Graphic of Sativex spraying mist

Sativex (nabiximols)

Sativex is the brand name for a cannabis-based drug called nabiximols. It’s the only drug in the UK with a licence to treat muscle stiffness and spasms (spasticity) caused by MS. A licence gives permission for a medicine to be used to treat certain symptoms. 

What is Sativex? 

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

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

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How do I take Sativex?

Sativex is a mouth spray (sometimes called an oromucosal spray) and you start off taking one dose a day. You then slowly add more doses until you get the most relief from your symptoms. You mustn’t take more than 12 doses of Sativex a day.

How well does Sativex work?

Sativex doesn’t work for lots of people. But for those it does work for, their spasticity symptoms get significantly better. Around half 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.

What MS symptoms can Sativex help with?

Sativex only has a licence to treat spasticity but some people say it helps with their other MS symptoms, including:

  • bladder problems
  • difficulty sleeping
  • 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?

Sativex is available on the NHS in England and Wales for some people with MS. It’s not recommended for people under 18. Sativex is not available on the NHS in Scotland and Northern Ireland.

In England, the National Institute for Health and Care Excellence (NICE) recommends which drugs you can get on the NHS. 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.

In Wales, Sativex has been available like this since 2014.  

We want to see it made available on the NHS in Scotland and Northern Ireland too, and hope this will happen soon. 

Getting treatments on the NHS doesn’t just depend on a recommendation from NICE or from the Scottish Medicines Consortium, which makes these decisions in Scotland. It might still be difficult to get because the NHS in some regions might not agree to pay for it, 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.

Our cannabis factsheet has more about access to cannabis-based treatments for MS symptoms.

What are the side effects of Sativex?

The side effects of Sativex can 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 fade after a few weeks. You can reduce them by taking fewer doses. If you get soreness in your mouth from taking Sativex, you can avoid this by changing the part of your mouth you spray on.

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

Does Sativex cause problems with memory, thinking or mental health?

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

But you shouldn’t take Sativex if you’ve had certain serious mental health problems.

Can I take Sativex if I’m pregnant or breastfeeding?

You shouldn’t use Sativex if you’re pregnant or breastfeeding.

Can I drive and operate machinery if I take 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.