Marinol vs. Cannabis: Which Is Better for Medicinal Use?

Marinol (dronabinol) is a synthetic form of tetrahydrocannabinol (THC), the main psychoactive ingredient of cannabis (marijuana). In addition to creating the "high" that many users seek, THC is known to reduce neuropathic pain, relieve nausea, and stimulate appetite. Marinol and cannabis contain a similar ingredient, but they have different effects and are used to treat different conditions.

In states where cannabis is legal, people now have a choice as to whether Marinol or cannabis is the better drug to treat their medical condition. While there remains no clear consensus as to which is "better" or "worse," there are pros and cons that may help direct your decision.

This article compares cannabis to Marinol and discusses the benefits and drawbacks of each. It also offers some advice on how to choose which one is right for you.

Medical marijuana and pill bottle on a white background
Tommy Flynn/Photographer's Choice / Getty Images

What Is Marinol Used For?

Marinol was first approved by the U.S. Food and Drug Administration (FDA) in 1985 to treat nausea and vomiting related to cancer chemotherapy. Its approval has since been extended to include the treatment of weight loss and anorexia in people with advanced HIV infection.

As a result of its benefits for people with HIV wasting, Marinol was rescheduled as a schedule III drug in 1999 (meaning that it has an accepted medical use). When used as prescribed, Marinol is considered safe and has a lower risk of dependence than opioid pain medication.

Off-label uses include treatment of:

  • Fibromyalgia pain
  • Glaucoma-related eye pressure
  • Menstrual migraines
  • Postoperative nausea and vomiting
  • Obstructive sleep apnea
  • Muscle spasticity related to multiple sclerosis (MS)

What Are the Differences Between Marinol and Cannabis?

Marinol and cannabis have a similar active ingredient, but they are not the same in how they work. They are also used to treat different conditions.

  • Legality: Marinol is legal in all 50 states and can be purchased from most pharmacies. Cannabis, however, is still considered illegal by the federal government. There is no FDA-approved medical use of medical cannabis.
  • Purity: Cannabis contains over 400 chemicals, little of which is known about their long-term effects. Marinol contains a pure isomer of THC, which means you won't be exposed to any of these other chemicals.
  • Method: Marinol comes in pill or liquid form and is taken by mouth. Cannabis is most commonly smoked but may also be added to food, ingested in tinctures and oils, or inhaled through vaporizers ("vaping"), and may be used topically on the skin. Outside of smoking, other methods of intake may be more erratic in their effect.
  • Effectiveness: Studies have been conflicted as to how effective Marinol is at controlling neuropathic pain.
  • Potential for contamination: Marinol is manufactured under controlled conditions, meaning that it is less likely to be tainted or contaminated.
  • Onset: Smoked cannabis has a rapid onset of action, bringing almost an immediate relief of symptoms. Marinol has a low absorption rate and can take up to an hour before the effects are felt. This is an important consideration for someone undergoing chemotherapy.
  • Dosing: Smoked cannabis "doses" are easier to control than oral medications like Marinol.
  • Length of action: Marinol has a long drug half-life and will usually remain at a therapeutic level in your blood for longer than cannabis.
  • Affect on lungs: Smoked cannabis may not be appropriate for people with respiratory diseases, including lung cancer. Marinol is not smoked and is less likely to cause throat and lung irritation (an important consideration for someone with asthma or COPD).
  • Strains: There are a variety of cannabis strains to choose from, some of which have fewer psychoactive effects and may be more effective in stimulating appetite, fighting fatigue, or curbing depression or anxiety.
  • Other cannabinoids: Smoked cannabis contains other potentially beneficial cannabinoids, as well as potent antioxidant and anti-inflammatory compounds (such as terpenes found in medicinal oils).
  • Insurance: Marinol is covered by most health insurance plans, but medical cannabis is not. If your insurance doesn't cover Marinol, however, it may be more expensive than cannabis.
  • Cost: Medical cannabis can be prohibitively expensive in some states, particularly those that only allow it for medical purposes. However, it is easy and inexpensive to grow.

Side Effects of Marinol and Cannabis

Marinol can affect people differently. Some may experience extreme drowsiness, rapid heart rate (tachycardia), and dry mouth even at the prescribed dose. Others may experience dizziness, drowsiness, confusion, feeling "high," an exaggerated sense of well-being, nausea, vomiting, and stomachache as the body adapts to the medication. A healthcare provider should be notified if these side effects persist or worsen.

Side effects of cannabis include a characteristic "high," dizziness, drowsiness, dry mouth, red eyes, dilated pupils, increased heart rate, increased appetite, euphoria, anxiety, restlessness, impaired coordination, and an altered perception of time and space. Symptoms are often dose-dependent, with higher doses sometimes triggering panic, paranoia, or hallucinations.

How to Use Marinol

When taking Marinol, follow your healthcare provider's instructions or the instructions on the bottle. How you take this medication may differ depending on the condition it is being used to treat. 

To help manage the side effects of chemotherapy, healthcare providers recommend taking Marinol one to three hours before your treatment and every two to four hours afterward, up to six times a day. Take the first dose on an empty stomach at least 30 minutes before a meal or snack. Subsequent doses can be taken with or without food.

When taking Marinol as an appetite stimulant, take it twice a day one hour before lunch and one hour before dinner.  

Marinol capsules should be swallowed whole. If taking the liquid solution, swallow with a 6- to 8-ounce glass of water.  

Your healthcare provider may start you on a lower dose of this medication and then increase it gradually over time. If you have side effects that don't resolve in one to three days, you may need a smaller dose. Marinol may be habit-forming. Do not take this medication more often than needed or in larger doses than prescribed.

Dronabinol dosing options

Marinol oral capsules
  • • 2.5 milligrams (mg)


    • 5 mg


    • 10 mg

Syndros oral solution
  • • 5 mg/mL

What Is Medical Cannabis Used For?

Medical cannabis is used for a range of conditions to treat symptoms ranging from pain to nausea and loss of appetite. Some of the conditions it may be used in include:

  • Cancer
  • HIV/AIDS
  • Epilepsy and other seizure disorders
  • Chronic pain disorders
  • Multiple sclerosis
  • Glaucoma
  • Severe muscle spasms
  • Wasting syndrome

What's the difference between medical cannabis and cannabis?

The primary difference between medical cannabis and recreational cannabis is its purpose. Medical cannabis is intended for medicinal purposes and can only be purchased from a medical dispensary. Medical dispensaries may also offer cannabis products that are higher in THC or CBD to treat a range of different conditions.

Do Marinol and Cannabis Help With Pain?

Marinol and cannabis are both used to treat chronic pain. They are thought to work by blocking pain signals from peripheral nerves.

Cannabis is often used for chronic pain conditions such as neuropathy and cancer-related pain, and to manage pain associated with spasms in people with multiple sclerosis. Review studies have reported mixed findings on the effectiveness of cannabis-based medications. Some studies have reported that smoked cannabis can provide "moderate" relief of chronic pain, but researchers also warn that the side effects may outweigh the benefits.

Other studies have found that Marinol is effective for treating chronic pain, with patients reporting improvements in pain, quality of life, daily function, and sleep. 

Studies have also found that using cannabis to treat pain may reduce or limit the need for opioid pain relief in some people.

Do Marinol and Cannabis Help With Nausea and Appetite?

Studies have found that various forms of medicinal cannabis (including Marinol) can help people undergoing cancer treatment who may be experiencing nausea and/or loss of appetite. Compared to placebo, cannabis has been found to help improve appetite as well as the taste of food and the number of calories consumed.

Marinol has also been found to reduce nausea and vomiting in people who have undergone surgery, however, it has not been found more effective than other medications like ondansetron and may have more side effects.

It is common for people with HIV/AIDs to develop wasting syndrome or the involuntary loss of at least 10% of their body weight. Marinol or smoked cannabis is often recommended as a way to increase appetite in this group, though the evidence for its effectiveness is still unclear. 

Medical cannabis was first legalized in California in 1996 at the height of the HIV crisis. Today, all but three U.S. states and one inhabited territory have some form of legalization on their books. With that being said, as a Schedule I drug, cannabis has only been officially decriminalized in a handful of states.

Synthetic Cannabis Alternatives

Another cannabinoid drug approved by the FDA is Cesamet (nabilone), which contains a synthetic substance that is similar to THC. Cesamet may also be prescribed to people undergoing chemotherapy to help treat nausea and vomiting.

It is also good to keep an eye on other THC products undergoing development, some of which may be appropriate to your needs. One such example is Sativex (nabiximols), a THC mouth spray currently undergoing phase III clinical trials in the United States. The spray has already been approved for use in the United Kingdom for the treatment of neuropathic pain, spasticity, overactive bladder, and other symptoms of multiple sclerosis.

Summary

Ultimately, the choice between Marinol and cannabis is largely dependent on your state laws. In some states, there may be no choice.

If you would like to explore medical cannabis use, start by checking the laws of your state on the National Organization for the Reform of Marijuana Laws (NORML) website. You should then speak with your healthcare provider about the benefits and consequences of each drug as they to apply to your condition and overall health. Try to keep an open mind but take extra care to avoid medical advice from non-medical sources.

12 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Population Health and Public Health Practice; Committee on the Health Effects of Marijuana: An Evidence Review and Research Agenda. The health effects of cannabis and cannabinoids: The current state of evidence and recommendations for research. Therapeutic Effects of Cannabis and Cannabinoids. 2017.

  2. Sihota A, Smith BK, Ahmed SA, et al. Consensus-based recommendations for titrating cannabinoids and tapering opioids for chronic pain control. Int J Clin Pract. 2021;75(8):e13871. doi:10.1111/ijcp.13871

  3. Häuser W, Fitzcharles MA, Radbruch L, Petzke F. Cannabinoids in Pain Management and Palliative Medicine. Dtsch Arztebl Int. 2017;114(38):627-634. doi:10.3238/arztebl.2017.0627

  4. National Library of Medicine. Dronabinol.

  5. National Library of Medicine. Marijuana as medicine? The science beyond the controversy.

  6. Häuser W, Petzke F, Fitzcharles MA. Efficacy, tolerability and safety of cannabis-based medicines for chronic pain management - An overview of systematic reviews. Eur J Pain. 2018;22(3):455-470. doi:10.1002/ejp.1118

  7. Ueberall MA, Horlemann J, Schuermann N, Kalaba M, Ware MA. Effectiveness and tolerability of dronabinol use in patients with chronic pain: A retrospective analysis of 12-week open-label real-world data provided by the German Pain e-Registry. Pain Med. 2022;23(8):1409-1422. doi:10.1093/pm/pnac010

  8. Hill KP, Palastro MD, Johnson B, Ditre JW. Cannabis and pain: A clinical review. Cannabis Cannabinoid Res. 2017;2(1):96-104. doi:10.1089/can.2017.0017

  9. Razmovski-Naumovski V, Luckett T, Amgarth-Duff I, Agar MR. Efficacy of medicinal cannabis for appetite-related symptoms in people with cancer: A systematic review. Palliat Med. 2022;36(6):912-927. doi:10.1177/02692163221083437

  10. Lewandowska J, Kapała JM, Puchała Ł. Therapeutic potential of dronabinol: A systematic review of human trials. Farm Pol. 2021;77(8):477-90. doi:10.32383/farmpol/142693 

  11. Núñez A, Núñez C, Corsi O, Rada G. Are cannabinoids effective for HIV wasting syndrome? Medwave. 2017;17(9):e7107. doi:10.5867/medwave.2017.09.7107

  12. National Center for Complementary and Integrative Health. Cannabis (marijuana) and cannabinoids: What you need to know.

Additional Reading

By Angela Morrow, RN
Angela Morrow, RN, BSN, CHPN, is a certified hospice and palliative care nurse.