Patients titrate their Sativex dose over two weeks, up to a maximum of 12 sprays per 24 hour period, until they achieve optimal symptom relief.
Can Sativex be taken with other medicines?1
Care should be taken with hypnotics, sedatives and drugs with potential sedating effects, as there may be an additive effect on sedation and muscle relaxing effects.
Also, although there has been no greater rate of adverse events in patients already taking anti-spasticity agents when they also take Sativex, care should be taken when co-administering Sativex with anti-spasticity agents, since a reduction in muscle tone and power may occur, leading to a greater risk of falls.
Refer to the SmPC for details of interactions with other medicinal products and other forms of interactions.
Can patients drive while using Sativex?1
You must not drive or use machinery when you first start to take Sativex, as it is likely to affect
your ability to drive. Sativex may cause you to feel sleepy or dizzy, which may impair your
judgement and performance of skilled tasks. It has also rarely been reported to cause a brief loss
It is an offence to drive if Sativex is affecting your ability to drive safely. Do
not drive until you know how the medicine affects you. However, you would not be
committing an offence and are able to drive so long as Sativex is not affecting your
ability to drive safely AND
Sativex has been prescribed to you to treat a medical problem AND
You have taken it according to the instructions given by your doctor and according to the
information provided with the medicine.
Are there any patients for whom Sativex is contraindicated?1
Sativex is contraindicated in patients:
With hypersensitivity to cannabinoids or to any of the excipients.
With any known or suspected history or family history of schizophrenia, or other psychotic illness; history of severe personality disorder or other significant psychiatric disorder other than depression associated with their underlying condition.
Who are breast feeding (in view of the considerable levels of cannabinoids likely in maternal breast milk and the potential adverse developmental effects in infants).
NB. Sativex should not be used during pregnancy unless the potential risks to the fetus and/or embryo are considered to be outweighed by the benefit of treatment. Men and women of child-bearing age should take reliable contraceptive precautions for the duration of the treatment and for three months after discontinuation of therapy.
What does the Sativex spray contain, apart from cannbinoids?1,2
Sativex contains ethanol, propylene glycol and peppermint oil. The amount of alcohol in the maximum
daily dose of Sativex for most people is about the same as one teaspoon of wine (less than 1/16th of
a unit of alcohol). This is not sufficient to have any effect on most patients beyond a slight
enhancement of the effect of alcoholic drinks.
However, there will be some MS patients for whom this small amount of alcohol must be taken into
consideration. For example:
Patients with alcoholism
Patients with epilepsy
Patients with liver disease
Why is the cannabis in Sativex legal?
The cannabis in Sativex is grown with permission from the UK Government, under highly controlled
Two different sorts of cannabis plant are used to make Sativex. Each plant is carefully selected to
produce the same amount of active ingredients. Every vial of Sativex is manufactured to make sure it
contains exactly the same balance of the active ingredients from each type of plant, to make an
Will the cannabis in Sativex make patients high?3
In clinical trials, less than 3% of patients treated with Sativex found that it caused a
euphoric mood (feeling high). If this does happen, patients should reduce their dose and talk to their
doctor or nurse.
Can patients travel abroad with Sativex?4
Sativex is a Controlled Drug and its legal status will vary between countries. Patients should check
that it is legal for them to take Sativex into any countries to which they are travelling. Driving
while taking Sativex might be illegal in some countries.
If they leave the United Kingdom, patients will not need a Home Office licence if they are travelling
for less than three months, or they are carrying no more than three months supply of Sativex.
However, they will need to carry a letter from their doctor that includes:
Patient’s name, address and date of birth
Outward and return dates of travel
The countries they are visiting and the medicine they are carrying
The letter will also need to include details about the dosages of the medicine and the total
amount the patient has with them.
Patients should contact the Embassy/Consulate/High Commission of the country they are travelling to
for the rules of that country concerning Controlled Drugs. Information on travelling with controlled
drugs is given at: https://www.gov.uk/travelling-controlled-drugs.
How long will a vial of Sativex last?1
A new vial of Sativex contains about 90 sprays. Therefore, for someone taking four sprays a day, a vial should last around 22 days. Every pack of Sativex contains 3 vials.
How should Sativex be stored?1
Sativex vials that are not in use should be stored upright in a fridge. Once opened, they
can be stored outside a fridge, away from direct heat and sunlight, for up to 42 days. However, any
Sativex vials stored outside a fridge for more than 42 days should be disposed of.
If an opened vial is left in the fridge, can it be kept for longer than 42 days?1
No – vials that have been open for more than 42 days should not be used.
How should empty vials of Sativex be disposed of?1
Empty vials of Sativex should be returned to a pharmacy for safe disposal.