What is Marinol and How is it Different than THC?

In our latest question, our pharmacist discusses the FDA-approved medication, dronabinol also known as Marinol.
What is Marinol and How is it Different than THC?

Marianne Asked

What is Marinol and How is it Different than THC?


Marinol is the brand name for the FDA-approved medication, dronabinol. It is a synthetic form of THC.
Dronabinol is provided as 2.5, 5, and 10 mg gelatin capsules formulated in sesame oil.
Dronabinol is approved for nausea and vomiting associated with chemotherapy, and anorexia with associated weight loss in patients with AIDS.


What Is Marinol?

Marinol (Dronabinol) is an FDA-approved prescription medicine available for patients suffering from nausea and vomiting due to chemotherapy or wasting syndrome due to AIDS. The active ingredient in dronabinol is delta-9-tetrahydrocannabinol, i.e., THC. However, dronabinol is synthetically produced in a laboratory. Dronabinol is available as 2.5, 5, and 20 mg capsules that are formulated in sesame oil. 

What's the difference between Marinol and THC?

THC is a compound naturally found in the cannabis plant and is responsible for many of the effects commonly associated with cannabis. Conversely, Marinol is a specific pharmaceutical formulation of synthetic THC that is created in a lab and has been tested in clinical trials. Marinol (dronabinol) has been found to be safe and effective for two conditions when taken as prescribed. 

Marinol (dronabinol) is available by prescription only. Whereas, natural THC can be found in every cannabis plant, but the availability and accessibility of products containing natural THC will depend on your jurisdiction. This tends to vary greatly in the US because of State laws.

Doctors typically don't prescribe cannabis because it varies greatly in potency and chemical composition which is dependent upon a multitude of factors including growing conditions, time of harvest, strain, storage conditions, and more. 

On the other hand, Marinol offers a very standardized way to deliver a consistent and bioavailable dose of THC to patients. Furthermore, Marinol (dronabinol) has passed rigorous quality and safety standards set by the FDA. This assures us that dronabinol is safe and effective when it is prescribed and used in accordance with its product label

How Marinol Works?

Marinol contains a synthetic form of THC that binds t cannabinoid type 1 receptors (CB1) in the brain and central nervous system. Once these receptors are activated, numerous signaling cascades are produced that ultimately result in a net decrease in neurotransmission. These effects are thought to be what's responsible for the majority of Marinol's clinical effects. 

"The Endocannabinoid System in the Nervous System" Courtesy of Health-Canada


Many people report developing "the munchies" after consuming cannabis. Indeed, appetite stimulation is a well-known effect of THC and this is what underlies dronabinol's effectiveness in helping patients with AIDS eat more and stop losing weight. Unfortunately, studies investigating Marinol's effectiveness for treating other conditions, such as anorexia nervosa found that the drug wasn't as effective. 

How is Marinol used?

How Marinol is used depends on which condition is being treated. For anorexia associated with AIDS, the recommended starting dose for adults is 2.5 mg taken by mouth twice daily, one hour before lunch and dinner. The dose can then be titrated up by 2.5 mg at a time, usually by increasing the dose before dinner first. The maximum recommended dose is 10 mg twice daily. 

For nausea and vomiting associated with chemotherapy, Marinol is dosed based on the patient's Body Surface Area (BSA). This might seem weird, to dose a drug based on BSA, but it is a very common practice in oncology. The dose of Marinol is 2.5 mg/m2 taken by mouth 1 to 3 hours before chemotherapy and then every 2 to 4 hours after chemotherapy, for a total of 4 to 6 doses per day. 

Is Marinol a Controlled Substance?

While cannabis is still considered a Schedule I controlled substance under federal law, Marinol (dronabinol) is a Schedule III controlled substance. This is a less stringent category. This is because dronabinol is FDA-approved to treat medical conditions. Therefore, it cannot be listed in the Schedule I category which by definition means there is no accepted medical use of the drug (and that the drug has high abuse potential). 

So although THC derived from cannabis is still considered Schedule I, synthetic THC that dronabinol is made from is considered Schedule III.

Side Effects of Marinol

Unsurprisingly, the side effects of dronabinol tend to be very similar to the side effects that can be expected from using cannabis. These include things like dizziness, euphoria, altered mood, dry mouth, and increased heart rate. 

Concluding Remarks

Medicines like Marinol (dronabinol) show that cannabinoids hold great therapeutic potential and prove they can be manufactured and standardized to treat various conditions. Although Marinol (dronabinol) differs from its natural counterpart, these differences are necessary to meet the rigorous quality and testing standards set forth by the Food and Drug Administration. 

  1. Marinol. North Chicago, IL: AbbVie Inc.; 2017. [package insert] [package insert].
  2. Dronabinol in severe, enduring anorexia nervosa: A randomized controlled trial (Article).

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