Standardised cannabis medications

Last week, NICE updated their draft guidelines on medical cannabis. Of note, they approved the use of two standardised cannabis medications, Sativex and Epidiolex. Here’s a quick run down on both.

Sativex

Sativex (nabiximols) is an oromucosal spray containing cannabinoids and is the first cannabis-based medicinal product to be licensed in the UK. Sativex is currently the only licensed drug in the UK for the treatment of spasticity caused by Multiple Sclerosis.

Much like many other cannabis-based medicinal products, Sativex is only recommended for use when other conventional treatments have proved ineffective, or if an individual’s side effects are proving intolerable.

Sativex can also be used in some rare instances in combination with an individual’s usual anti-spasticity medications.

How do you use Sativex?

Sativex comes in an oromucosal spray form which you administer into orally.

In this spray is an equal combination of CBD and THC and you can take up to 12 doses a day, although the starting dose is only once per day before increasing to responsiveness.

This dose can be increased over a number of days until the optimal dosage is achieved for the patient in question. Required dosages can differ from person to person, so finding the correct number of sprays for each person should be figured out by evaluating how many doses give good relief of symptoms whilst giving the fewest side effects.

If the drug hasn’t had any noticeable effect on spasticity symptoms after 4 weeks, the patient is encouraged to stop taking it and to look for alternative therapies.

Epidiolex

Epidiolex is used to treat seizures from certain epileptic conditions like Dravet or Lennox-Gastaut syndrome. These forms of epilepsy are particularly rare early childhood forms, with Lennox-Gastaut syndrome affecting between 1 and 5 out of every 100 children with epilepsy whilst Dravet syndrome affects 2 or 3 children per 500 children with epilepsy. Both forms are also often resistant to typical forms of treatment.

Due to this resistance to typical forms of treatment, Epidiolex has been considered by many as a possible medical alternative for these conditions.

The cannabidiol in Epidiolex is thought to work by acting on the body’s TRPV1 and GPR55 protein channels,where it has an effect on the epileptic activity in the brain.

How do you use Epidiolex?

As always, cannabis-based drugs should only be taken after close consultation with a doctor, who will determine if the medication is suitable for the patient and what dose would best suit their symptoms and specific epileptic condition. The doctor will also take into account the other medications the patient is taking, the patient’s response to this treatment and their weight.

Epidiolex should be taken orally as instructed by the doctor, usually around twice daily,with care being taken to administer the drug the same way with each dose (for instance if you take the dose with food, you should always maintain this method when taking the next dose to achieve consistent results).

As is often the case with drugs containing cannabidiol, the doctor will most likely suggest that the patient takes a ‘start low and go slow’ approach to dosing, so that detrimental side effects can be avoided.

You can find out more about these drugs and if they’re the right treatment option for you by speaking with one of our specialists.

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