If you have narcolepsy, your doctor may suggest Xyrem as a treatment option for symptoms of this condition.

Xyrem is a medication that can be used to treat the symptoms of narcolepsy.

  • excessive daytime It is too sleepy. is a problem.
  • cataplexy

For more information, see the “Is Xyrem used for narcolepsy?” section below.

Xyrem basics

The drug is called sodium oxybate. An active drug is a medication that works. It is part of a group of drugs called central nervous system depressants.

Xyrem is a liquid solution that you swallow. It’s not available as a generic drug.

“The article discusses Xyrem’s side effects and uses.”

Mild or serious side effects may occur with Xyrem. The side effects that Xyrem may cause are described in the lists below. All possible side effects are not included in these lists.

Side effects of a drug can depend on other factors.

  • Your age.
  • You have other health conditions.
  • You take other drugs.

The doctor or pharmacist can tell you more about the side effects of Xyrem. They can suggest ways to reduce side effects.

Mild side effects

Here’s a short list of some of the mild side effects that Xyrem can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read Xyrem’s prescribing information.

Mild side effects of Xyrem have been reported.

Mild side effects have been reported in children using Xyrem.

The side effects of many drugs can be gone in a few days. If they become intolerable, talk to your doctor or pharmacist.

Serious side effects

There are serious side effects from Xyrem, but they are not common. If you have serious side effects from Xyrem, you should call your doctor. If you think you have a medical emergency, you should call the emergency number.

There have been serious side effects of Xyrem.

* For more information about risk of misuse, see the “Can Xyrem be misused?” section below.
† For more information about this side effect, see the “Side effect focus” section below.

Suicide prevention

If you think someone is at risk of self-injury or hurting another person.

  • You can call your local emergency number.
  • Stay with the person until help arrives.
  • Guns, knives, medications, and other things should be removed.
  • “Don’t judge, argue, threaten, or yell.”

If you or someone you know is considering suicide, you should get help from a hotline. The National Suicide Prevention Hotline is 800-273-8255.

Side effect focus

There are some side effects that Xyrem may cause.

Boxed warnings

Xyrem has boxed warnings. A boxed warning is a serious warning from the Food and Drug Administration (FDA).

Risk of misuse. It’s possible to misuse Xyrem. (Misuse is sometimes called abuse.) Misuse of Xyrem can result in serious side effects, including A coma. or breathing problems. In rare cases, it can even be fatal.

To learn more, see the “Can Xyrem be misused?” section below.

Risk of CNS Depression.. Xyrem depresses (slows down) activity in your CNS. This is called CNS Depression.. Even when you take Xyrem at doses prescribed by your doctor, the drug will cause this side effect. CNS Depression. can impair your motor skills, judgment, and thinking.

Due to the risk of CNS Depression., you should not take Xyrem with alcohol. And you should not take Xyrem together with drugs called sedative hypnotics. These are a type of medication prescribed to treat certain sleep disorders.

Xyrem can be combined with other depressants to cause serious side effects.

In rare cases, taking Xyrem with other depressants can be fatal.

For more about sedative hypnotics and CNS depressants, see the “What should be considered before taking Xyrem?” section below.

What can help?

Due to the risks of misuse and CNS Depression., only certain healthcare professionals with special certification may prescribe Xyrem. And only a specially licensed pharmacy may fill Xyrem prescriptions.

These restrictions apply to Xyrem because the drug is prescribed under a program called a risk evaluation and mitigation strategy (REMS). The Food and Drug Administration (FDA) can require certain drugs to have a REMS so that they’re prescribed only when their benefits outweigh their risks. To learn more, see the “Can Xyrem be misused?” section below.

Xyrem has effects on the central nervous system that can be dangerous after you take it. You should wait at least 6 hours after a dose before you take part in activities that require you to be awake. Driving a car and operating machinery are examples.

Breathing problems, including sleep apnea

Treatment with Xyrem can cause breathing problems, including sleep apnea. If you have existing breathing problems or sleep apnea, taking Xyrem may worsen your condition.

Some people may be at higher risk of breathing problems if they take Xyrem.

  • people with obesity
  • Men*
  • feMen* who have gone through menopause and aren’t taking hormone replacement therapy

With sleep apnea, your breathing stops and restarts while you’re sleeping. This side effect was rare in studies of Xyrem. But a few people in these studies had to stop taking Xyrem due to this side effect.

Sleep apnea can have symptoms.

  • choking or gasping during sleep
  • having a There is a throbbing head. upon waking up
  • snoring
  • feeling tired after sleeping

* In this article, we use the terms “male” and “female” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.

What can help?

If you notice any of the symptoms of sleep apnea or breathing problems while taking Xyrem, you should talk to your doctor. If you have a breathing problem while you are taking Xyrem, you should contact your doctor. They can tell you if it is safe to use Xyrem. They can recommend another treatment for your condition.

Abnormal dreams or unusual behaviors during sleep

Taking Xyrem may cause you to have abnormal dreams or unusual behaviors during sleep. These were among Xyrem’s most common side effects in studies.

Some of the behaviors reported are unusual during sleep.

  • sleep walking
  • You can perform tasks in your sleep.
  • Eating while you sleep.
  • Talking in the night.

These behaviors have led to injury for some people.

What can help?

If you notice abnormal dreams or strange behaviors during sleep, immediately notify your doctor. They will want to look at your symptoms further. Your doctor can recommend to you alternatives to Xyrem.

Allergic reaction

Some people may have an allergic reaction to Xyrem. While allergic reaction wasn’t reported in studies of the drug, it has occurred in rare cases since the drug became available on the market.

A mild allergic reaction can include some symptoms.

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include swelling under your skin, typically in your eyelids, lips, hands, or feet. They can also include swelling of your tongue, mouth, or throat, which can cause breathing problems.

If you have an allergic reaction to Xyrem, call your doctor. If you think you have a medical emergency, call the emergency number.

Find out what the answers are to some questions.

Is Xyrem used to treat insomnia, idiopathic hypersomnia, or fibromyalgia?

Xyrem is not approved by the Food and Drug Administration (FDA) to treat these conditions. Insomnia is a sleep disorder that causes difficulty falling or staying asleep. Idiopathic hypersomnia is a condition that causes you to feel excessive It is too sleepy. during the day. And fibromyalgia is a condition that causes pain and a lack of energy.

But doctors may prescribe Xyrem off-label to treat these conditions. Off-label drug use means that a drug that’s been approved by the FDA for one purpose is used for a different purpose that has not been approved.

If you would like to learn more about off-label uses of Xyrem, you should talk to your doctor or pharmacist.

Will Xyrem make me feel high? Does it have a risk of addiction or withdrawal?

Xyrem is unlikely to make you feel high. Feelings of euphoria weren’t reported in studies of the drug.

Xyrem does have a risk of addiction and dependence, which may cause withdrawal. To learn more, see the “Can Xyrem be misused?” section below.

If you have concerns about addiction or withdrawal, talk to your doctor.

What is a controlled substance, and does Xyrem fall in this category?

Yes, Xyrem is a controlled substance. Certain laws control the use of Xyrem to prevent possible misuse. Misuse occurs when a person uses a drug in a way other than how it’s prescribed. Misusing Xyrem can lead to serious side effects, including breathing problems or A coma.. It can even be fatal in rare cases.

Xyrem is considered a Schedule III controlled substance. This type of controlled substance has an approved medical use but also has risks of misuse, dependence, and tolerance. With dependence, the body needs a drug to function normally. Tolerance means the body gets used to a drug and needs a higher dose for the same effect.

Xyrem is only available through certain prescribers and a specialty pharmacy. The drug is prescribed under a program called a risk evaluation and mitigation strategy. The FDA can require certain drugs to have REMS so that they are only prescribed when their benefits outweigh their risks.

To learn more about Xyrem and risk of misuse, see the “Can Xyrem be misused?” section below.

What is Xyrem’s half-life? Does it affect whether Xyrem shows up on a drug test?

“A drug’s half-life is how long it takes for a person’s body to excrete half a dose. Xyrem has a half-life of about 30 to 60 minutes. It takes a drug roughly four to five times its half-life to be mostly removed from the body. This does not mean that the drug will not be detected on a drug test.”

“Someone may show up for a drug test. Xyrem is an illegal drug because it is a form of the drug GhB. You should bring your doctor’s prescription or note when you have a drug test. This can show that you are using Xyrem under the supervision of a doctor.”

Can Xyrem cause long-term side effects?

It is not known if Xyrem causes long-term side effects.

Certain side effects reported in studies of the drug are considered long-term conditions when they occur in people who aren’t taking Xyrem. Examples include Depression. and psychosis (loss of contact with reality). But it’s not known if these side effects are long term or whether they go away if you stop taking Xyrem.

If you want to learn more about the long-term side effects of Xyrem, you should talk to your doctor or pharmacist.

Does Xyrem cause weight gain?

No, Xyrem doesn’t cause weight gain. This side effect wasn’t reported in studies of the drug. In fact, weight loss was reported by some children taking Xyrem in these studies.

If you are concerned about weight changes while taking Xyrem, talk to your doctor.

Xyrem is a medication prescribed to treat the following symptoms of narcolepsy:

  • Excessive daytime It is too sleepy. (EDS). EDS is a sudden, overwhelming urge to sleep. It can make completing activities and tasks during the day difficult.
  • Cataplexy. With cataplexy, muscles can weaken or go completely limp without warning.

Xyrem can be used in adults and children of a certain age.

Narcolepsy is a nervous system condition that causes abnormal sleep patterns. In addition to EDS and cataplexy, people with narcolepsy sometimes have “sleep attacks” (suddenly falling asleep). These can happen at any time, with no warning.

How Xyrem treats narcolepsy is not known. The drug is thought to affect certain chemicals in the brain, which can help improve sleep and treat narcoleau symptoms.

Your doctor will recommend the dosage of Xyrem that’s right for you. Below are commonly used dosages, but always take the dosage your doctor prescribes.

Form

Xyrem is a liquid solution that you swallow.

Recommended dosages

The recommended schedule for Xyrem is as follows.

  1. You should take one dose before you go to bed.
  2. Take a second dose after 4 hours.

Questions about Xyrem’s dosage

There are a lot of questions about Xyrem.

  • What if I miss a dose of Xyrem? If you miss a Xyrem dose, skip the missed dose. You should never take two or more doses of Xyrem at one time.
  • Will I need to take Xyrem long term? If you and your doctor agree Xyrem is safe and working for you, you’ll likely take it long term.
  • How long does Xyrem take to work? Most people fall asleep within 15 minutes of taking a dose of Xyrem. Some fall asleep within 5 minutes of taking a dose.

Before you start treatment with Xyrem, it is important to have a discussion with your doctor about your health. Any medical conditions and any medications you take are included. This information helps them decide if Xyrem is the right option for you.

Interactions

Taking a medication with certain vaccines, foods, and other things can affect how the medication works. These effects are called interactions.

Before you take Xyrem, you should tell your doctor about all your medications. You should describe any vitamins, herbs, or supplements you use. Your doctor or pharmacist can tell you about any interactions that may occur with Xyrem.

Interactions with drugs or supplements

Xyrem can interact with a lot of drugs. These drugs are used.

Note: Because of possible interactions, your doctor will likely recommend that you don’t take Xyrem with certain drugs listed above.

Boxed warnings

Xyrem has boxed warnings. These are serious warnings from the Food and Drug Administration (FDA).

Xyrem has warnings in its box.

  • Risk of misuse. It’s possible to misuse Xyrem. (Misuse is sometimes called abuse.) Misuse of Xyrem can result in serious side effects, including A coma. or breathing problems. It can even be fatal in rare cases. To learn more, see the “Can Xyrem be misused?” section below.
  • Risk of CNS Depression.. Xyrem depresses (slows down) activity in your CNS. This effect is called CNS Depression.. Even when you take Xyrem at doses prescribed by your doctor, the drug causes this side effect. CNS Depression. can impair your motor skills, judgment, and thinking. For more information, see the “What are Xyrem’s side effects?” section above.

Other warnings

If you have a medical condition that affects your health, Xyrem may not be right for you. Before you take Xyrem, talk to your doctor about your health history. Those discussed below are factors to consider.

Succinic semialdehyde dehydrogenase deficiency. Having a rare brain disorder called succinic semialdehyde dehydrogenase deficiency can cause Xyrem levels to build up in the body. This could result in serious side effects. As a result, having this disorder is considered a contraindication to taking Xyrem. This means that your doctor will not prescribe Xyrem if you have this disorder due to the risk of harm. Your doctor can suggest safer treatments for you instead.

Suicidal thoughts. In rare cases, Xyrem has caused suicidal thoughts or actions as a side effect. If you have or have had suicidal thoughts or behaviors, talk with your doctor before you begin taking Xyrem. Taking Xyrem could worsen these feelings. Your doctor can determine whether Xyrem is safe for you to take. For guidance on suicide prevention, see “Suicide prevention” above.

Depression. Depression or depressed mood are possible side effects of Xyrem. If you have Depression., tell your doctor. Taking Xyrem could worsen your condition. Your doctor can determine whether Xyrem is safe for you to take.

Heart failure or high blood pressure. Xyrem contains a high amount of sodium. In people who have heart failure or high blood pressure, the drug may worsen their condition. For more information, see the “Ask a Pharmacist” section below.

Breathing or lung problems. Xyrem can cause lung-related side effects, such as decreased breathing rate and respiratory Depression.. If you have existing lung problems, you may have a higher risk of these side effects with Xyrem. Tell your doctor about any lung problems you have. This will help them determine whether Xyrem is safe for you to take.

Sleep apnea. Xyrem may cause sleep apnea. Taking Xyrem can worsen this condition in people who already have it. If you have sleep apnea, talk with your doctor. They can let you know whether Xyrem is safe for you to take.

Liver problems. If you have liver problems, your body may have trouble breaking down Xyrem after you take a dose. This can cause Xyrem levels to build up in your body, which may result in serious side effects. Before starting Xyrem treatment, tell your doctor about any liver problems you have. This will help them determine whether Xyrem is safe for you to take.

Allergic reaction. If you’ve had an allergic reaction to Xyrem or any of its ingredients, your doctor will likely not prescribe Xyrem. Ask them what other medications are better options for you.

Xyrem and alcohol

You should not drink alcohol with Xyrem.

Xyrem works by depressing (slowing down) your central nervous system (CNS). This effect is referred to as CNS Depression.. CNS Depression. can impair your motor skills, thinking, and judgment.

Alcohol also depresses your CNS. As a result, combining alcohol and Xyrem can lead to serious side effects. These include breathing problems or A coma.. In rare cases, it can be fatal.

Let your doctor know if you want to drink alcohol. They can suggest other treatments for your symptoms.

Pregnancy and breastfeeding

It is not known if it is safe to take Xyrem while pregnant or breastfeeding.

If you are pregnant or breastfeeding, you should talk to your doctor. They will discuss safe options for treating your symptoms.

Xyrem and Provigil (modafinil) may be prescribed to treat narcolepsy symptoms in adults. Xyrem may also be prescribed for this use in some children.

Provigil is a type of stimulant medication. It works by exciting your nervous system to release chemicals that make you feel more energetic. Xyrem isn’t a stimulant, so it works in a different way.

To find out more about these two medications, see this detailed comparison. Also, check with your doctor about which drug is right for your condition.

“Don’t take more than your doctor prescribes. Side effects can be serious if you use more than this.”

Symptoms of overdose

In studies of Xyrem, there were only two reports of overdose. So it’s not clear exactly what the symptoms of Xyrem overdose are.

Xyrem has an active drug called sodium oxybate. It is thought to cause overdose symptoms similar to GHB, which is an illegal drug.

Symptoms of GHB overdose include:

What to do in case you take too much Xyrem

Call your doctor if you think you’ve taken too much Xyrem. You can also call 800-222-1222 to reach the American Association of Poison Control Centers or use its online resource. But if you have severe symptoms, immediately call 911 or your local emergency number. Or go to the nearest emergency room.

“Your doctor will explain how to take Xyrem. They will explain how much to take and how often. Follow your doctor’s instructions for administering this drug.”

Taking Xyrem

Xyrem is a liquid solution that you swallow.

Taking Xyrem with other drugs

Your doctor may suggest using Xyrem with other drugs to treat excessive daytime It is too sleepy. resulting from narcolepsy. Examples include:

If you have questions about taking other drugs to treat symptoms of narcolepsy, talk to your doctor.

Should I take Xyrem with food?

“You shouldn’t take Xyrem with you. You should take Xyrem after 2 hours.”

Questions for your doctor

You may have questions about Xyrem. Discuss your concerns with your doctor.

Here are a few tips that might help you.

  • Before your appointment, write down questions such as:
    • How will Xyrem affect me?
  • Bring someone with you to your appointment to make you feel more comfortable.
  • “If you don’t understand something, ask your doctor to explain it.”

“Your doctor and other healthcare professionals are available to help you. They want you to get the best care possible. Don’t be afraid to ask questions or give feedback on your treatment”

Costs of prescription drugs can vary depending on many factors. These factors include what your insurance plan covers and which pharmacy you use. To find current prices for Xyrem in your area, visit WellRx.com.

If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. You can also visit the Xyrem manufacturer’s website to see if it has support options.

And to learn more about saving money on prescriptions, check out this article.

Xyrem has a boxed warning about the risk of misuse.* Boxed warnings are serious warnings from the Food and Drug Administration (FDA).

With misuse, a person uses a drug in a way other than how it is prescribed. This can include taking more of a drug than a doctor instructed or taking a drug that’s prescribed to someone else. Xyrem misuse can result in serious side effects. This can include A coma. or breathing problems. In rare cases, it can be fatal.

Xyrem is considered a Schedule III controlled substance. This type of controlled substance has an approved medical use but also has risks of misuse, dependence, and tolerance. With dependence, the body needs a drug to function normally. Tolerance means the body gets used to a drug and needs a higher dose for the same effect.

Before you begin treatment with Xyrem, tell your doctor if you have a history of substance use disorder. You may have a higher risk of dependence with Xyrem, which could increase your risk of misuse.

* Xyrem also has a boxed warning about risk of central nervous system Depression.. For more information about this side effect, see the “What are Xyrem’s side effects?” section above.

About the Xyrem REMS program

“Only healthcare professionals with special certification can prescribe Xyrem. Only a pharmacy that is licensed by the FDA can fill Xyrem prescriptions. You can’t get Xyrem at your local pharmacy.”

These restrictions apply to Xyrem because the drug is prescribed under a program called a risk evaluation and mitigation strategy (REMS). The FDA can require certain drugs to have a REMS so that they’re prescribed only when their benefits outweigh their risks.

You must enroll in the Xyrem REMS program before your doctor can prescribe Xyrem. You will need to complete documentation that you are using the drug safely, and only if your doctor tells you to.

If you’d like to learn more about the Xyrem REMS program, talk with your doctor or pharmacist. You can also get information about the program by visiting the Xyrem REMS website or calling 866-997-3688.

Ask your doctor questions about taking Xyrem if you are considering treatment. Knowing more about Xyrem can help you feel more comfortable with the risks and benefits. Here are a few things you can do to get started.

  • What should I know about treatments for narcolepsy other than Xyrem?
  • Do I need to limit my salt intake while taking Xyrem?
  • How will I know if it is safe to drive while using Xyrem?
  • My job requires me to do drug tests. Will Xyrem show up for a drug test?

You may be interested in learning more about that.

Q:

If I have heart failure, what should I know about taking Xyrem?

Anonymous

A:

It’s important to note that Xyrem has a high salt content. If you have heart failure, your doctor may suggest limiting your daily salt intake. This can help with symptoms of heart failure, including water retention. It can also help lower blood pressure.

The following list the amount of salt in Xyrem.

  • Xyrem has a lot of salt.
  • The 4.5 g of Xyrem has more salt than the state of Connecticut.
  • Xyrem has 1,100 salt.
  • 1,400 of the salt is in Xyrem 7.5 g.
  • 1,640 is the amount of salt in Xyrem 9 g.

If your salt intake is a concern, your doctor may suggest Xywav (calcium, magnesium, potassium, and sodium oxybates) for treating your narcolepsy symptoms. This drug works similarly to Xyrem but contains a lower amount of salt per dose.

Talk to your doctor about heart failure and Xyrem.

The Healthline Pharmacist TeamAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.