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Sativex vs Marinol vs Epidiolex vs Real Marijuana: What Are the Differences?

The world of medicinal cannabis can be overwhelming for a newbie.

There’s marijuana, cannabis, cannabidiol (CBD), tetrahydrocannabinol (THC), and the myriad forms it comes in. Then there’s Sativex, Epidiolex, and Marinol, which are pharmaceutically-developed cannabis-based drugs. Depending on where you live and which stores you look in, you will find a different selection of cannabis medicines with different names and formulations.

But what is the difference between all these?

First, let’s take a look at Marinol, Epidiolex, and Sativex.

Marinol (dronabinol)

Marinol or Syndros is a synthetic cannabis-based drug approved by the US Food and Drug Administration in 1985.

Its active ingredient is dronabinol, a synthetic or laboratory-made version of tetrahydrocannabinol (THC), the compound found naturally in marijuana that gets you high. In other words, it’s artificial THC. The FDA approved Marinol to treat nausea and vomiting caused by chemotherapy and weight loss and anorexia caused by AIDS or HIV. Some pharmacies sell the generic version of Marinol (Dronabinol), although they serve the same purpose.

This drug does not contain any other derivatives of the marijuana plant. However, the dronabinol is blended with sesame oil, glycerin, gelatin, and titanium dioxide. Higher dose capsules also contain additional ingredients such as iron oxide.

Marinol and its generic versions are available in capsules with different dosages: 2.5 mg, 5 mg and 10 mg. It should be taken only as directed by your doctor and its effects will be felt approximately 30 minutes to an hour after ingestion. The effects of Marinol last about 4 hours.

Some known side effects of Marinol include confusion, seizures, drowsiness, difficulty concentrating, insomnia, drowsiness, and anxiety. Also, since it contains synthetic THC, it is 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 (nabiximols)

Sativex is another cannabis-based pharmaceutical drug manufactured by GW Pharmaceuticals.

It was specifically approved by the UK Medicines and Healthcare Products Regulatory Agency in the United Kingdom in 2010 for the treatment of spasticity due to multiple sclerosis. Sativex is prescribed to patients suffering from treatment-resistant spasticity caused by multiple sclerosis. It can also be used to treat other side effects of multiple sclerosis, including bladder disorders, pain, trouble sleeping, and tremors.

Formulated as an oral spray, Sativex contains two artificial extracts based on the marijuana plant: THC and CBD. A 100 microliter spray is formulated with 2.5mg of CBD and 2.7mg of THC along with peppermint oil, propylene glycol and ethanol. Usually, patients are prescribed a few pumps by their doctors 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 get relief.

Some common side effects of Sativex include drowsiness, dizziness, fatigue, problems concentrating or memory, and dry mouth. Because this drug contains THC, it is best not to take it if you drive or operate machinery due to possible psychoactive effects.

Sativex can legally be prescribed by doctors in the UK, although access is still severely restricted. It is also available on prescription in other European countries, as well as Norway, Switzerland, Mexico and Turkey.

Epidiolex (cannabidiol)

Epidiolex is a cannabidiol (CBD)-based oral antiepileptic drug approved by the US Food and Drug Administration in 2018 to treat rare forms of seizures, specifically Dravet syndrome and Lennox-Gastaut syndrome. It can also be used to treat tuberous sclerosis complex (TSC). The drug can be taken by patients from two years of age.

When Epidiolex was approved by the FDA, it was a milestone as it was the first drug containing a purified compound of marijuana ever to be legalized by the agency. It is also safe enough to be taken by pediatric epileptics as it contains no THC. Other ingredients in Epidiolex include sesame seed oil, dehydrated alcohol, sucralose, and strawberry flavor.

Epidiolex is taken orally, with a recommended dosage of 10 mg per kilogram of body weight. Depending on the patient’s age and condition, the doctor may recommend increasing the dose by 2.5 mg/kg.

Some of the most common side effects of Epidiolex include drowsiness, loss of appetite, fatigue, jaundice, upper stomach discomfort, fever, diarrhea, increase in liver enzymes, nausea, and vomiting.

Marijuana / Cannabis

The marijuana or cannabis plant contains around 400 compounds, of which around 130 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 of these hundreds of compounds work together when whole plant medicine is consumed in any form. Through the entourage effect, they amplify each other’s therapeutic benefits, although it’s also possible to take isolated forms of compounds, particularly THC and CBD, for each of their own exclusive benefits. Because THC is psychoactive, it is unsafe for young children and some elderly people who are sensitive to it, although consuming THC and CBD in various ratios, particularly a 1:1 ratio, is an excellent way to experience the powerful health benefits of both to enjoy.

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 anti-epileptic properties and ability to reduce anxiety, schizophrenia, addiction, PTSD, and more. These are just a few of the countless health benefits that individuals can enjoy from taking whole plant medicine.

There are also countless brands of cannabis out there, so remember that no two brands are the same. It’s important that you do your own due diligence with brands that are reputable, so you can trust any ingredients they claim to contain. They come in a variety of forms such as edibles, topicals, oils, and capsules. Of course, you can also opt to take whole-plant medicine: smoking cannabis in flower form remains the most popular way of consumption for medical patients.

In addition, marijuana is safer and well-tolerated compared to many drugs. It is, after all, an all-natural plant medicine.


With all the many forms available for consuming marijuana, choosing the right one for your needs can be confusing. You can speak to a doctor who is knowledgeable about cannabis to put you on the right path to having the best experience treating your conditions.


FDA Approved Cannabis Drugs


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