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What is Marinol?
Marinol is available in a number of countries, including the United States and Germany.
In the US, Marinol was initially placed in the Schedule II category of controlled substances, but was later moved to Schedule III after an analysis found no evidence of abuse or illegal diversion potential.
Its lack of abuse potential can be partially attributed to its slow onset of action, generally taking over an hour to reach effect.
Marinol was originally developed and brought to market by Unimed Pharmaceuticals, which was acquired by Solvay Pharmaceuticals in 1999.
In 1985, Marinol received FDA approval for use in the treatment of nausea and vomiting associated with cancer chemotherapy.
In 1992, Marinol was approved for use in the treatment of anorexia and weight loss associated with AIDS (also known as AIDS wasting syndrome). Today, AIDS patients represent the largest group of patients that use Marinol.
Besides AIDS wasting syndrome and nausea associated with chemotherapy, Marinol has demonstrated promise in a number of other clinical settings, including pain, spasticity, spinal cord injury and glaucoma.
In a recent study published in 2013, Marinol was compared side-by-side with medical marijuana in healthy subjects that underwent pain simulations. Both were found to significantly reduce the pain experienced, although Marinol seemed to have a longer-lasting effect – 4.5 hours verses 2.5 hours on average. On the other hand, smoked marijuana took action quicker – 15 minutes verses 1 hour on average.
Marinol vs. Medical Marijuana
Marinol is a slow-acting drug with blood levels of THC peaking 2-4 hours after ingestion.
On the other hand, medical marijuana has been found to take effect much faster, depending on the route of ingestion. Studies show that smoking marijuana results in an almost immediate peak in THC levels, while THC levels have been found to peak at 60-90 minutes following oral consumption.
Marinol’s delayed onset of action is one of its largest drawbacks, due to the desire of patients to control the timing and dosing of their treatments. Because of this, alternative delivery methods for Marinol are currently being investigated, including lung aerosols, nasal sprays and sublingual (under the tongue) formulations.
Perhaps the largest drawback of Marinol is its lack of other cannabinoid compounds. Indeed, while Marinol contains the main ingredient of marijuana, over 60 other cannabinoids have been identified in the cannabis plant.
Besides THC, CBD is also present in high concentrations in cannabis. CBD has been found to exert many of the same medical properties as THC, but without the high. Medical marijuana research has shifted to CBD in recent years due to its lack of affinity to CB1 receptors and, subsequently, its lack of psychoactive effects.
A number of side effects associated with Marinol have been identified. Most of these side effects are similar to those of medical marijuana and largely result from THC’s action on CB1 receptors, which are most prominent within the brain.
Common side-effects of Marinol include:
• Abnormal thoughts
Approximately one-third of patients report experiencing side-effects, but only a small percentage of patients stop using Marinol because of them. (IOM, 1999)
Interestingly, while marijuana has never been identified as a primary suspect in mortality, the FDA attributed 4 deaths to Marinol between 1997-2005.