indicated for the treatment of nausea and vomiting associated with cancer chemotherapy 3, 4
  • Additionally, dronabinol has been used to treat refractory nausea and vomiting related to peritoneal carcinomatosis 5
  • It has also been used to treat failure to thrive secondary to intestinal dysmotility 6

Dose of Marinol

  • The studies provided do not specify a particular dose of Marinol for its indications
  • However, it is mentioned that available prescription tracking data indicates that use remains within the therapeutic dosage range over time 3
  • The therapeutic dosage range is not specified in the provided studies, but it can be inferred that the dose is tailored to the individual patient's needs and response to the medication

Off-Label Uses

  • Dronabinol has been used off-label for the treatment of nausea, vomiting, and anorexia in patients with other etiologies, such as intestinal dysmotility 6
  • Its use in these cases may be limited by lack of insurance coverage, as seen in the case report of a patient with intestinal dysmotility 6

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Abuse potential of dronabinol (Marinol).

Journal of psychoactive drugs, 1998

Research

Dronabinol treatment of refractory nausea and vomiting related to peritoneal carcinomatosis.

The American journal of hospice & palliative care, 2015

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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