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What is Sativex (Nabiximols)?

Sativex, also known as Nabiximols, is a pharmaceutical cannabis extract containing THC and CBD in a 1-to-1 ratio.

The compounds in the cannabis plant are known to treat various health conditions. By extracting THC and CBD, as well as a variety of terpenes and flavonoids, it’s possible to deliver them in a distilled and standardized product.

GW Pharmaceuticals, a UK-based company, manufactures a cannabinoid oral spray known as Sativex. The product contains THC, CBD, as well as other cannabinoids and terpenes.

Sativex has been approved for medical use in 30 countries, with 21 of them authorized to market it as a treatment for MS spasticity.

What is Sativex?

What is Sativex?

Sativex, also known as nabiximols, is a cannabis-based oral spray. It is the first pharmaceutical drug made with ingredients extracted from the cannabis plant. Sativex contains an equal 1:1 ratio of THC and CBD. It also contains a variety of other compounds found in cannabis.

Sativex was developed by a UK company called GW Pharmaceuticals. The company received an exclusive, government-issued license in 1998 to cultivate cannabis for research purposes.

Sativex is fairly expensive and is only available by prescription in certain countries, such as Canada, Australia, the United Kingdom, and Spain. Sativex is not available in the United States, but is currently awaiting FDA approval as a treatment for cancer pain.

How It Works

Sativex comes as a peppermint flavoured mouth spray. Each 100 microlitre spritz delivers 2.7mg of THC and 2.5mg of CBD directly to the mouth, tongue and cheeks. The active ingredients are absorbed into the bloodstream through the inner linings of the mouth.

Administering the drug in this manner allows it to take effect instantly, unlike edibles which can take up to an hour to take effect since they must be digested before the cannabinoids can enter the bloodstream.

Despite being a highly researched and specialized product, like many pharmaceuticals Sativex still has side effects.

In clinical trials some patients reported anxiety, mood changes, and paranoia. These effects, however, were relatively mild and well-tolerated, and quickly subsided with discontinuation of the drug.

For any individual user, it can take up to two weeks of experimentation with varying dosages and timings of dosages to find the ideal treatment schedule.

Benefits of Sativex

Benefits of Sativex
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Sativex has been shown to stop muscle spasms in people with MS, and it also reduces nerve pain and improves sleep. It contains an even mix of THC and CBD, and the two cannabinoids have a synergistic effect when consumed together.

For example, CBD is known to mitigate the anxiety and paranoia-inducing effects of THC. Since Sativex contains equal measures of both, users can expect to experience less severe side effects when taking Sativex.

Sativex also contains many terpenes, the chemicals that give each strain of cannabis its unique smell and flavor profile. Different terpenes are associated with different flavor notes such as fruit, nut, pine, wood, and citrus.

These terpenes are also thought to enhance the medical benefits of THC and CBD through “the entourage effect.”

All of the medical ingredients in the spray combine to deliver an effect greater than the sum of its parts.

Medical Uses of Sativex

Medical Uses of Sativex
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So far, there are only a few approved therapeutic uses for Sativex. Its primary use is for treating muscle spasms (spasticity) associated with MS, but it can also treat several other MS symptoms. It is also approved in some countries for managing pain.

MS Spasticity

Sativex has been clinically proven to be effective at treating muscle spasms associated with MS.

A 2007 study which looked at 189 MS patients using Sativex found evidence to support the long term effectiveness and tolerability of the drug at treating resistant forms of MS. 40% of patients taking Sativex showed a significant reduction in spasticity symptoms.

Sativex isn’t a single treatment for MS, however, and should be used with other prescribed treatments. It’s recommended for patients who haven’t had enough success with conventional treatment options and are looking for an alternative.


A 2012 study of 360 patients with cancer pain looked at the efficacy of Sativex for providing pain relief. The results showed that those who took low to medium doses of the cannabinoid spray had significantly reduced pain, and improved sleep.

A 2007 study which looked at neuropathic pain in 125 patients found that those who took Sativex had significantly less pain than those who took a placebo.

Sleep Disturbances

Sativex can be useful for easing insomnia caused by pain.

A 2007 meta-analysis looked at 2000 patients using Sativex, and found it was effective in improving sleep for people with a wide variety of pain conditions, such as cancer and rheumatoid arthritis.

Non-Approved Uses

Aside from these approved uses, Sativex has also shown promise in treating the following conditions:

  • Arthritis: A small trial found Sativex could reduce pain and improve sleep quality in rheumatoid arthritis patients.
  • Bladder dysfunction: A small trial found Sativex could reduce bladder symptoms in MS patients.
  • Spinal cord injury: A small trial found Sativex could improve pain, spasticity, and sleep quality in spinal cord injury patients.


Sativex shows great potential as a treatment for symptoms of MS, including muscle spasticity, sleep disturbances and pain. The oral spray delivers the medical benefits of THC and CBD in a standardized dose.

Sativex can be a useful treatment option for patients living with MS who have not responded to other therapies. It is available by prescription in 30 countries around the world.

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