Will the Real Mary Jane Please Stand Up?
Sativex vs. Marinol vs. Epidiolex vs. Real Marijuana: What Are The Differences?
The world of cannabis medicine can be overwhelming for a newbie to navigate.
There’s marijuana, cannabis, cannabidiol (CBD), tetrahydrocannabinol (THC), and the myriad of forms it comes in. Then there’s Sativex, Epidiolex, and Marinol, which are pharmaceutically-developed, cannabis-based medications. Depending where you live and what shops you’re looking in, you’ll find a different array of cannabis medicines in various names and formulations.
But what’s the difference between all these?
Let’s take a look at Marinol, Epidiolex, and Sativex first.
Marinol or Syndros is a synthetic cannabis-based drug that was approved by the US Food and Drug Administration in 1985.
Its active ingredient is dronabinol, which is a synthetic or laboratory-made version of tetrahydrocannabinol (THC), the compound found in natural marijuana that gets you high. In other words, it’s man-made THC. The FDA approved Marinol for treating nausea and vomiting caused by chemotherapy, as well as weight loss and appetite loss due to AIDS or HIV. Some pharmacies sell the generic version of Marinol (dronabinol), though they serve the same purpose.
This medication doesn’t contain any other derivatives of the marijuana plant. However, the dronabinol is mixed with sesame oil, glycerin, gelatin, and titanium dioxide. Higher dosage capsules also contain additional ingredients such as iron oxide.
Marinol and its generic versions are available in capsules with varying dosages: 2.5mg, 5mg, and 10mg. It should only be taken as prescribed by your doctor, and its effects will be felt around 30 minutes to an hour after you have consumed it. The effects of Marinol last around 4 hours.
Some known side effects of Marinol include confusion, seizures, lightheadedness, difficulty concentrating, insomnia, drowsiness, and anxiety among others. Since it contains synthetic THC, it’s also common for patients to experience a high, and thus should not operate machinery or drive vehicles.
Dronabinol is sold as Marinol or Syndros in many countries around the world, including the United States as well as Australia, South Africa, and Germany.
Sativex is another cannabis-based pharmaceutical drug that is manufactured by GW Pharmaceuticals.
It was approved for use in the UK in 2010 by the UK Medicines and Healthcare products Regulatory Agency, specifically for the treatment of spasticity due to multiple sclerosis. Sativex is prescribed for patients who suffer from treatment-resistant spasticity caused by multiple sclerosis. It can also be used to treat other side effects of multiple sclerosis including bladder conditions, pain, sleep problems, and tremors.
Sativex is formulated as a mouth spray, and contains two man-made extracts based on the marijuana plant: THC and CBD. A 100-microliter spray is formulated with 2.5mg of CBD and 2.7 mg THC, together with peppermint oil, propylene glycol, and ethanol. Normally, patients are prescribed by their doctors to take a few pumps depending on their condition, which can gradually increase over the course of a few days or weeks. Different patients may need different doses of Sativex to obtain relief.
Some common side effects of Sativex include drowsiness, dizziness, fatigue, problems with concentration or memory, and dry mouth. Since this medication contains THC, it’s best not to take it if you will be driving or operating machinery due to potential psychoactive effects.
Sativex can be legally prescribed by doctors in the United Kingdom, though access is still highly restricted. It’s also available for prescription in other European nations plus Norway, Switzerland, Mexico, and Turkey.
Epidiolex is a cannabidiol (CBD) based oral antiepileptic drug that was approved by the US Food and Drug Administration in 2018 to treat rare forms of seizures, specifically the Dravet syndrome and Lennox-Gastaut syndrome. It can also be used to treat tuberous sclerosis complex (TSC). The medication can be taken by patients aged two years old and up.
When Epidiolex was approved by the FDA, it was a milestone moment as it was the first drug containing a purified compound of marijuana to ever be legalized by the agency. It’s also safe enough to be taken by pediatric epileptic patients since it does not contain any THC. Other components of Epidiolex include sesame seed oil, dehydrated alcohol, sucralose, and strawberry flavoring.
Epidiolex is taken by mouth, with a recommended dosage of 10mg for every kilogram of body weight. Depending on the age and condition of the patient, doctors may recommend increasing dosage of 2.5mg/kg.
Some of the common side effects of Epidiolex sleepiness, a decrease in appetite, fatigue, jaundice, discomfort in the upper stomach area, fever, diarrhea, increase in liver enzymes, nausea, and vomiting among others.
Marijuana / Cannabis
The marijuana or cannabis plant contains around 400 compounds, some 130 of which are cannabinoids while the rest are other non-cannabinoid compounds such as terpenes and flavonoids among others. However, the main compounds are THC (psychoactive) and CBD (non-psychoactive).
All these hundreds of compounds work together when whole-plant medicine is consumed in any form. Through the entourage effect, they strengthen each others’ therapeutic benefits, though taking isolated forms of compounds particularly THC and CBD for each of their own exclusive benefits is possible as well. Since THC is psychoactive, it is not safe for toddlers and some of the elderly who are sensitive to it, though consuming both THC and CBD in various ratios especially in 1:1 ratio is an excellent way to enjoy the potent health benefits of each.
THC can get you high but more importantly, it’s also a powerful antioxidant, anti-inflammatory, and analgesic. On the other hand, CBD is touted for its powerful antiepileptic properties and its ability to help reduce anxiety, schizophrenia, addiction, PTSD, and much more. These are only some of the countless health benefits that individuals can enjoy from taking whole plant medicine.
There are also countless cannabis brands out there, so remember that no two brands are alike. It’s important to do your own due diligence on brands that are reputable so that you can trust all the ingredients they say they contain. They come in a wide array of forms such as edibles, topicals, oils, and capsules. Of course, you can also choose to take whole plant medicine: smoking cannabis in flower form remains to be the most popular way to consume for medical patients.
Additionally, marijuana is safer and well tolerated compared to numerous pharmaceutical drugs. It’s all-natural plant medicine, after all.
With all the many forms available for consuming marijuana, choosing the right one for your needs can be confusing. You can speak to a cannabis-knowledgeable doctor to set you on the right path so that you have the best experience in treating your conditions.