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Xyrem

What is narcolepsy?

Narcolepsy is a chronic disease of the central nervous system. Excessive daytime sleepiness (EDS) is the main symptom and is present in 100% of patients with narcolepsy. Other primary symptoms of narcolepsy include:

  • loss of muscle tone (cataplexy),
  • distorted perceptions (hypnagogic hallucinations), and
  • inability to move or talk (sleep paralysis).

Additional symptoms include disturbed nocturnal sleep and automatic behavior (patients carry out certain actions without conscious awareness). All of the symptoms of narcolepsy may be present in various combinations and degrees of severity.

Narcolepsy usually begins in teenagers or young adults and affects both sexes equally. The first symptom to appear is excessive daytime sleepiness, which may remain unrecognized for a long time in that it develops gradually over time. The other symptoms can follow excessive daytime sleepiness by months...

Xyrem

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Xyrem®
(sodium oxybate) Oral Solution

WARNING: Central nervous system depressant with abuse potential.

Should not be used with alcohol or other CNS depressants.

Sodium oxybate is GHB, a known drug of abuse. Abuse has been associated with some important central nervous system (CNS) adverse events (including death). Even at recommended doses, use has been associated with confusion, depression and other neuropsychiatric events. Reports of respiratory depression occurred in clinical trials. Almost all of the patients who received sodium oxybate during clinical trials were receiving CNS stimulants.

Important CNS adverse events associated with abuse of GHB include seizure, respiratory depression and profound decreases in level of consciousness, with instances of coma and death. For events that occurred outside of clinical trials, in people taking GHB for recreational purposes, the circumstances surrounding the events are often unclear (e.g., dose of GHB taken, the nature and amount of alcohol or any concomitant drugs).

Xyrem (sodium oxybate) is available through the Xyrem (sodium oxybate) Success Program, using a centralized pharmacy 1-866-XYREM (sodium oxybate) 88® (1-866-997-3688). The Success Program provides educational materials to the prescriber and the patient explaining the risks and proper use of sodium oxybate, and the required prescription form. Once it is documented that the patient has read and/or understood the materials, the drug will be shipped to the patient. The Xyrem (sodium oxybate) Success Program also recommends patient follow-up every 3 months. Physicians are expected to report all serious adverse events to the manufacturer. (See WARNINGS).

DRUG DESCRIPTION

Xyrem (sodium oxybate) is a central nervous system depressant that reduces excessive daytime sleepiness and cataplexy in patients with narcolepsy. Sodium oxybate is intended for oral administration. The chemical name for sodium oxybate is sodium 4-hydroxybutyrate. The molecular formula is C4H7NaO3 and the molecular weight is 126.09 grams/mole. The chemical structure is:

Xyrem®
  (sodium oxybate) Structural Formula Illustration

Sodium oxybate is a white to off-white, crystalline powder that is very soluble in aqueous solutions. Xyrem oral solution contains 500 mg of sodium oxybate per milliliter of USP Purified Water, neutralized to pH 7.5 with malic acid.

What are the possible side effects of sodium oxybate (Xyrem)?

Stop using sodium oxybate and get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using sodium oxybate and call your doctor at once if you have any of these serious side effects:

  • hallucinations or severe confusion;
  • shallow breathing;
  • sleepwalking; or
  • waking and confused behavior at night.

Less serious side effects may include:

  • agitation or...

Read All Potential Side Effects and See Pictures of Xyrem »

What are the precautions when taking sodium oxybate (Xyrem)?

Before taking sodium oxybate, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: a certain rare metabolic condition (succinic semialdehyde dehydrogenase deficiency).

Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver disease, kidney disease, breathing problems (e.g., sleep apnea), personal/family history of regular use/abuse of drugs/alcohol, heart problems (e.g., heart failure, high blood...

Read All Potential Precautions of Xyrem »

Last reviewed on RxList: 4/2/2009
This monograph has been modified to include the generic and brand name in many instances.

Xyrem - User Reviews

Xyrem User Reviews

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Report Problems to the Food and Drug Administration

 

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.


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