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Synthetic THC / Marinol
Since 1986, synthetic THC (Marinol) has been available as a Schedule II drug, which allows physicians to prescribe it under highly regulated conditions. It is labeled as a anti-nauseant and an appetite stimulant, but doctors prescribe it for other conditions, such as depression and muscle spasticity. However, for people suffering from nausea and vomiting, who are unable to swallow and hold down a pill, smoking marijuana is often the only reliable method of delivery. Smoking has the added benefit of providing relief quickly, often producing relief in minutes, whereas swallowed THC may take four hours or more.

When THC is swallowed, the effects vary considerably, both from one person to the next and in the same person from one episode to another. Much of the swallowed THC is metabolized into other compounds by the liver. Effective dosage rates are difficult to achieve, since swallowed THC takes so long to go into effect and since its effects wear off slowly. Smoked marijuana is a more flexible route of administration, not only because its effects are more immediate, but also because the patient can take only as much as needed.

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DRONABINOL (Marinol®)
Classification: Cannabinoid

Indication: Anorexia, weight loss, wasting, nausea

Dose: 2.5mg/day to 20 mg/day, increasing or decreasing as below:

Starting dose is 2.5 mg po bid before lunch and supper. CNS effects usually resolve 1-3 days after starting, but if they do not, reduce dose to 2.5 mg before supper. If adverse effects (of 2.5 mg bid) are minimal and further appetite stimulation is needed, increase dose to 2.5 mg before lunch and 5 mg before supper, or to 5 mg before lunch and 5 mg before supper. Most patients respond satisfactorily at the 2.5 mg bid dose, but some have been raised to 10 mg bid and tolerated it well. Adverse effects tend to increase with dosage, however.

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