What Is The Difference Between Syndros, Marinol And Cesamet?

In our latest question and answer, the pharmacist discusses the difference between Syndros and Marinol.

Apr 05, 2018

Phillip asked

Can you describe the difference between all the THC prescription products?

Answer

Syndros (dronabinol), Marinol (dronabinol) and Cesamet (nabilone) are all synthetic forms of THC (delta-9-tetrahydrocannabinol), a psychoactive component of cannabis (i.e. marijuana). Below, we discuss the differences between these three products.

Chemical Formula

Syndros and Marinol are synthesized reproductions of natural THC (derived from cannabis). They both share the same generic name, dronabinol.

Cesamet has a slightly different chemical formula, but has similar effects to THC. If has a different generic name (nabilone) than Syndros and Marinol due to the different chemical structure.

Dosage Form

Marinol and Cesamet are available in capsule form while Syndros is a liquid form of THC.

Syndros may be a better option for certain individuals with severe nausea that have difficultly swallowing solid dosage forms such as tablets or capsules. However, Syndros does contain nearly 50% alcohol by volume.

Indications

All three medications are approved for the following indication:

  • Nausea and vomiting due to chemotherapy

Marinol and Syndros have the additional indication for anorexia (i.e. loss of appetite) due to AIDS.

Cost

All three products are fairly expensive but Marinol is available generically and is significantly cheaper than both Syndros and Cesamet. 

Co-pays will vary significantly by individual and insurance plan. However, below are the estimated non-insurance costs for each product:

  • Brand Marinol: ~$50-70/dose
  • Brand Cesamet: ~$80/dose
  • Brand Syndros: ~$70/dose
  • Generic dronabinol: ~$18/dose
Product Schedule

Although all products are synthetic THC (or THC derivative in the case of Cesamet), they are classified by the DEA in different controlled substance schedules:

  • Syndros C-II
  • Cesamet C-II
  • Marinol C-III

Marinol, being a C-III, has less restrictions on it than Syndros and Cesamet. Part of the rationale behind the different schedules is the fact that the characteristics of the oil in Marinol make hard to smoke or vape.

Summary
  • Marinol and Syndros are synthetic THC while Cesamet is a chemical derivative of THC.
  • Syndros is the only product available in liquid form.
  • Marinol is the only product available generically (as dronabinol) and is significantly less effective.

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