Provider Briefing: Marinol (Dronabinol) Supply in 2026

For clinicians prescribing Dronabinol — whether for chemotherapy-induced nausea and vomiting (CINV) or AIDS-related anorexia — the intermittent supply challenges of the past several years have created real clinical consequences. A 2025 retrospective study documented the negative outcomes when patients lost access to Dronabinol due to supply disruptions, reinforcing what many providers already know from their practice: medication access directly affects patient outcomes.

This article provides a clinical overview of the current Marinol supply situation, prescribing considerations, available alternatives, and tools to help your patients maintain access to therapy.

Timeline: How We Got Here

Dronabinol's supply challenges are not new, but they've evolved over time:

• 1985: Dronabinol (Marinol) first approved by the FDA as a Schedule II controlled substance for CINV
• 1992: Additional approval for AIDS-related anorexia with weight loss
• 1999: DEA rescheduled Marinol from Schedule II to Schedule III based on lower abuse potential relative to the sesame oil formulation and oral route
• 2016: Syndros (dronabinol oral solution) approved; classified as Schedule II due to liquid formulation
• 2017-present: Multiple periods of intermittent supply disruption affecting both brand and generic dronabinol capsules
• 2025: Peer-reviewed evidence published documenting clinical impact of dronabinol shortage on chronic pain patients
• 2026: Dronabinol is not on the FDA's official shortage list but regional availability remains inconsistent

Prescribing Implications

The supply inconsistency creates several practical challenges for prescribers:

Controlled Substance Logistics

As a Schedule III substance, Dronabinol prescriptions can be refilled up to 5 times within 6 months. However, if a patient's pharmacy can't source the medication, the prescription may need to be transferred or a new one written for an alternative pharmacy. Unlike Schedule II medications, Schedule III prescriptions can be called in or e-prescribed, which provides some flexibility.

Prior Authorization Delays

Many insurance plans require prior authorization for Dronabinol, particularly for the CINV indication where step therapy through conventional antiemetics (5-HT3 antagonists, NK1 antagonists) is typically required first. When combined with supply issues, the PA process can further delay patient access. Having documentation of failed conventional therapy readily available can expedite approvals.

Patient Communication

Patients who suddenly can't access their Dronabinol may experience both physical withdrawal symptoms (irritability, insomnia, restlessness, hot flashes, diarrhea) and disease-related symptom recurrence. Proactive communication about the supply situation and contingency plans is essential.

Current Availability Picture

As of early 2026:

• FDA shortage status: Not officially listed
• Real-world availability: Inconsistent; varies by region, pharmacy type, and manufacturer
• Brand-name Marinol: Limited availability at many retail pharmacies
• Generic Dronabinol capsules: More widely available than brand, but still subject to intermittent gaps
• Syndros (oral solution): Available through specialty pharmacies; Schedule II designation adds prescribing complexity

Specialty pharmacies serving oncology and HIV/AIDS populations generally maintain more reliable stock than retail chains. Hospital outpatient pharmacies are another option for patients in active treatment.

Cost and Access Considerations

Cost remains a significant barrier for many patients:

• Brand Marinol: $300-$800 for 30 capsules (cash price)
• Generic Dronabinol: ~$380 retail; as low as $58 with discount programs
• Insurance: Generally covered on formulary with prior authorization; Medicare Part D plans typically cover generic
• Patient assistance: No active manufacturer savings program for Marinol; third-party services (Prescription Hope) offer access for ~$70/month; NeedyMeds and RxAssist list additional programs

For patients struggling with cost, our provider's guide to helping patients save on Marinol offers specific strategies you can incorporate into your workflow.

Tools and Resources for Providers

Medfinder for Providers

Medfinder enables providers and clinical staff to search for pharmacies with Dronabinol in stock in real time. This can be incorporated into the prescribing workflow — before sending a prescription, check availability at nearby pharmacies and direct the patient accordingly.

Prescribing Alternatives

When Dronabinol is unavailable, the following alternatives should be considered based on indication:

For CINV:

• Nabilone (Cesamet) — Synthetic cannabinoid, Schedule II. Dosed 1-2 mg BID. Most pharmacologically similar to Dronabinol.
• Ondansetron (Zofran) — 5-HT3 antagonist. First-line antiemetic, widely available, not controlled. Available in multiple formulations.
• Granisetron, Palonosetron — Additional 5-HT3 options with different pharmacokinetic profiles
• Aprepitant/Fosaprepitant (Emend) — NK1 receptor antagonist for highly emetogenic regimens

For AIDS-related anorexia:

• Megestrol Acetate (Megace) — Progestational agent, FDA-approved for AIDS-related cachexia. Available as oral suspension. Note: carries risk of thromboembolism and adrenal suppression.
• Mirtazapine — Antidepressant with appetite-stimulating properties; off-label use

For detailed information on these alternatives, see our clinical overview of alternatives to Marinol.

Documentation Support

When switching patients to alternatives or requesting prior authorization, document:

• Previous trials of conventional antiemetics and response
• Duration of Dronabinol therapy and clinical benefit
• Evidence of pharmacy stock-out (pharmacy name, date, NDC if available)
• Clinical rationale for continued cannabinoid therapy if switching to Nabilone

Looking Ahead

Several factors suggest the supply picture may gradually improve:

• Additional generic manufacturers entering the market
• Potential DEA quota adjustments reflecting updated demand data
• Growing recognition of supply chain vulnerabilities for controlled substances at the regulatory level

However, given the structural constraints of controlled substance manufacturing, intermittent disruptions are likely to continue. Building flexibility into prescribing workflows — including familiarity with alternatives and use of real-time availability tools — remains the most practical approach.

Final Thoughts

The Marinol supply situation in 2026 requires providers to be both proactive and adaptive. While the medication is not in official shortage, the real-world availability gap affects patient outcomes. Using tools like Medfinder for Providers, maintaining familiarity with therapeutic alternatives, and communicating proactively with patients about contingency plans are the most effective strategies for managing this ongoing challenge.

For a patient-focused companion to this article, see our Marinol shortage update for patients. For practical steps to help your patients access medication, read our provider's guide to finding Marinol in stock.