Pharmaceutical compound
Tetrahydrocannabinol/cannabinol/cannabidiol (THC/CBN/CBD ), sold under the brand nameZenivol and also known by its developmental code nameZTL-101 , is acannabinoid medication used for the treatment ofinsomnia . It is approved and marketed inGermany .[ 1]
THC/CBN/CBD is indicated for the management ofinsomnia . Clinical trials have shown that it improvestime to sleep , reducesnighttime awakenings , increasestotal sleep time , and enhancessleep quality andfeeling refreshed after sleep .[ 2] [ 3] [ 4]
The drug is administeredsublingually as aliquid using asyringe about 1 hour before bedtime.[ 1] [ 3] [ 4] δ9 -tetrahydrocannabinol (THC), 1 mgcannabinol (CBN), and 0.5 mgcannabidiol (CBD), corresponding to a 20:2:1 mg/mL ratio.[ 2] [ 3] [ 4] [ 4]
Reportedside effects are generally mild and resolve upon waking.[ 2] [ 3] [ 4] dry mouth ,dizziness ,headache , and "feeling abnormal ".[ 2] [ 3] [ 4]
Thepharmacokinetics of the formulation have been investigated and described in clinical studies.[ 4]
THC is a psychoactivecannabinoid acting as aCB1 andCB2 receptor partial agonist .CBN is a mildly psychoactive cannabinoid that also acts as a CB1 and CB2 receptor partial agonist.CBD does not act as an agonist at cannabinoid receptors but modulates theendocannabinoid system and othermolecular targets .[ 2] [ 4] [ 5] [ 6] sleep architecture , aside from a near-significant 3.5% reduction inREM sleep duration.[ 2] [ 4]
THC/CBN/CBD was approved and launched as apharmaceutical drug for insomnia inGermany in 2022.[ 1] [ 1]
^a b c d "Cannabidiol/tetrahydrocannabinol" .AdisInsight . 25 July 2022. Retrieved1 October 2025 .^a b c d e f Maddison KJ, Kosky C, Walsh JH (2022)."Is There a Place for Medicinal Cannabis in Treating Patients with Sleep Disorders? What We Know so Far" .Nature and Science of Sleep .14 :957– 968.doi :10.2147/NSS.S340949 PMC 9124464 PMID 35611178 . ^a b c d e Lavender I, McGregor IS, Suraev A, Grunstein RR, Hoyos CM (August 2022). "Cannabinoids, Insomnia, and Other Sleep Disorders".Chest .162 (2):452– 465.doi :10.1016/j.chest.2022.04.151 .PMID 35537535 .The most robustly designed study to date examined the safety and efficacy of the cannabinoid formulation ZTL101 (D9-THC 10 mg, CBN 1 mg, and CBD 0.5 mg) relative to placebo in a sample of 23 patients with chronic insomnia disorder.11 Participants self-administered ZTL-101 one hour prior to bedtime for 2 weeks, with the option to double the dose after the fourth night (52% of participants increased the dose). ZTL-101 improved subjective sleep quality by 5.1 points (95% CI, –7.3 to –2.9) on the Insomnia Severity Index and improved self-reported sleep-onset latency, total sleep time, subjective sleep quality, and feelings of rest upon waking. Actigraphy measures indicated reduced wake following sleep onset and increased total sleep time; however, no differences in polysomnography indexes were observed.11 Headaches, xerostomia, dizziness, and "feeling abnormal" were reported more frequently with active treatment (n = 17) than with placebo (n = 4), but these adverse events were self-limiting and did not persist upon wake. ^a b c d e f g h i Walsh JH, Maddison KJ, Rankin T, Murray K, McArdle N, Ree MJ, et al. (November 2021)."Treating insomnia symptoms with medicinal cannabis: a randomized, crossover trial of the efficacy of a cannabinoid medicine compared with placebo" .Sleep .44 (11) zsab149.doi :10.1093/sleep/zsab149 .PMC 8598183 PMID 34115851 . ^ Sampson PB (January 2021). "Phytocannabinoid Pharmacology: Medicinal Properties ofCannabis sativa Constituents Aside from the "Big Two"Journal of Natural Products .84 (1):142– 160.doi :10.1021/acs.jnatprod.0c00965 .PMID 33356248 . ^ Britch SC, Babalonis S, Walsh SL (January 2021)."Cannabidiol: pharmacology and therapeutic targets" .Psychopharmacology .238 (1):9– 28.doi :10.1007/s00213-020-05712-8 .PMC 7796924 PMID 33221931 .
GABAA receptor Others: Alcohols (e.g.,ethchlorvynol ,amylene hydrate ,ethanol )Barbiturates (e.g.,amobarbital ,pentobarbital ,phenobarbital ,secobarbital )Bromides (e.g.,potassium bromide ,sodium bromide )Carbamates (e.g.,meprobamate )Chloral hydrate Clomethiazole Kava Neurosteroids (e.g.,progesterone ,zuranolone † )Paraldehyde Piperidinediones (e.g.,glutethimide )Quinazolinones (e.g.,methaqualone )Sulfonmethane Valerian Antihistamines (H1 receptor inverse agonists )Orexin receptor antagonists Melatonin receptor agonists Others α1 -Adrenergic receptor antagonists (e.g.,prazosin )α2 -Adrenergic receptor agonists (e.g.,clonidine )Antipsychotics (e.g.,quetiapine ,olanzapine ,risperidone ,chlorpromazine )Ashwagandha Benzoctamine Cannabinoids (e.g.,cannabis ,dronabinol ( THC) ,nabilone ,Zenivol )Chamomile Fenadiazole GABAA receptor agonists (e.g.,gaboxadol (THIP)† ,muscimol ,Amanita muscaria GABAB receptor agonists (e.g.,sodium oxybate (γ-hydroxybutyrate (GHB)),baclofen ,phenibut )GABA reuptake inhibitors (e.g.,tiagabine )Gabapentinoids (e.g.,gabapentin ,gabapentin enacarbil ,pregabalin )Hops Lavender Menthyl isovalerate Opioids (e.g.,hydrocodone ,oxycodone ,morphine )Passion flower Scopolamine Serotonin precursors (tryptophan ,5-hydroxytryptophan (5-HTP;oxitriptan ))Phenylpiperazines (e.g.,trazodone ,niaprazine )Theanine Tricyclic antidepressants (e.g.,amitriptyline ,doxepin ,trimipramine )Tetracyclic antidepressants (e.g.,mirtazapine )Valnoctamide
Phytocannabinoids comparison )
Cannabibutols Cannabichromenes Cannabicyclols Cannabidiols Cannabielsoins Cannabigerols Cannabiphorols Cannabinols Cannabitriols Cannabivarins Delta-3-tetrahydrocannabinols Delta-4-tetrahydrocannabinols Delta-7-tetrahydrocannabinols Delta-8-tetrahydrocannabinols Delta-9-tetrahydrocannabinols Delta-10-Tetrahydrocannabinols Delta-11-Tetrahydrocannabinols Miscellaneous cannabinoids Active metabolites
Endocannabinoids Synthetic
Classical cannabinoids Non-classical Adamantoylindoles Benzimidazoles Benzoylindoles Cyclohexylphenols Eicosanoids Indazole-3- Indole-3-carboxamides Indole-3-carboxylates Naphthoylindazoles Naphthoylindoles Naphthoylpyrroles Naphthylmethylindenes Naphthylmethylindoles Phenylacetylindoles Pyrazolecarboxamides Tetramethylcyclo- Tetramethylcyclo- Others
Allosteric CBR Tooltip Cannabinoid receptor ligands Endocannabinoid (inactivation inhibitors) Anticannabinoids (antagonists/inverse
Receptor (ligands )
CB1 Tooltip Cannabinoid receptor type 1
Agonists(abridged,full list ) Inverse agonists Antagonists
CB2 Tooltip Cannabinoid receptor type 2
Agonists 2-AG 2-AGE (noladin ether) 3,3'-Diindolylmethane 4-O-Methylhonokiol α-Amyrin · β-Amyrin A-796,260 A-834,735 A-836,339 AM-1172 AM-1221 AM-1235 AM-1241 AM-2232 Anandamide AZ-11713908 Cannabinol Caryophyllene CB-13 CBS-0550 CP 55,940 GW-405,833 (L-768,242) GW-842,166X HU-308 JTE 7-31 JWH-007 JWH-015 JWH-018 JWH-73 JWH-133 L-759,633 L-759,656 Lenabasum (anabasum) Magnolol MDA-19 Nabitan NADA Olorinab (APD-371) PF-03550096 S-444,823 SER-601 Serinolamide A UR-144 Tedalinab THC (dronabinol) THCV Tetrahydromagnolol Virodhamine Antagonists
NAGly GPR18)
GPR55
GPR119
Transporter (modulators )
eCBTs Tooltip Endocannabinoid transporter
Enzyme (modulators)
Others Others: 2-PG (directly potentiates activity of 2-AG at CB1 receptor) ARN-272 (FAAH-like anandamide transporter inhibitor)
