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Compare Xywav vs. Xyrem

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Xywav (calcium oxybate / magnesium oxybate / potassium oxybate / sodium oxybate) and sodium oxybate (Xyrem, Lumryz) are both used to treat cataplexy and excessive daytime sleepiness (EDS) in people with narcolepsy. Xywav also treats idiopathic hypersomnia (IH) in adults, which sodium oxybate does not. Xywav contains 92% less sodium than sodium oxybate, making it a better option for those needing a low-sodium diet. Sodium oxybate is available in both immediate-release and extended-release forms, while Xywav is only available as an immediate-release liquid. Both medications are controlled substances with risks of misuse and dependence, and they require enrollment in a REMS program for safe use. Common side effects for both include nausea, dizziness, and bedwetting, especially in children.

Xywav
Sodium oxybate
Xywav
Sodium oxybate
Summary of Xywav vs. Xyrem
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 CNS depressant
Prescription only
Sodium oxybate is used to treat cataplexy (sudden muscle weakness after strong emotions) and excessive daytime sleepiness (EDS) in people with narcolepsy. Common side effects of the medication include nausea, dizziness, and bedwetting (especially in children). Sodium oxybate is a controlled substance because it has the potential for misuse and dependence. Sodium oxybate is available as brand-name Xyrem and lower-cost generic that are taken twice at night for people age 7 years and older. There's also a newly-approved, extended-release version for adults called Lumryz that's taken only once at night (expected to be available in summer 2023).
Indications of Xywav vs. Xyrem
Indications for

•Cataplexy (sudden muscle weakness) or excessive daytime sleepiness (EDS) in people ages 7 years and older with narcolepsy

•Idiopathic hypersomnia (IH) in adults

Indications for

•Excessive daytime sleepiness (EDS) or cataplexy in people with narcolepsy
Pros and Cons of Xywav vs. Xyrem
Pros and Const for CNS depressant
Pros

•Works well to prevent cataplexy attacks during the day in people with narcolepsy

•Works well to lessen daytime sleepiness in adults with idiopathic hypersomnia

•Can use in children as young as 7 years old with narcolepsy

•Comes as a liquid that's stored at room temperature, so easy to keep next to your bed

•Has 92% less sodium than Xyrem (sodium oxybate), so might be a better choice for people who need to follow a low-salt diet

Cons

•Is a controlled substance because of the risk of misuse and dependence

•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 CNS depressant
Pros

•One of the first-choice medications to treat narcolepsy

•Can use in children 7 years and older (immediate-release version only)

•Is a liquid mixture, so you don't need to swallow a pill

•Dose can be adjusted if needed

Cons

•Need to wake up in the middle of the night to take the second dose (immediate-release version only)

•Need to mix the doses with water before taking

•Risk of dependence and misuse

•Can't take with other sleep medications
Common Side Effects of Xywav vs. Xyrem
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
Immediate-release (Xyrem and generic)

Adults

•Nausea (up to 20%)

•Dizziness (up to 15%)

•Vomiting (up to 11%)

•Sleepiness (up to 8%)

•Bedwetting (up to 7%)

•Tremor or shakiness (up to 5%)

Children

•Nausea (20%)

•Bedwetting (19%)

•Vomiting (18%)

•Headache (17%)

•Weight loss (13%)

•Poor appetite (9%)

•Dizziness (8%)

•Sleepwalking (6%)

Extended-release Lumryz

•Bedwetting (up to 9%)

•Nausea (up to 8%)

•Headache (up to 7%)

•Dizziness (up to 6%)

•Vomiting (up to 6%)
Warnings of Xywav vs. Xyrem
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

•Unusual sleep behavior

Common Side Effects for

•Potential for misuse

•Changes in mental alertness and potentially deadly slowed breathing

•Behavior changes, including depression and suicidal thoughts

•Sleep disorders (e.g., sleep walking)

•Contains high amount of sodium
Prices with our coupons for Xywav vs. Xyrem
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Learn more about Sodium oxybate

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Compare Xywav vs. Xyrem

Key takeaways

Summary of Xywav vs. Xyrem

Indications of Xywav vs. Xyrem

Pros and Cons of Xywav vs. Xyrem

Common Side Effects of Xywav vs. Xyrem

Warnings of Xywav vs. Xyrem

Prices with our coupons for Xywav vs. Xyrem

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