Dronabinol (synthetic THC) is approved for appetite loss in AIDS and shows promise in cancer | Research

The takeaway

A review of dronabinol for anorexia and weight loss found it FDA-approved for HIV/AIDS-related appetite loss, with growing but inconclusive evidence for cancer-related cachexia.

Read this if you or someone you know is dealing with appetite loss from HIV/AIDS or cancer and considering dronabinol.

FDA-approved for HIV/AIDS appetite loss since 1985; no cancer indication yet

What the researchers found

Researchers reviewed the evidence for dronabinol, a synthetic form of THC, in treating anorexia and weight loss associated with HIV/AIDS and cancer. Dronabinol works by acting on cannabinoid receptors in the brain that control appetite and prevent vomiting.

For HIV/AIDS, dronabinol has been FDA-approved since 1985 in capsule form, with a newer oral solution approved in 2016. The oral solution provides an "easy-to-swallow" alternative that may improve adherence in patients who struggle with capsules.

For cancer-related anorexia and weight loss, there is no approved indication despite the condition being common and debilitating. The review noted a lack of standardized definitions and recent clinical data in both settings, making it difficult to quantify the true incidence of the problem and the treatment response. The pharmacokinetic considerations of the newer oral solution formulation were also characterized.

Why it matters

Appetite loss and wasting are devastating complications of HIV/AIDS and cancer that significantly reduce quality of life and survival. Dronabinol remains one of the few FDA-approved options specifically targeting appetite stimulation, and the newer oral solution formulation may improve access for patients with swallowing difficulties.

The numbers in context

Dronabinol oral capsule FDA-approved in 1985. Oral solution approved in 2016. Available in two formulations: oral capsule and oral solution. Indicated for HIV/AIDS-related anorexia. No approved indication for cancer-related anorexia.

How the study worked

This was a narrative review of available data on oral dronabinol formulations for the management of anorexia and weight loss in HIV/AIDS and cancer, including pharmacotherapeutic considerations of the newest oral solution formulation.

What this study cannot tell us

This is a narrative review without systematic search methodology. The lack of standardized definitions for anorexia in these populations limits the ability to compare studies. Much of the clinical data for dronabinol is dated. The review focuses on dronabinol specifically and does not compare it to whole-plant cannabis products or other cannabinoid formulations.

How to read the evidence

This is a narrative review summarizing available evidence on an FDA-approved medication, providing moderate-level clinical guidance.

When this study was published

Published in 2018. The dronabinol oral solution (approved 2016) was relatively new at the time of this review.

The bigger picture

The use of cannabinoids for appetite stimulation was one of the earliest medical applications of cannabis. While dronabinol has been available for decades, the lack of robust recent clinical data and the absence of a cancer indication highlight how slowly cannabinoid therapeutic research has progressed, even for well-established applications.

Questions still open

How does dronabinol compare to whole-plant cannabis products for appetite stimulation? Could the oral solution formulation improve outcomes through better adherence? What standardized endpoints should be used to study appetite and weight in HIV/AIDS and cancer?

Common questions

Is synthetic THC approved for appetite loss?

Dronabinol (synthetic THC) is FDA-approved for treating anorexia associated with weight loss in AIDS patients. It is available as both capsules (since 1985) and an oral solution (since 2016). It is not approved for cancer-related appetite loss, though it is sometimes used off-label.

How does dronabinol work for appetite?

Dronabinol activates cannabinoid receptors in the brain that control appetite and nausea. It directly stimulates the appetite center and suppresses the vomiting center, which can help patients eat more and keep food down.

Read the original research

Dronabinol oral solution in the management of anorexia and weight loss in AIDS and cancer.

Therapeutics and clinical risk management, 14, 643-651

View on PubMed ↗Publisher’s paper ↗

Citation

Badowski, Melissa E; Yanful, Paa Kwesi. (2018). Dronabinol oral solution in the management of anorexia and weight loss in AIDS and cancer.. Therapeutics and clinical risk management, 14, 643-651. https://doi.org/10.2147/TCRM.S126849