Sativex is an oromucosal spray derived from extracts of Cannabis sativa L (Cannabis leaf and flower), cultivated for controlled proportions of the active compounds delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD).1
Sativex is a licensed medication 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