Graphic of Sativex spraying mist

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 your spasticity symptoms haven’t got better by at least 20% after 4 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 2019 it decided Sativex could be available to people in England with ‘moderate’ to ‘severe’ spasticity. This is only when other treatments haven’t helped.

Sativex has already been available in Wales since 2014. We want to see it made available on the NHS in Scotland and Northern Ireland too, and hope this will happen soon.

It may still not be easy to get Sativex even if you live in a nation of the UK where it’s available on the NHS. That’s because the NHS in some regions might not agree to pay for it the drug or local prescribers decide not to give it to people.   

All the same, it could still be worth talking to your doctor about your chances of getting a prescription for Sativex.

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.