Educational information, not medical advice — ask your doctor or midwife.
Nabiximols is a prescription mouth spray made from cannabis plants. Most countries sell it under the brand name Sativex. Doctors prescribe it mainly for muscle stiffness and spasms in multiple sclerosis (MS, a long-term disease of the nerves).
It is a licensed medicine, not a herbal supplement. You cannot buy it over the counter or online. In most countries a specialist must start it.
Each spray holds a fixed, measured mix of two cannabis compounds, THC and CBD. That fixed dose is the main thing that sets it apart from herbal cannabis.
Here is the short verdict on the evidence. Good trials show a modest benefit for MS muscle spasms in some people. Results for cancer pain and most other uses have been weak or mixed.
Cannabis itself has a long history in herbal medicine. Long use is not proof that a thing works, and it is not proof that a thing is safe. This page keeps the two apart.
The THC in the spray acts on cannabinoid receptors called CB1. These sit on nerve cells in the brain and spinal cord. That binding is well established in human drug studies.
Why this eases muscle spasms is still not fully worked out. In animal studies, CB1 activity damps the nerve traffic that drives stiff muscles. Whether the same thing happens in people with MS is not proven.
The role of CBD here is less clear. In lab and animal work it appears to blunt some THC effects, such as anxiety. Human proof of that at this small dose is thin.
One thing is worth saying plainly. The spray does not slow MS or repair nerves. At best it eases symptoms while you keep taking it.
Nabiximols comes in one form only: a pump spray for the mouth.
- The spray goes under the tongue or inside the cheek, not down the throat. - It is sold in a small glass vial that gives about 90 sprays.
- Labels ask you to keep the vial cold before opening, then at room temperature once in use. - Each label sets a limit on how long an opened vial may be used.
It is not the same as CBD oil, hemp oil, cannabis flower or edibles. Those products have no fixed THC and CBD content. Do not treat them as swaps.
Cannabis was used as a herbal medicine for a very long time before this spray existed. Old Chinese and Ayurvedic texts listed it for pain and cramps. Victorian doctors in Britain prescribed cannabis tinctures for spasm, pain and sleep.
Most countries then banned the plant during the twentieth century. Medical use largely stopped, and research slowed for decades.
Nabiximols was developed in Britain in the 1990s and 2000s by GW Pharmaceuticals. The aim was a standard dose from a plant extract. Canada approved it in 2005, and the United Kingdom in 2010.
Its place in medicine rests on modern trials, not on the old herbal record.
Stop and get urgent medical help if you have any of these:
- Hallucinations, paranoia or severe confusion. - Thoughts of harming yourself. - Chest pain, a pounding heartbeat or fainting. - Severe, repeated vomiting that will not settle. - A fall that causes injury.
Call your prescriber sooner, not urgently, if you get mouth ulcers or white patches, steady dizziness, or low mood. Also tell them if four weeks bring no real benefit.
Nabiximols is a prescription-only controlled medicine in the United Kingdom, Canada and many European countries. It is not approved by the United States Food and Drug Administration. It is never sold as a food or supplement.
Evidence grades and traditional-use labels are explained in our methodology. Nothing here is medical advice.
What it is typically used for, usual dose, cautions, and the study behind it where real trial data exists.
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