What is the recommended dosage of Marinol (dronabinol) for adults?

Recommended Dosage of Marinol (Dronabinol) for Adults

The recommended adult starting dosage of Marinol (dronabinol) is 2.5 mg orally twice daily, taken one hour before lunch and dinner. 1

Dosage by Indication

For Anorexia Associated with Weight Loss in AIDS:

• Starting dose: 2.5 mg twice daily, one hour before lunch and dinner
• Titration: If tolerated and further therapeutic effect is desired, may gradually increase to 2.5 mg before lunch and 5 mg before dinner
• Maximum dose: 10 mg twice daily
• Elderly patients: Consider starting with 2.5 mg once daily (before dinner or at bedtime) to reduce CNS side effects 1

For Chemotherapy-Induced Nausea and Vomiting:

• Starting dose: 5 mg/m² orally 1-3 hours before chemotherapy, then every 2-4 hours after chemotherapy (total of 4-6 doses per day)
• Titration: May increase in 2.5 mg/m² increments to achieve clinical effect
• Maximum dose: 15 mg/m² per dose, 4-6 doses per day
• Elderly patients: Consider starting with 2.5 mg/m² once daily 1

Special Considerations

Timing of Administration:

• For anorexia: Take one hour before meals
• For chemotherapy-induced nausea: First dose on empty stomach (at least 30 minutes before eating); subsequent doses can be taken without regard to meals
• Dosing later in the day may reduce frequency of CNS adverse reactions 1

Dose Adjustments:

• Elderly patients: Start with lower doses (2.5 mg once daily) 1
• Patients with CNS side effects: If side effects are severe or persistent, reduce to 2.5 mg in the evening or at bedtime 1

Side Effect Management:

• Common CNS adverse reactions (feeling high, dizziness, confusion, somnolence) usually resolve in 1-3 days without dosage reduction
• CNS adverse reactions are dose-related, so monitor patients and reduce dosage as needed 1, 2
• Dizziness, somnolence, cognitive impairment, and dysphoria may occur, particularly at higher doses 2

Formulations Available

• 2.5 mg white capsules
• 5 mg dark brown capsules
• 10 mg orange capsules 1

Important Precautions

• Marinol is contraindicated in patients with hypersensitivity to dronabinol or sesame oil 1
• Older persons may be prone to postural hypotension and other side effects 2
• Increase dose gradually to reduce frequency of dose-related adverse reactions 1

Marinol has demonstrated effectiveness for anorexia associated with weight loss in AIDS patients and for nausea and vomiting associated with cancer chemotherapy in patients who have failed conventional antiemetic treatments 1, 3. Clinical studies have shown that dronabinol can stabilize weight in AIDS patients and improve appetite, with 22% of patients gaining ≥2 kg in controlled trials 3.

Human subject studies have confirmed that Marinol (synthetic THC) and natural cannabis have different metabolic profiles, which may be relevant when interpreting drug testing results 4.

Human subject studies have confirmed that Marinol (synthetic THC) and natural cannabis have different metabolic profiles, which may be relevant when interpreting drug testing results 4.