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Indications

REMS

Contraind./Precautions

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects

CV: hypertension, hypotension, palpitations, syncope, tachycardia.

Derm: facial flushing.

EENT: dry mouth.

GI: abdominal pain, nausea, vomiting.

Neuro: anxiety, concentration difficulty, confusion, dizziness, drowsiness, mood change, abnormal thinking, amnesia, ataxia, depression, disorientation, euphoria, hallucinations, headache, impaired judgment, paranoia, paresthesia, SEIZURES.

Misc: physical dependence, psychological dependence (high doses or prolonged therapy).

Interactions

Drug-Drug:

Drug-Natural Products:

Drug-Food:

Availability

(Generic available)

Route/Dosage

see Calculator

Nausea and Vomiting Associated with Cancer Chemotherapy

Anorexia Associated with Weight Loss in AIDS

US Brand Names

Marinol, Syndros

Action

Therapeutic Effects:

Classifications

Therapeutic Classification: antiemetics

Pharmacologic Classification: cannabinoids

Pharmacokinetics

Absorption: Extensively metabolized following absorption, resulting in poor bioavailability (10–20%).

Distribution: Enters breast milk in high concentrations. Highly lipid-soluble. Persists in tissues for prolonged period of time.

Protein Binding: 97%.

Metabolism/Excretion: Primarily metabolized in the liver via the CYP2C9 isoenzyme with some metabolism by the CYP3A4 isoenzyme; the CYP2C9 enzyme system exhibits genetic polymorphism; poor metabolizers may have significantly dronabinol concentrations and an risk of adverse effects; 50% excreted via biliary elimination. At least one metabolite is psychoactive.

Half-life: 25–36 hr.

Contr. Subst. Schedule


Schedule II (C-II)(oral solution)
Schedule III (C-III)(capsules)

Time/Action Profile

(antiemetic effect)

ROUTEONSETPEAKDURATION
POunknown2–4 hr4–6 hr

†Appetite stimulation lasts 24 hr or longer.

Patient/Family Teaching

Pronunciation

droe-NAB-i-nol audio

Code

NDC Code*