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[Pharmacology](https://durgical.com/en/pharmacology/) · Class

# Cannabinoids (medical antiemetics and appetite stimulants)

Synthetic THC and related drugs that act on cannabinoid receptors. Reserved for chemotherapy vomiting that resists other drugs and AIDS weight loss.

Updated 2026-11-01

## What they are

Dronabinol (synthetic delta-9-tetrahydrocannabinol) and nabilone are oral cannabinoids used when standard antiemetics fail in chemotherapy-induced nausea and vomiting; dronabinol also stimulates appetite in AIDS-related weight loss. They cause psychoactive effects and carry a risk of misuse.

## Mechanism of action

Cannabinoids activate CB1 receptors, Gi/o-coupled receptors on presynaptic nerve terminals that reduce neurotransmitter release, densely expressed in the brain, including the brainstem vomiting centres and the hypothalamic circuits that control appetite; they also act on CB2 receptors, mostly on immune cells. Dronabinol is a low-efficacy agonist at both. The antiemetic and appetite effects come mainly from central CB1 activation, which also explains euphoria, sedation and changes in thinking.

Target: Cannabinoid receptor 1 (CB1)

## Key points

- They are third-line antiemetics for chemotherapy-induced vomiting, after setrons, NK1 antagonists, dexamethasone and dopamine antagonists.
- Psychiatric and cognitive effects (euphoria, paranoia, abnormal thinking) are common; they are avoided in people with psychosis, mania or depression.
- Paradoxically, long-term use can cause cyclic vomiting like the cannabinoid hyperemesis syndrome.
- Dronabinol is highly lipid-soluble and protein-bound, with heavy first-pass metabolism by CYP2C9 and CYP3A4.

## Drugs in this class

- [**Dronabinol** Synthetic THC in capsules. It relieves chemotherapy vomiting when standard drugs fail and stimulates appetite in AIDS… Cannabinoid receptor 1 (CB1)](https://durgical.com/en/pharmacology/dronabinol/)

## Others in the class

- Nabilone
- Cannabidiol (used in some epilepsies, not as an antiemetic)

## Test yourself

Think of the answer, then tap the question to see it.

## Which receptor mediates the antiemetic and appetite effects of dronabinol?

The cannabinoid CB1 receptor in the central nervous system.

## When are cannabinoids used for chemotherapy-induced nausea and vomiting?

When conventional antiemetic regimens have failed.

## Which paradoxical gut syndrome is linked to long-term cannabinoid use?

Cyclic nausea, vomiting and abdominal pain resembling the cannabinoid hyperemesis syndrome.

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Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [DailyMed - DRONABINOL capsule](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=adb1801c-0fb5-4e16-b969-1db91230e0b9) (DailyMed (U.S. National Library of Medicine), 2026); Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed., ch. 26 (McGraw Hill, 2023); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=A04AD) (WHO Collaborating Centre for Drug Statistics Methodology, 2026).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/pharmacology/classes/cannabinoids/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/classes/cannabinoids/