Sativex is an oromucosal spray derived from two strains of cannabis leaf and flower, cultivated for their controlled proportions of the active compounds delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD).1
Sativex is indicated as treatment for symptom improvement in adult patients with moderate to severe spasticity due to multiple sclerosis (MS) who have not responded adequately to other anti-spasticity medication and who demonstrate clinically significant improvement in spasticity related symptoms during an initial trial of therapy.1
Treatment with Sativex must be initiated and supervised by a physician with specialist expertise in treating this patient population.1
How does Sativex work?
Delta-9-tetrahydrocannabinol (THC) acts as a partial agonist at both the CB1 and CB2 human cannabinoid receptors, which are found predominantly at nerve terminals, where they have a role in retrograde regulation of synaptic function which may modulate the effects of neurotransmitters (e.g. reduce effects of excitatory neurotransmitters such as glutamate).1
Cannabidiol (CBD) has a role in calcium homeostasis and is an inhibitor of adenosine uptake, acting largely independently of known cannabinoid receptors;2,3 it also has the potential to modulate the anxiogenic and psychoactive effects of THC.4,5