Syndros (Dronabinol) for AIDS-Related Weight Loss

Syndros (dronabinol) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) to treat adults with acquired immune deficiency syndrome (AIDS) who have loss of appetite, also called anorexia, along with weight loss.

How Syndros Works and How It’s Taken

Syndros is a type of medicine called a cannabinoid. Its active ingredient is dronabinol. Cannabinoid receptors are found in nerve tissue and may play a role in how dronabinol works.

Dronabinol can help stimulate appetite. Doctors prescribe Syndros when adults with AIDS have anorexia, or loss of appetite, along with weight loss.

Syndros is a liquid medicine taken by mouth. It contains 5 milligrams of dronabinol in each milliliter of liquid.

Typical Dosing for AIDS-Related Anorexia and Weight Loss

The recommended starting dose is 2.1 milligrams twice daily, one hour before lunch and one hour before dinner.

For older adults or people who cannot tolerate this dose, a doctor may start with 2.1 milligrams once daily, one hour before dinner or at bedtime.

If the medicine is well tolerated and more benefit is needed, the dose may be increased gradually. It may first be increased to 2.1 milligrams before lunch and 4.2 milligrams before dinner. If needed and tolerated, it may be increased to 4.2 milligrams before lunch and 4.2 milligrams before dinner.

The maximum dose is 8.4 milligrams twice daily.

This information is based on prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.

Syndros Side Effects

In clinical studies of dronabinol, the active ingredient in Syndros, the most common side effects occurred in about 3 percent to 10 percent of people. These include:

Abdominal (stomach) pain
Dizziness
Euphoria (feeling unusually “high” or very happy)
Nausea
Paranoid reaction (feeling unusually suspicious or fearful)
Sleepiness
Trouble thinking clearly
Vomiting

Serious Side Effects and Warnings

Syndros can cause serious side effects that may require immediate medical attention. These include:

Serious mental health or behavior changes — New or worsening mania, depression, schizophrenia, hallucinations, confusion, or delirium can occur.
Cognitive impairment and altered mental state — Problems with thinking, attention, or awareness can occur.
Hemodynamic instability — Blood pressure or heart rate changes can include low blood pressure, high blood pressure, tachycardia (fast heartbeat), or syncope (fainting).
Seizures — Convulsions or seizurelike activity can occur.
Severe nausea, vomiting, or abdominal pain — These symptoms can be new or worsening and may lead to dehydration or electrolyte problems.
Hypersensitivity (allergic reaction) — Signs can include lip swelling, hives, widespread rash, mouth sores, skin burning, flushing, or throat tightness.
Falls — Injury risk can increase because of dizziness, sleepiness, or fainting, especially in older adults.

Get medical help right away if you think you are having a serious reaction.

How To Save on Syndros

The Syndros Cares Discount Card may help eligible people save on Syndros. People with commercial insurance may pay as little as $0 copay per prescription.

The program also offers a free trial bottle voucher for new patients and a cash-pay discount of up to $400 per bottle.

To learn more, visit the Syndros Cares patient support page or call 877-369-5158.

What To Know Before Taking Syndros

Tell your doctor if you have any allergies to dronabinol, alcohol, or any ingredients in Syndros.

Tell your doctor about all medicines you take or have taken in the last 14 days, including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements.

Also tell your doctor if you:

Have or have had heart problems
Have or have had problems with drug misuse or dependence
Have or have had problems with alcohol misuse or dependence
Have or have had mental health problems, including mania, depression, or schizophrenia
Have had a seizure or have a condition that may increase your risk of seizures

Do not take Syndros if you have had an allergic reaction to dronabinol or alcohol. Do not take it if you are taking, or have taken within the last 14 days, a medicine containing disulfiram or metronidazole.

Syndros is also FDA-approved in adults to treat nausea and vomiting caused by cancer chemotherapy when usual anti-nausea medicines have not worked well enough.

Syndros may cause fetal harm and should be avoided during pregnancy. Tell your doctor if you are pregnant.

If you have HIV, do not breastfeed while taking Syndros because HIV can pass to your baby through breast milk.

Community FAQs

These answers are fact-checked by our editorial staff.

How effective is Syndros for AIDS-related loss of appetite?

The effectiveness of Syndros is based on studies of dronabinol capsules, which contain the same active ingredient. Separately, the prescribing information notes that studies of people with AIDS-related weight loss included 157 people who received dronabinol capsules and 67 who received a placebo (an inactive treatment).

In clinical studies of dronabinol capsules in people with AIDS, the appetite-stimulating effect at the recommended dose lasted for up to five months.

How long does Syndros take to work?

The prescribing information reports that dronabinol capsules have an onset of action of approximately half an hour to one hour, with peak effect about two to four hours after a dose. The appetite-stimulating effect may last for 24 hours or longer.

For Syndros oral solution, the prescribing information does not give a specific time for when appetite improvement begins.

Can Syndros interact with other medicines?

Yes. Syndros can interact with other medicines.

Some important interactions include:

Disulfiram and metronidazole — Syndros contains alcohol and can cause a disulfiram-like reaction when taken with these medicines. Products containing disulfiram or metronidazole should be stopped at least 14 days before starting Syndros and should not be used until seven days after Syndros treatment ends.
Medicines that affect CYP2C9 or CYP3A4 enzymes — Some medicines can raise or lower the amount of dronabinol in the body. This may increase side effects or make Syndros less effective.
Highly protein-bound medicines — Syndros may affect medicines such as warfarin, cyclosporine, or amphotericin B. Your healthcare provider may need to watch for side effects.
Medicines that cause sleepiness, dizziness, confusion, or other mental effects — Taking these with Syndros may increase these effects.
Medicines that affect blood pressure or heart rate — These may increase the risk of low or high blood pressure, a fast heartbeat, or fainting.

Tell your healthcare provider about all medicines you take before starting Syndros, including prescription and over-the-counter medicines.