Overview
This guideline covers prescribing of cannabis-based medicinal products for people with intractable
nausea and vomiting, chronic pain, spasticity and severe treatment-resistant epilepsy.
NICE is developing technology appraisal guidance on cannabidiol with clobazam for treating
seizures associated with Lennox-Gastaut syndrome and Dravet syndrome.
Products covered by the guideline include:
- cannabis-based products for medicinal use as set out by the UK Government in the 2018
Regulations - the licensed products delta-9-tetrahydrocannibinol combined with cannabidiol (Sativex) and
nabilone - plant-derived cannabinoids such as pure cannabidiol (CBD)
- synthetic compounds which are identical in structure to naturally occurring cannabinoids such
as delta-9-tetrahydrocannabinol (THC), for example, dronabinol.
Who is it for?
Healthcare professionals
People taking cannabis-based medicinal products, their families and carers
Contents
Overview ………………………………………………………………………………………………………………………………………………………………… 4
Who is it for?…………………………………………………………………………………………………………………………………………………………… 4
Recommendations ……………………………………………………………………………………………………………………………………………….. 5
1.1 Intractable nausea and vomiting …………………………………………………………………………………………………………………. 5
1.2 Chronic pain……………………………………………………………………………………………………………………………………………………… 5
1.3 Spasticity…………………………………………………………………………………………………………………………………………………………… 6
1.4 Severe treatment-resistant epilepsy …………………………………………………………………………………………………………… 6
1.5 Prescribing ……………………………………………………………………………………………………………………………………………………….. 7
Terms used in this guideline……………………………………………………………………………………………………………………………….. 10
Recommendations for research…………………………………………………………………………………………………………………………. 12
Key recommendations for research …………………………………………………………………………………………………………………. 12
Other recommendations for research …………………………………………………………………………………………………………….. 13
Rationale and impact…………………………………………………………………………………………………………………………………………… 15
Intractable nausea and vomiting ………………………………………………………………………………………………………………………. 15
Chronic pain ………………………………………………………………………………………………………………………………………………………….. 16
Spasticity ……………………………………………………………………………………………………………………………………………………………….. 18
Severe treatment-resistant epilepsy………………………………………………………………………………………………………………… 19
Prescribing: who should prescribe and shared care ……………………………………………………………………………………… 20
Prescribing: factors to think about when prescribing……………………………………………………………………………………. 22
Prescribing: supporting shared decision making…………………………………………………………………………………………….. 23
Context……………………………………………………………………………………………………………………………………………………………………. 25
Current practice …………………………………………………………………………………………………………………………………………………… 25
Finding more information and committee details………………………………………………………………………………………….. 27
Continue at: https://www.nice.org.uk/guidance/ng144
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