Frequently asked questions
Will Sativex work for me? (1)
Like most medicines, Sativex won’t work for everyone. However, unlike many medicines, you should usually know within the first four weeks of taking Sativex whether or not it works for you.
After the first four weeks, your specialist doctor will see you to find out whether the symptoms of your spasticity are improving. If there has been no improvement they may suggest you don’t continue to take Sativex.
What do I do if my spasticity changes? (1)
MS spasticity symptoms often change over time, and you or your doctor can also change the dose of Sativex so that you continue to get relief. To do this either:
- Take a different number of sprays per day (up to a maximum of 12)
- Take your sprays at different times of the day
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.
Is there anything I need to keep in mind when taking my first dose? (1)
As people’s reactions to Sativex can vary, you should take your first dose in the evening (between 4pm and bedtime).
You may also like to have someone with you.
How long will Sativex take to work? (1)
The length of time Sativex takes to work will be different for everyone, but most people will know within four weeks whether or not is it going to work for them.
The titration period (the first two weeks of treatment) is designed to help you slowly get used to your medicine, and to find the best dose for you. This is the number of sprays in a day that gives you the symptom relief you need with as few unwanted effects as possible.
You will probably know within the first four weeks if Sativex is working for you. Your specialist doctor will want to see you after the first four weeks to check how you are getting on, and whether or not you should continue to take Sativex.
What should I do if I forget to take a spray of Sativex? (1)
If you forget to take a spray, don’t worry. Simply take your next spray as soon as you remember or as soon as you feel you need it. (Remember to leave at least 15 minutes between sprays.) You should then return to your normal dosing plan.
What are the possible side effects of Sativex? (1,2)
As with any medication, Sativex can cause unwanted side effects. These will vary from person to person, and not everyone will get them.
The most common side effects with Sativex are dizziness and tiredness. Some people may also feel depressed or confused, may feel over-excited or lose touch with reality, may have difficulties with memory or trouble concentrating and may feel sleepy or giddy. The patient information leaflet in each pack of Sativex will give you a full list of all the side effects that have been reported with this medicine.
For most people taking Sativex, these side effects are mild to moderate, last only a few hours and can be managed by changing the number of sprays or taking a short break from using the medicine. Side effects are most likely to happen when you start treatment and will often decrease as you become more used to Sativex.
However, it is important to tell your doctor or nurse of any side effects you may be experiencing – they can advise you on how best to manage them.
Can I drive while taking 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 of consciousness.
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.
Can I use Sativex if I’m pregnant? (1,2)
You should not use Sativex if you are pregnant. Reliable contraception must be used by men and women while taking Sativex, and for three months after stopping treatment. If you become pregnant while taking Sativex, tell your doctor immediately.
Can I use Sativex if I am breast-feeding? (1,2)
No, you should not use Sativex if you are breast-feeding because Sativex may enter breast milk.
Can I drink alcohol while taking Sativex? (1,2)
You may drink alcohol while taking Sativex.
However, you might find that Sativex increases the effects you usually feel when drinking alcohol.
You may also notice that drinking alcohol adds to the effects you usually feel with Sativex.
If I keep my opened vial in the fridge, can I then keep it for longer than 42 days? (1,2)
No – vials that have been open for more than 42 days should not be used.
What do I do with empty vials of Sativex? (1,2)
Empty vials of Sativex should be returned to a pharmacy for safe disposal.
Why is the cannabis in Sativex legal?
The cannabis in Sativex is grown with permission from the Government, under highly controlled conditions.
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 contains exactly the same balance of each type of plant, to make an effective medicine.
Sativex is a legal medicine when prescribed by specialist doctors for treating MS spasticity.
Will the cannabis in Sativex make me 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.
What does the Sativex spray contain, apart from its cannabis medicine? (1,2)
Sativex contains ethanol (alcohol), 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.
Take this into account if you have another medical condition that may be affected by alcohol.
Can I travel abroad with my Sativex? (4)
Sativex is a Controlled Drug and its legal status will vary between countries. You should check that it is legal to take Sativex into any countries to which you are travelling. Driving while taking Sativex might be illegal in some countries.
If you leave the United Kingdom, you will not need a Home Office licence if you are travelling for less than three months, or you are carrying no more than three months’ supply of Sativex. However, you will need to carry a letter from your doctor that includes:
- Your name, address and date of birth
- Outward and return dates of travel
- The countries you are visiting and the medicine you are carrying
- The letter will also need to include details about the dosages of the medicine and the total amount you will be taking with you
You should contact the Embassy/Consulate/High Commission of the country you 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.
- Sativex Patient Information Leaflet.
- Sativex Summary of Product Characteristics.
- Novotna A et al. Eur J Neurol 2011;18(9):1122-1121.
- https://www.gov.uk/travelling-controlled-drugs (last accessed February 2015)