About Marinol (dronabinol): Is it the same as CBD? What about medical marijuana?
Marinol (dronabinol) and CBD are quite different, and have divergent paths in terms of FDA approval and use. Dronabinol is pure THC, which is unique from cannabidiol (CBD). THC and CBD are two derivative chemical compounds of the cannabis plant. Per the FDA, there are more than 80 active chemical compounds in the organic form of cannabis; these are just two.
The important difference here is that Marinol (dronabinol) contains delta-9-tetrahydrocannabinol which is one of many cannabinoids that comes from cannabis sativa, the plant that is most often employed for recreational drug use. CBD comes from hemp, a relative of cannabis sativa that does not contain THC. THC, as you may know from various drug campaigns, is the compound believed to be most responsible for cannabis’s psychoactive effects.
In theory, this means that THC has a psychoactive effect while CBD does not. Peter Grinspoon, M.D., pointed out for the Harvard Health Blog that CBD is not believed to cause a high of any sort. It is therefore thought not to lead to dependency or addiction.
What are Marinol and dronabinol prescribed for?
Marinol is one of two FDA-approved products that contain dronabinol. Both Marinol and its cousin Syndros can be used to treat extreme weight loss, such as in patients with anorexia and HIV/AIDs, or vomiting and nausea caused by cancer treatment. The FDA approved both products initially in 1985.
Of the two, Marinol is by far the cheaper option at your local pharmacy, running an average of about $4 per tablet. Syndros, which is administered by an oral syringe, is ten times more expensive, running more than $1,000 for just 30 ml.
Compare Marinol (dronabinol) vs. Syndros (dronabinol) U.S. Prices
|Drug (generic name) Strength Quantity||U.S. Average Retail Price||U.S. Prescription Discount Card Price|
|Dronabinol (Marinol) 2.5mg 30 tablets||$129.51||$24.92|
|Syndros (dronabinol) 5 mg/ml 30 ml||$1,398.43||$1,159.39|
|Cbd-kings with lidocaine (generic) 30 patches 4%/9%/1%||N/A||$1,096|
Sources: Average U.S. Retail Price calculated based on pricing on GoodRx.com. U.S. discount card pricing based on availability near the ZIP Code 70119.
What is the difference between medical marijuana and dronabinol?
According to Dr. Victor Chou, a medical marijuana doctor and founder of the Medical Marijuana Clinic of Louisiana, Marinol (dronabinol) is “basically just a synthetic, lab-concocted THC substitute…So, it's a pharmaceutical.” Meanwhile, medical marijuana is what Dr. Chou calls a “full spectrum” medicine, i.e., it can contain the full spectrum of active chemical compounds available in the cannabis plant. Medical marijuana also requires the actual cannabis plant, which may require more labor than just manifesting dronabinol in a lab.
Medical marijuana can also treat a wider variety of disorders. In Louisiana, where Dr. Chou operates, patients with “debilitating conditions” such as Parkinson’s Disease, may be eligible for medical marijuana treatment. Meanwhile, Marinol is specifically for nausea, vomiting, and weight loss associated with anorexia, cancer treatment, or HIV/AIDs.
From Dr. Chou’s perspective, prescribing Marinol for a patient with a debilitating condition may occur if the patient needs a low-cost alternative to medical marijuana:
If you're using it for the two FDA indications, some insurance companies will cover [Marinol]. If you're using it for nausea and vomiting related to chemotherapy, which is one of the FDA indications, then your insurance might cover it.”
SAVINGS TIP: If their insurance is not going to cover Marinol, a patient may find medical marijuana to be more cost-effective.
Can Marinol (dronabinol) be used for pain?
Marinol (dronabinol) is not traditionally prescribed for pain, although it can treat nausea and vomiting caused by cancer medication. In fact, one side effect of Marinol is abdominal pain.
Per the FDA, Marinol “demonstrates reversible effects on appetite, mood, cognition, memory, and perception.”
What are the side effects of Marinol?
Side effects of Marinol can include:
Feeling of being “high” or elevated mood
PHARMACIST TIP: Get up slowly from a seated or lying position in order to reduce your risk of lightheadedness or dizziness.
The side effects of Marinol have seemingly hampered the drug’s success. From Dr. Chou’s point of view:
When you use Marinol, you literally just have that single ingredient, THC. What we've found is people tend to have side effects to that. And it's also in a delivery mechanism that's not very useful to most patients. So, it never took off.”
Marinol arrived in the ‘80s as a way to circumvent the legal issues surrounding the marijuana plant itself. Because it was just a single ingredient, and pharmaceutical companies could make it in a lab, Marinol was free of marijuana’s “illegal” status. But for all its effort, Marinol could not accomplish what it was set out to do, at least for some. A CBS report from 2009 quoted a patient comparing the drug to “M&Ms” in terms of its effectiveness.
Can Americans buy dronabinol from a Canadian pharmacy?
Marinol (dronabinol) is a schedule III controlled substance, so consumers cannot purchase it from overseas pharmacies. The FDA generally turns a blind eye to personal importation of prescription drugs, but not to the importation of potentially addictive substances. Dronabinol, the active ingredient in Marinol, is not known to be extremely addictive, but it still falls under the umbrella of “cannabis.” Per the FDA:
Both psychological and physiological dependence have been noted in healthy individuals receiving dronabinol, but addiction is uncommon and has only been seen after prolonged high dose administration.”
What is CBD approved for?
The FDA has only approved CBD in one format: Epidiolex, a medication that can be prescribed to treat seizures. When it first hit the market, it reportedly cost $32,000 for a year’s worth of the medication, according to FiercePharma. It no longer appears to be so expensive:b With the U.S. Prescription Discount Card, 30 ml of Epidiolex can cost as little as $394.
Will the FDA approve any more applications of CBD?
The FDA has stated an interest in approving more applications of the cannabis plant, although the department is also keenly interested in keeping snake oil salesmen away from CBD. After the approval of Epidiolex, then FDA Commissioner Scott Gottlieb, M.D., said in a press release:
We’ll continue to support rigorous scientific research on the potential medical uses of marijuana-derived products and work with product developers who are interested in bringing patients safe and effective, high quality products.”
Gottlieb added the caveat:
But, at the same time, we are prepared to take action when we see the illegal marketing of CBD-containing products with serious, unproven medical claims.”
Indeed, in November of 2019, the agency sent out an official warning to 15 companies regarding false claims about cannabinoids.
Where is Marinol manufactured?
Marinol sold in U.S. pharmacies is manufactured by Patheon Softgels in North Carolina, U.S.