dosage and administration1

Antiemetic Treatment of Chemotherapy-Induced Emesis:

  • MARINOL Capsules is best administered at an initial dose of 5 mg/m2, given 1 to 3 hours prior to the administration of chemotherapy, then every 2 to 4 hours after chemotherapy is given, for a total of 4 to 6 doses/day.
  • Should the 5 mg/m2 dose prove to be ineffective, and in the absence of significant side effects, the dose may be escalated by 2.5 mg/m2 increments to a maximum of 15 mg/m2 per dose.
  • Caution should be exercised in dose escalation, however, as the incidence of disturbing psychiatric symptoms increases significantly at maximum dose.

Clinical trials dosing

Antiemetic Treatment of Chemotherapy-Induced Emesis:

The pharmacologic effects of MARINOL Capsules are dose-related and subject to considerable interpatient variability. Therefore, dosage individualization is critical in achieving the maximum benefit of MARINOL Capsules treatment.

  • Most patients respond to 5 mg three or four times daily.
  • Dosage may be escalated during a chemotherapy cycle or at subsequent cycles, based upon initial results.
  • Therapy should be initiated at the lowest recommended dosage and titrated to clinical response.
  • Administration of MARINOL Capsules with phenothiazines, such as prochlorperazine, has resulted in improved efficacy as compared to either drug alone, without additional toxicity.

Dosing Considerations:

Pediatrics: MARINOL Capsules is not recommended for AIDS-related anorexia in pediatric patients because it has not been studied in this population. The pediatric dosage for the treatment of chemotherapy-induced emesis is the same as in adults. Caution is recommended in prescribing MARINOL Capsules for children because of the psychoactive effects.

Geriatrics: Caution is advised in prescribing MARINOL Capsules in elderly patients because they may be more sensitive to the neurological, psychoactive, and postural hypotensive effects of the drug. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range.

MARINOL Capsules should be used with caution when administered to elderly patients with dementia, who are at increased risk for falls as a result of their underlying disease state which may be exacerbated by the central nervous system effects of somnolence and dizziness associated with MARINOL Capsules. These patients should be monitored closely and placed on fall precautions prior to initiating MARINOL therapy. In antiemetic studies, no difference in efficacy was apparent in patients >55 years old.