Illustration of Sativex spray

Sativex

Sativex is a cannabis-based medicine. It’s used to treat the common MS symptom of muscle stiffness and spasms (known as ‘spasticity’). 

It was the first MS drug based on cannabis to get a licence in the UK. A licence gives permission for a medicine to be used to treat certain symptoms.

What is Sativex?

This is the brand name for a drug called nabiximols. It’s the only drug in the UK with a licence to treat spasticity caused by MS.

Sativex is a spray you use in your mouth. In it are two chemicals from the cannabis plant called cannabinoids. They’re in an equal mix of tetrahydrocannabinol (THC) and cannabidiol (CBD).

You start off taking one dose a day. You then slowly add more doses you get the most relief from your symptoms. You mustn’t take more than 12 doses a day.

How well does this drug work?

Sativex doesn’t work for lots of people. But for those it does work for, their spasticity symptoms get significantly better. Around half of the people in one study found it reduced their symptoms by 20% within four weeks.

If the drug hasn’t had an effect on your spasticity symptoms after four weeks, you usually stop taking it.

Sativex only has a licence to treat spasticity but some people say it helps with their other MS symptoms. These include pain, bladder problems, difficulty sleeping and tremor (uncontrolled shaking of the leg or arm). A 2014 study found the drug didn’t help with tremor, but that it was ‘probably effective’ for spasticity, pain and bladder problems.

Can I get Sativex?

The National Institute for Health and Care Excellence (NICE) recommends which drugs you can get on the NHS in England. In 2014 it decided Sativex didn’t give people enough benefit to justify its cost. Because of this, the drug isn’t available on the NHS in England. The drug’s makers have never tried to get it recommended in Scotland or Northern Ireland, so you can’t have it on the NHS there either.

The makers of Sativex and health regulators can’t agree on a deal that would allow people to get the drug on the NHS in England, Scotland & Northern Ireland. We want to see Sativex made available on the NHS across the UK so that more people with MS can benefit from it.

In Wales:

A separate organisation can decide if a drug is made available on the NHS in Wales (the All-Wales Medicines Strategy Group). It decided in 2014 that Sativex was worth the money it costs, so could be paid for by the NHS.

Since then doctors can prescribe the drug to you if you live in Wales and your spasticity is ‘moderate’ to ‘severe’, and other treatments haven’t worked for you (such as baclofen). There’s been concern that Sativex is still hard to get in Wales. But in all Local Health Boards in Wales there are now clinics set up that should be able to prescribe it.

A small number of people in the rest of the UK have been able to get the NHS to pay for Sativex. In some cases their doctors helped them make a successful Individual Funding Request (IFR) to the local NHS to pay for it. But people are more likely to be turned down than given the drug. In Scotland this is called an Individual Patient Treatment Request.

Wherever you live in the UK, you can get Sativex on a private prescription. It costs around £500 for a month’s supply, depending on the size of the dose. It’s mainly prescribed by neurologists.

Since cannabis was legalised as a medicine:

In November 2018 the law in the UK about using cannabis-based products as a medicine changed. In theory, this made it easier for neurologists to prescribe these products to a small number of people with MS.

The change in the law didn’t cover getting Sativex on the NHS. So this drug is no easier to get now than it was before.

Side effects of Sativex

These include:

  • feeling sick
  • feeling sleepy
  • dizziness
  • tiredness
  • diarrhoea
  • headaches
  • a dry mouth

Sativex could make some MS symptoms worse, such as fatigue.

Side effects tend to get less after a few weeks. You can reduce them by taking fewer doses. You can avoid soreness in the mouth by changing the part of your mouth you spray on.

Some people report a feeling similar to the ‘high’ you get from smoking cannabis. This is caused by the THC in Sativex.

You can still drive if you use Sativex, but not when it’s making you feel sleepy, dizzy, or is affecting your concentration or eyesight. This goes for other dangerous activity like operating machinery.

For some people cannabis causes problems with their memory, thinking, mental health, or they become dependent on it. These aren’t seen in people who use Sativex, despite it having THC in it.

You shouldn’t use this drug if you’re pregnant or breastfeeding, under 18, or have had certain serious mental health problems.