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Dronabinol oral solution in the management of anorexia and weight loss in AIDS and cancer.
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Summary
Narrative review on oral dronabinol solution (synthetic THC) for anorexia and weight loss in the context of HIV/AIDS and cancer. Dronabinol acts centrally on appetite and vomiting centers and increases appetite; it is approved in the USA for the treatment of anorexia and weight loss in HIV/AIDS, but there is no approved indication for cancer-related anorexia/cachexia. The oral solution approved in 2016 offers an alternative that is easier to swallow than the capsule. No pooled quantitative effect estimates, purely narrative summary of available data; low strength of evidence.
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Abstract
The true incidence of anorexia secondary to human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) and cancer is not well classified owing to the fact that there is a lack of standardized definitions and recent clinical data in these settings. Dronabinol, or Δ-9-tetrahydrocannabinol, is a synthetic molecule that closely mimics the action of <i>Cannabis sativa</i> L., a naturally occurring compound activated in the central nervous system by cannabinoid receptors. Dronabinol exerts its effects by directly acting on the vomiting and appetite control centers in the brain, which in turn increases appetite and prevents vomiting. In the USA, dronabinol is currently available in two dosage formulations - oral capsule and oral solution. While the oral capsule was initially approved by the US Food and Drug Administration in 1985, the recent approval of the oral solution in 2016 presents an "easy-to-swallow" alternative for patients using or intending to use dronabinol. Dronabinol is indicated in adult patients with HIV/AIDS for the treatment of anorexia and weight loss. However, there is no approved indication in the setting of cancer-related anorexia and weight loss. This review aims at presenting available data on the use of oral dronabinol in the management of anorexia and weight loss in HIV/AIDS and cancer, as well as characterizing and highlighting the pharmacotherapeutic considerations of the newest formulation of dronabinol.
The impediment to action advances action.