Marinol is an encapsulated synthetic preparation of THC, the primary psychoactive cannabinoid found in the cannabis plant, suspended in sesame oil. It was created and marketed initially to treat nausea and vomiting associated with cancer chemotherapy in people who failed to respond adequately to conventional treatments. Later it was made available for the treatment of anorexia associated with weight loss for people living with HIV/AIDS. Marinol's oral route of administration, however, hampers its effectiveness because of slow absorption and difficulty in controlling dosing.
In a review by the Institute of Medicine, Marinol was found to have only about a 10-20% absorption rate in one oral dose. And it takes two to four hours to take effect. By contrast, inhalation yields very rapid onset of therapeutic effects, allowing for both more immediate relief and control over dosage.
Cesamet is a synthetic derivative of THC with a slightly modified molecular structure from Marinol. Currently available for medical use in Canada, United Kingdom, and Mexico, it was approved by the FDA in 1985 for treatment of chemotherapy-induced nausea and vomiting.
Although Cesamet was approved more than twenty years ago, it has only been marketed in the United States since 2006 as a treatment for nausea and vomiting caused by cancer chemotherapy
Epidiolex is the most recent cannabis-derived pharmaceutical drug to be approved by the FDA for the treatment of 3 seizure disorders that primarily affect children - Tuberous Sclerosis Syndrome, Lennox-Gastaut Syndrome and Dravet syndrome. It was approved in 2019 and is only the second pharmaceutical drug to be derived directly from the cannabis plant.
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