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Pharmacologic class: Cannabinoid
Therapeutic class: Antiemetic
Controlled substance III
Pregnancy risk category B
Unknown. May exert antiemetic effect by inhibiting vomiting control mechanism in medulla oblongata.
Capsules: 2.5 mg, 5 mg, 10 mg
Indications and dosages
➣ Prevention of nausea and vomiting caused by chemotherapy
Adults and children: Initially, 5 mg/m2 P.O. 1 to 3 hours before chemotherapy. Repeat dose q 2 to 4 hours after chemotherapy, up to four to six doses per day. If 5-mg/m2 dose is ineffective and patient has no significant adverse reactions, dosage may be increased in increments of 2.5 mg/m2 to a maximum dosage of 15 mg/m2.
➣ Appetite stimulant
Adults and children: Initially, 2.5 mg P.O. b.i.d. May reduce dosage to 2.5 mg/day given as a single evening or bedtime dose. Maximum dosage is 10 mg P.O. b.i.d.
• Hypersensitivity to cannabinoids or sesame oil
Use cautiously in:
• hypertension, heart disease, bipolar disorder, schizophrenia, drug abuse, seizures
• pregnant patients.
• When used to stimulate appetite, give before lunch and dinner.
CNS: drowsiness, anxiety, impaired coordination, irritability, depression, headache, hallucinations, memory loss, paresthesia, ataxia, paranoia, disorientation, nightmares, speech difficulties, syncope, suicidal ideation
CV: tachycardia, hypotension, hypertension
EENT: visual disturbances, tinnitus
GI: dry mouth
Skin: facial flushing, diaphoresis
Drug-drug. Anticholinergics, antihistamines, tricyclic antidepressants: increased tachycardia and hypertension
CNS depressants: increased CNS depression
Ritonavir: increased dronabinol blood level and risk of toxicity
Drug-behaviors. Alcohol use: increased CNS depression
• Monitor vital signs for hypotension and tachycardia.
☞ Check for adverse CNS reactions. Report significant depression, paranoid reaction, or emotional lability.
• Monitor nutritional status and hydration.
• Teach patient about drug's significant adverse CNS and cardiovascular effects. Emphasize that he should take it only as prescribed and needed.
☞ Advise patient (and significant other) to immediately report depression, suicidal thoughts, paranoid reactions, seizures, and other serious CNS reactions.
• Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and behaviors mentioned above.
See also: tetrahydrocannabinols.
dronabinol/dro·nab·i·nol/ (dro-nab´in-ol) one of the major active substances in cannabis, used as an antiemetic for cancer chemotherapy and anorexia and weight loss in AIDS; it is subject to abuse because of its psychotomimetic activity.
dronabinolMarinol® A synthetic Δ9THC-tetrahydrocannabinol, an active ingredient of marijuana, which may be used to manage glaucoma, pain, N&V, anorexia, wasting linked to chemotherapy, AIDS Adverse effect Drowsiness, confusion, poor coordination. See Marijuana, THC.
See also: tetrahydrocannabinols