Head-to-head comparisons of medication uses, side effects, warnings, and more.
Key takeaways
Xywav (calcium oxybate/magnesium oxybate/potassium oxybate/sodium oxybate) and Sunosi (solriamfetol) are both used to treat excessive daytime sleepiness, but they work in different ways and treat different conditions. Xywav is a central nervous system depressant that helps manage sudden muscle weakness and daytime sleepiness associated with narcolepsy and idiopathic hypersomnia by increasing GABA activity in the brain. It is comes in a liquid dosage form and is usually twice a night with 2.5 to 4 hours separating the two doses. Xywav can cause side effects like nausea, headache, and dizziness. Sunosi, on the other hand, is a norepinephrine-dopamine reuptake inhibitor that treats narcolepsy and obstructive sleep apnea by raising norepinephrine and dopamine levels in the brain. It is taken as a pill once a day and can cause side effects like headache, nausea, and insomnia. Xywav is a Schedule III controlled substance, while Sunosi is Schedule IV, indicating different levels of potential misuse and dependence. Xywav has a higher risk for misure and dependency. Both medications are only available as a brand-name medication.
Xywav
Sunosi (solriamfetol)
Xywav
Sunosi (solriamfetol)
Summary of Xywav vs. Sunosi
Summary for CNS depressant
Prescription only
Xywav is a medication that contains calcium, magnesium, potassium, and sodium oxybates. It's a central nervous system (CNS) depressant that's used to treat cataplexy (sudden muscle weakness) or excessive daytime sleepiness in people ages 7 years and older with narcolepsy. This medication can also treat idiopathic hypersomnia (IH) in adults. Xywav is a liquid that's taken by mouth twice each night, but some people with IH can take it just once at night. Some side effects can include headache, nausea, and dizziness.
Summary for Dopamine and norepinephrine reuptake inhibitor
Prescription only
Sunosi (solriamfetol) is used to improve wakefulness in adults with narcolepsy or obstructive sleep apnea. Sunosi (solriamfetol) belongs to the drug class called dopamine and norepinephrine reuptake inhibitors, and it's currently only available as a brand-name medication. Sunosi (solriamfetol) is available as tablets that are taken by mouth once daily when you first wake up. Common side effects include headache, a smaller appetite, and nausea.
Indications of Xywav vs. Sunosi
Indications for
•Cataplexy (sudden muscle weakness) or excessive daytime sleepiness (EDS) in people ages 7 years and older with narcolepsy
•Can cause most people to fall asleep within 5 to 15 minutes, so must be ready for bed when you take it
•Has to be mixed with water and taken at least 2 hours after food
•Can affect your mood and behavior
•Have to wake up in the middle of the night to take the medication if you're taking it twice per night
Pros and Const for Dopamine and norepinephrine reuptake inhibitor
Pros
•Taken once a day
•Comes in two different strengths
•Unlikely to cause withdrawal symptoms if you stop taking the medication suddenly
Cons
•No lower-cost generic available
•Can make your blood pressure go up
•Is a controlled substance so there are special requirements to getting a prescription filled
•Not approved for children
Common Side Effects of Xywav vs. Sunosi
Common Side Effects for
Adults with IH:
•Nausea (21%)
•Headache (16%)
•Anxiety (12%)
•Dizziness (12%)
•Difficulty sleeping (9%)
•Sweating (8%)
•Low appetite (8%)
Adults with narcolepsy:
•Headache (20%)
•Nausea (13%)
•Dizziness (10%)
•Low appetite (8%)
Children with narcolepsy:
•Nausea (20%)
•Bed-wetting (19%)
•Vomiting (18%)
•Headache (17%)
•Weight loss (13%)
•Low appetite (9%)
•Dizziness (8%)
Common Side Effects for
•Headache (16%)
•Having a smaller appetite (9%)
•Nausea (7%)
•Anxiety (6%)
•Insomnia (trouble sleeping, 5%)
Note: Side effect percentages were reported from studies of adults with narcolepsy. These percentages might differ slightly for adults with obstructive sleep apnea.
Warnings of Xywav vs. Sunosi
Common Side Effects for
•Extreme sleepiness and dangerously slow breathing (respiratory depression)
•Potential for misuse
•Only available through the Xywav REMS program
•Possible withdrawal symptoms
•Depression, suicidal thoughts, and other mental health problems