[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Cannabinoids (medical antiemetics and appetite stimulants)](https://durgical.com/en/pharmacology/classes/cannabinoids/) › Dronabinol

[Pharmacology](https://durgical.com/en/pharmacology/) · [Cannabinoids (medical antiemetics and appetite stimulants)](https://durgical.com/en/pharmacology/classes/cannabinoids/)

# Dronabinol

Synthetic THC in capsules. It relieves chemotherapy vomiting when standard drugs fail and stimulates appetite in AIDS, at the cost of psychoactive effects.

Updated 2026-11-01

- Class: [Cannabinoids (medical antiemetics and appetite stimulants)](https://durgical.com/en/pharmacology/classes/cannabinoids/)
- Receptor: Cannabinoid receptor 1 (CB1)
- ATC code: A04AD10

Also called: Delta-9-tetrahydrocannabinol (THC)

◎**Cannabinoid receptor 1 (CB1)**Dronabinol

ⓘ No structure of dronabinol bound to CB1 exists; the figure shows AM11542, a synthetic analogue built on the same THC scaffold, in the orthosteric pocket of the human CB1 receptor.

**Target in 3D:** Cannabinoid receptor 1 (CB1). PDB structure 5XRA (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/5XRA) · Drag to rotate · pinch to zoom

## Mechanism of action

Dronabinol is chemically synthesised delta-9-tetrahydrocannabinol, the main psychoactive compound of cannabis. It is a low-efficacy agonist of CB1 and CB2 receptors. Activation of CB1 receptors in the brainstem and hypothalamus reduces nausea and vomiting and increases appetite; the same receptors in the cortex and limbic system produce euphoria, sedation, altered perception and, at times, anxiety or paranoia. It also has central sympathomimetic effects (tachycardia).

- Dronabinol (synthetic THC) is absorbed and reaches the brain
- It activates CB1 receptors in the brainstem and hypothalamus
- Nausea falls and appetite rises
- CB1 in the cortex and limbic system causes euphoria and sedation

## Pharmacokinetics

**Absorption**
90–95% absorbed by mouth, but only 10–20% reaches the circulation because of first-pass metabolism and high lipid solubility.

**Distribution**
Very large volume of distribution (fat-soluble); about 97% protein-bound together with its metabolites.

**Metabolism**
Extensive first-pass metabolism in the liver, mainly by hydroxylation (CYP2C9 and CYP3A4 involved); the main metabolite, 11-hydroxy-THC, is also active.

**Half-life**
Initial half-life about 4 hours and terminal half-life 25–36 hours.

**Onset and duration**
Acts within 0.5–1 hour; psychoactive effects last 4–6 hours, while the appetite effect may last 24 hours.

## Indications

- Anorexia with weight loss in adults with AIDS. [HIV infection and AIDS →](https://durgical.com/en/conditions/hiv-infection-and-aids/)
- Nausea and vomiting from cancer chemotherapy that has not responded to conventional antiemetics.

## Adverse effects

### Common

- Dizziness and drowsiness
- Euphoria, abnormal thinking and paranoid reactions
- Abdominal pain, nausea and vomiting
- Tachycardia

### Serious (rare, important)

- Worsening of mania, depression or schizophrenia; cognitive impairment, especially in older adults
- Hypotension, hypertension, syncope or tachycardia in people with heart disease
- Seizures
- Misuse and dependence (controlled substance)
- Paradoxical nausea, vomiting and abdominal pain similar to cannabinoid hyperemesis syndrome

## Contraindications

- Hypersensitivity to dronabinol or to sesame oil (in the capsules)

## Key interactions

**Alcohol, benzodiazepines, barbiturates and other CNS depressants**
Additive sedation and CNS depression.

**Amphetamines, sympathomimetics, atropine, antihistamines, tricyclic antidepressants and other anticholinergics**
Additive tachycardia, hypertension and drowsiness.

**CYP2C9 and CYP3A4 inhibitors (ketoconazole, itraconazole, clarithromycin, ritonavir, grapefruit juice) or inducers**
Inhibitors raise dronabinol levels and adverse effects; inducers lower its effect.

**Highly protein-bound drugs with a narrow margin (warfarin, ciclosporin, amphotericin B)**
Possible displacement from plasma proteins; their effects are monitored.

## What is monitored

- Mood, thinking and psychiatric symptoms, especially at the start and after dose increases
- Blood pressure, heart rate and fainting in people with heart disease
- Signs of misuse
- Weight and appetite in AIDS-related weight loss

## Administration and safety

- Oral capsules (in sesame oil) or oral solution
- It is a controlled substance: storage and records follow local rules
- Patients do not drive or operate machinery until they know how it affects them

## Nursing care

- Ask about psychiatric history, seizures, heart disease and past substance use before starting
- Check for sesame allergy
- Watch for dizziness and falls, especially in older adults
- Teach the patient to avoid alcohol and other sedatives and to report mood changes or worsening vomiting

## Pregnancy and breastfeeding

It may cause fetal harm and is avoided in pregnancy; cannabis use in pregnancy has been linked to adverse fetal outcomes.

## Memory aid

«DRONAbinol = DRONE over the CB1 field»: it hovers over the vomiting and hunger centres, but the drone's camera shows euphoria, paranoia and a racing heart.

## Test yourself

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

## What is dronabinol chemically?

Synthetic delta-9-tetrahydrocannabinol (THC), formulated in sesame oil.

## Why does only a small fraction of oral dronabinol reach the circulation although it is well absorbed?

Heavy first-pass hepatic metabolism and high lipid solubility.

## Which allergy is a contraindication to dronabinol capsules?

Allergy to sesame oil, the vehicle of the capsules.

## Which two indications does dronabinol have?

Anorexia with weight loss in AIDS, and chemotherapy-induced nausea and vomiting that does not respond to conventional antiemetics.

[Add to my cards (4)](https://durgical.app/estudiar/?add=/en/pharmacology/dronabinol/)

## Related drugs

- [Ondansetron](https://durgical.com/en/pharmacology/ondansetron/)
- [Aprepitant](https://durgical.com/en/pharmacology/aprepitant/)

## Related conditions

- [HIV infection and AIDS](https://durgical.com/en/conditions/hiv-infection-and-aids/)

[← Back to the class: Cannabinoids (medical antiemetics and appetite stimulants)](https://durgical.com/en/pharmacology/classes/cannabinoids/)

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); [Dronabinol: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a607054.html) (MedlinePlus (U.S. National Library of Medicine), 2026); Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed., ch. 26 (McGraw Hill, 2023); [RCSB PDB - 5XRA: Crystal structure of the human CB1 in complex with agonist AM11542](https://www.rcsb.org/structure/5XRA) (RCSB Protein Data Bank, 2026).

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Representative model, for educational purposes only.

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