Comparative Pharmacology
Head-to-head clinical analysis: MARINOL versus MEZOFY.
Peer-Reviewed Evidence
Head-to-head clinical analysis: MARINOL versus MEZOFY.
MARINOL vs MEZOFY
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Dronabinol is a cannabinoid receptor agonist at CB1 and CB2 receptors. It stimulates appetite and reduces nausea/vomiting via central CB1 receptor activation.
MEZOFY is a selective serotonin reuptake inhibitor (SSRI) that potentiates serotonergic activity in the CNS by inhibiting the reuptake of serotonin at the presynaptic neuronal membrane.
Dronabinol (Marinol) 2.5 mg orally twice daily, titrated to 5–20 mg daily in divided doses; max 20 mg/day. For chemotherapy-induced nausea/vomiting: 5 mg/m² orally 1–3 hours before chemotherapy, then every 2–4 hours up to 6 doses/day. For anorexia: 2.5 mg orally twice daily (before lunch and dinner).
MEZOFY (mexiletine) 200 mg orally every 8 hours; may increase to 300 mg every 8 hours if needed.
None Documented
None Documented
Dronabinol terminal half-life is 25–36 hours in adults, with a prolonged elimination phase (25–36 h) due to enteric recirculation. Chronic users may exhibit a shorter half-life due to enzyme induction.
Terminal half-life: 8-12 hours (mean 10 h); prolonged in renal impairment (up to 24 h in CrCl <30 mL/min)
Primarily fecal (65%) with biliary excretion; renal excretion of metabolites accounts for ~20% (mostly as glucuronide conjugates). Less than 5% of unchanged drug is excreted renally.
Renal: 60% unchanged; biliary/fecal: 25% as metabolites; 15% other
Category C
Category C
Antiemetic
Antiemetic/Antivertigo