Marinol Restrictions Eased

Marinol, a medication used to stimulate appetite and cope with nausea, will soon become easier and more convenient for people with HIV disease to receive, according to new federal guidelines.

Manufactured by Boehringer Ingelheim/Roxane Laboratories, Marinol is a form of THC, a substance which occurs naturally in marijuana. The drug is used for the treatment of weight loss in people with HIV disease and nausea and vomiting as a result of chemotherapy for cancer treatment. Because weight loss can have many causes, discussing any unintended loss of weight with your helath care provider is important.

Marinol was shown in clinical trials to be significantly more effective in stimulating appetite than placebo. The most commonly reported side effects from Marinol include elation, dizziness, confusion, drowsiness and other symptoms affecting the central nervous system. These effects were reported by 33 percent of Marinol users.

Marinol is now classified as a "Schedule III" drug. According to the U.S. Department of Justice Drug Enforcement Agency, a Schedule III drug is one that is currently accepted for medical use in treatment in the U.S. with less potential for abuse than drugs in Schedules I and II. Other Schedule III drugs include steroids, codeine and some barbiturates. Schedule III drugs may also lead to moderate or low physical dependence or high psychological dependence.

According to Boehringer Ingelheim/Roxane Laboratories, the rescheduling is due to a "thorough review of the abuse potential of this agent. The review found that Marinol's lower abuse, addiction, and diversion potential in a wide range of settings and patient types did not justify Marinol being classified as a Schedule II agent."

Once California adopts the federal rescheduling action, physicians will be able to phone in prescriptions to pharmacies and patients will able to receive up to five months of refills. Under current scheduling, neither of these steps is possible.

The effect of the rescheduling, if any, on the clinical investigation of marijuana remains to be seen.

John Slovick is a treatment advocate in AIDS Project Los Angeles' Treatment Advocacy Program. He can be reached by calling (323)993-1526 or by e-mail at jslovick@apla.org.