Dronabinol, Oral

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KEY POINTS

• This medicine is taken by mouth to relieve nausea and vomiting caused by chemotherapy or to stimulate the appetite of people with AIDS. Take it exactly as directed.
• This medicine may cause unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take.

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What are other names for this medicine?

Type of medicine: antiemetic (antinausea); appetite stimulant

Generic and brand names: dronabinol, oral; Marinol; Syndros

What is this medicine used for?

This medicine is taken by mouth to relieve nausea and vomiting caused by chemotherapy. This medicine is also used to stimulate the appetite of people with AIDS who are losing weight.

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• An allergic reaction to any medicine, marijuana products, or sesame oil
• Seizures
• Heart disease
• High or low blood pressure
• Liver disease
• Mental health problems such as depression, mania, or schizophrenia
• Problems with alcohol or substance abuse

The liquid form of this medicine contains alcohol. Tell your provider if you have taken disulfiram or metronidazole within the past 14 days.

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant. It is not known whether this medicine will harm an unborn baby. Do not breast-feed while you are taking this medicine.

How do I take it?

Check the label on the medicine for directions about your specific dose. This medicine may be habit-forming. Take it exactly as directed by your healthcare provider. Do not take more of it or take it more often than directed. Taking too much of this medicine will increase the chances of side effects. Do not stop taking this medicine without your healthcare provider's approval.

Check with your healthcare provider before using this medicine in children under age 18.

Do not break, crush, or chew the capsules. Swallow them whole.

If you have the liquid, use the measuring oral syringe that comes with the medicine, or ask your pharmacist for one. Do not use a kitchen spoon because the dose may not be correct.

What if I miss a dose?

If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: dry mouth, extreme drowsiness, fast heartbeat, memory problems, decreased urination, confusion, loss of coordination, panic, fainting, slurred speech, seizures.

What should I watch out for?

This medicine may make you drowsy or dizzy and may interfere with your coordination and ability to think clearly. Do not drive or operate machinery unless you are fully alert and thinking clearly.

You may feel dizzy or faint when you get up quickly after sitting or lying down. Getting up slowly may help.

This medicine can cause mood changes and behavior changes. Contact your healthcare provider if they are severe.

Adults over the age of 65 may be at greater risk for side effects. Talk with your healthcare provider about this.

This medicine increases the effects of alcohol and other drugs that slow down your nervous system. Do not drink alcohol, smoke marijuana, or take other medicines unless your healthcare provider approves.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you are taking this medicine.

This medicine is a controlled substance. It is illegal for you to give it to anyone else.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives; itching; rash; trouble breathing; chest pain or tightness in your chest; swelling of your lips, tongue, and throat).

Serious (Report these to your healthcare provider right away.): Severe mood changes, panic attacks, hallucinations, severe confusion, unusual behavior, severe depression, slurred speech, vision changes, memory problems, balance or walking problems, seizures, severe headache, fast or irregular heartbeat, severe dizziness or fainting.

Other: Mild headache, weakness, dry mouth, tingling, drowsiness, mild dizziness, nausea, vomiting, stomach pain.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• Alcohol
• Antianxiety medicines such as alprazolam (Xanax), buspirone, clonazepam (Klonopin), clorazepate (Gen-Xene, Tranxene), diazepam (Valium), lorazepam (Ativan), and oxazepam
• Antibiotics such as clarithromycin (Biaxin), rifabutin (Mycobutin), rifampin (Rifadin), rifapentine (Priftin), and telithromycin (Ketek)
• Anticholinergic medicines such as amantadine (Symmetrel), atropine/diphenoxylate (Lomotil), belladonna, benztropine (Cogentin), dicyclomine (Bentyl), hyoscyamine (HyoMax, Levbid, Levsin), methscopolamine (Pamine), propantheline, scopolamine (Transderm Scop), and trihexyphenidyl
• Antidepressants such as amitriptyline, desipramine (Norpramin), fluoxetine (Prozac), fluvoxamine (Luvox), imipramine (Tofranil), nefazodone, nortriptyline (Pamelor), and sertraline (Zoloft)
• Antifungal medicines such as itraconazole (Sporanox), ketoconazole (Nizoral), metronidazole (Flagyl), posaconazole (Noxafil), and voriconazole (Vfend)
• Antipsychotic medicines such as aripiprazole (Abilify), clozapine (Clozaril, FazaClo), haloperidol (Haldol), olanzapine (Zyprexa), quetiapine (Seroquel), risperidone (Risperdal), and ziprasidone (Geodon)
• Antiseizure medicines such as carbamazepine (Carbatrol, Epitol, Equetro, Tegretol), felbamate (Felbatol), gabapentin (Neurontin), lamotrigine (Lamictal), levetiracetam (Keppra), oxcarbazepine (Trileptal), phenytoin (Dilantin, Phenytek), primidone (Mysoline), tiagabine (Gabitril), topiramate (Qudexy, Topamax, Trokendi), and valproic acid (Depacon, Depakene, Depakote)
• Barbiturates such as butabarbital (Butisol), pentobarbital (Nembutal), phenobarbital, and secobarbital (Seconal)
• Caffeine
• Cancer medicines such as abiraterone (Zytiga), capecitabine (Xeloda), enzalutamide (Xtandi), fluorouracil (Adrucil, Carac, Efudex, Fluoroplex), idelalisib (Zydelig), and mitotane (Lysodren)
• Cimetidine (Tagamet)
• Conivaptan (Vaprisol)
• Cough, cold, or allergy medicines such as brompheniramine, chlorpheniramine (Chlor-Trimeton), diphenhydramine (Benadryl), loratadine (Alavert, Claritin), phenylephrine (Neo-Synephrine, Sudafed PE), and pseudoephedrine (Sudafed) (including nose drops or sprays)
• Cyclosporine (Gengraf, Neoral, Sandimmune)
• Disulfiram (Antabuse)
• Doxepin (Silenor)
• Gemfibrozil (Lopid)
• Heart medicines such as amiodarone (Cordarone, Pacerone), diltiazem (Cardizem, Cartia, Tiazac), dronedarone (Multaq), nicardipine (Cardene), and verapamil (Calan, Covera, Verelan)
• HIV medicines such as atazanavir (Reyataz), cobicistat (Tybost), darunavir (Prezista), delavirdine (Rescriptor), elvitegravir/cobicistat/emtricitabine/tenofovir (Stribild), fosamprenavir (Lexiva), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), and saquinavir (Invirase)
• Lithium (Lithobid)
• MAO inhibitors such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate) (Do not take this medicine and an MAO inhibitor within 14 days of each other.)
• Medicines to treat breathing or lung problems such as aminophylline, arformoterol (Brovana), fluticasone/salmeterol (Advair), formoterol (Perforomist), salmeterol (Serevent), and theophylline
• Muscle relaxants such as baclofen (Gablofen, Lioresal), carisoprodol (Soma), cyclobenzaprine (Amrix), dantrolene (Dantrium), methocarbamol (Robaxin), and tizanidine (Zanaflex)
• Natural remedies such as ephedra, gotu kola, guarana, kava, St. John's wort, and valerian
• Nausea medicines such as prochlorperazine (Compro) and promethazine
• Pain medicines such as codeine, fentanyl (Abstral, Actiq, Duragesic, Fentora, Sublimaze), hydrocodone (Hysingla, Zohydro), meperidine (Demerol), oxycodone (OxyContin, Roxicodone), oxycodone/acetaminophen (Percocet, Roxicet), pentazocine (Talwin), tapentadol (Nucynta), and tramadol (ConZip, Ultram)
• Paroxetine (Brisdelle, Paxil, Pexeva)
• Sleeping pills such as estazolam, eszopiclone (Lunesta), flurazepam, temazepam (Restoril), triazolam (Halcion), zaleplon (Sonata), and zolpidem (Ambien, Edluar, Intermezzo)
• Stimulants such as armodafinil (Nuvigil), dextroamphetamine (Dexedrine), methamphetamine (Desoxyn), and modafinil (Provigil)

Do not drink alcohol while you are taking this medicine without your healthcare provider’s approval.

Ask your healthcare provider or pharmacist if you need to avoid products that contain grapefruit, Seville oranges, and tangelos while you are taking this medicine. These fruits and juices can affect the way this medicine works and may increase your risk of serious side effects.

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine in the refrigerator. Do not let it freeze. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.