In the midst of the growing popularity of CBD in the United States and around the world, it may have been missed by many that the US Food and Drug Administration (FDA) approved four cannabinoid-based medications: Epidiolex (cannabidiol), Marinol (Dronabinol), Syndros (Dronabinol) and Cesamet (Nabilone). Each medication is used for a specific condition, comes with particular side effects, and routes of administration.
Epidiolex (Cannabidiol)
This is the only plant-based cannabinoid that is FDA-approved for the management of several childhood seizure disorders like Lennox-Gastaut and Dravey syndrome as well as tuberous sclerosis complex in both adults and children. It is administered as a liquid oral medication. It was approved by the FDA in 2018 and is officially the first cannabis-based medicine. This medication may reduce the frequency and severity of seizures and doesn’t produce any “high”.
Possible side effects include:
- Fatigue
- Decreased appetite, fever
- Vomiting
- Infections
- Increase in liver enzymes
- Rash
- Insomnia
- Diarrhea
Marinol (Dronabinol)
This is a synthetic cannabinoid very similar to THC and is given in capsule form. It is FDA-approved for anorexia and wasting syndrome associated with AIDS as well as chemotherapy-induced nausea and vomiting. It was FDA-approved back in 1985. Possible side effects include:
- Allergic reactions (hives, skin rash, difficulty breathing, swelling of face, lips, tongue or throat)
- Rapid heart beat
- Lightheadedness
- Confusion
- Mood changes
- Slurred speech
- Increased blood pressure
- Feeling high or euphoric
- Restlessness
- Nausea, vomiting or stomach pain
Syndros (Dronabinol)
Syndros contains the same synthetic cannabinoid as Marinol but is an oral solution. It was approved by the FDA in 2016 for anorexia induced by AIDS and nausea and vomiting brought on by chemotherapy. The side effects are similar to Marinol.
Cesamet (Nabilone)
This is another synthetic, THC-like medication, similar to Marinol and although it was wasn’t approved by the FDA in the United States in 1985 for the management of chemotherapy-induced nausea and vomiting, it wasn’t marketed as a treatment until 2006. It is important to note that this drug is a DEA Schedule II controlled substance and does have the potential for abuse which can lead to severe psychological or physical dependence. It is administered orally in pill form. It has side effects including:
- CNS effects (drowsiness, anxiety, dizziness, hallucinations, psychosis)
- Tachycardia and orthopedic hypotension
Caution should be used when given to geriatric patients or those diagnosed with hypertension and/or cardiovascular disease as well as individuals with a history of bipolar disorder, depression or schizophrenia.
Final Thoughts on FDA-Approved Cannabinoid-Based Medications
Cannabidiol or CBD has taken the spotlight in science, culture, nutrition and alternative medicine for decades, while FDA-approved cannabinoid-based medications have not seen the same attention. According to much research, these medications can be very successful in reducing anorexic symptoms and seizure activity when taken appropriately, with close monitoring. Although these conditions represent a smaller proportion of society, it is hoped that science will continue to develop cannabinoid-based medications for many more physical, mental and neurological conditions for a wider group of individuals.