Evaluation of the tolerability and efficacy of Sativex in multiple sclerosis

Expert Rev Neurother. 2014 Nov;14(11):1243-50. doi: 10.1586/14737175.2014.971758.


Refractory spasticity, central neuropathic pain and bladder dysfunction are common clinical problems in patients with multiple sclerosis (MS). None of the currently available oral medications has proven to be reliably effective and can be limited by toxicity. Cannabinoids have shown therapeutic effects on those MS-associated symptoms. Delta-9-tetrahydrocannabinol (THC)/cannabidiol (CBD) Sativex (nabiximols) is an oromucosal spray formulation that contains THC and CBD in an approximate 1:1 ratio and is described as an endocannabinoid system modulator. The efficacy of THC/CBD on MS-associated spasticity, pain and bladder dysfunction has been studied in clinical trials as well as in clinical practice studies. Adverse effects are usually mild or moderate and the low rate of drug discontinuation provides good evidence of long-term tolerability. This article focuses on the pharmacological properties, clinical efficacy and tolerability of THC/CBD in MS patients.

Keywords: Sativex; cannabinoids; central neuropathic pain; multiple sclerosis; nabiximols; spasticity.

Publication types

  • Review

MeSH terms

  • Cannabidiol
  • Dronabinol
  • Drug Combinations
  • Humans
  • Multiple Sclerosis / drug therapy*
  • Muscle Spasticity / drug therapy*
  • Neuralgia / drug therapy*
  • Plant Extracts / adverse effects
  • Plant Extracts / therapeutic use*


  • Drug Combinations
  • Plant Extracts
  • Cannabidiol
  • Dronabinol
  • nabiximols