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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

 

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Sodium oxybate

(Xyrem)

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Summary for Xywav

Prescription only

Xywav is a prescription medication that contains calcium, magnesium, potassium, and sodium oxybates. It treats cataplexy (sudden muscle weakness from strong emotions) and excessive daytime sleepiness in people ages 7 years and older with narcolepsy. It can also treat idiopathic hypersomnia (IH) in adults. Xywav works in the brain as a central nervous system (CNS) depressant to help with these sleep conditions. The medication is an oral solution that's taken by mouth, usually twice each night. Some adults with IH can take it once at night instead. Side effects can include headache, nausea, and dizziness.

Indications for Xywav

Pros and Cons for Xywav

Pros

Cons

  • Is a controlled substance, so there are special requirements to get the prescription filled
  • Need to prepare your doses before taking and also take at least 2 hours after food
  • Can cause most people to fall asleep within 5 to 15 minutes, so need to be ready for bed when you take it
  • Need to wake up in the middle of the night to take a second dose if you take it twice each night

Common Side Effects for Xywav

Adults with IH:

  • Nausea (21%)
  • Headache (16%)
  • Anxiety (12%)
  • Dizziness (12%)
  • Trouble 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%)

Warnings for Xywav

  • Extreme sleepiness and dangerously slow breathing (respiratory depression)
  • Potential for misuse
  • Only available through the Xywav REMS program
  • Changes in behavior or thoughts, including depression and suicidal thoughts
  • Unusual sleep behavior

Summary for Xyrem

Prescription only

Sodium oxybate (Xyrem) is for people 7 years and older with narcolepsy. It's used to treat cataplexy (sudden muscle weakness after strong emotions) and excessive daytime sleepiness (EDS). This medication works as a central nervous system depressant. It's a liquid solution that you have to mix with water before you take it. The dosage is taken by mouth two times at night, once at bedtime, and then again 2.5 to 4 hours later. Side effects include nausea and dizziness. Some people, but especially children, might wet the bed. Sodium oxybate (Xyrem) is available with a prescription as a brand-name and generic medication.

Indications for Xyrem

Pros and Cons for Xyrem

Pros

  • A first-choice medication for narcolepsy
  • Okay for children 7 years and older with narcolepsy to take
  • Is a liquid mixture, so no need to swallow whole pills
  • Dose can be adjusted if needed

Cons

  • Need to take two doses each night (one at bedtime, and another in the middle of the night)
  • Need to mix the medication with water before taking
  • Is a controlled substance, so there are special requirements to getting the medication filled
  • Can't take with sedatives

Common Side Effects for Xyrem

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%)

Warnings for Xyrem

  • Potential for misuse
  • Changes in mental alertness
  • Dangerously slowed breathing
  • Only available through the Xyrem REMS program
  • Behavior changes, including depression and suicidal thoughts
  • Unusual sleep behaviors (e.g., sleepwalking)
  • Contains a high amount of sodium

Prices with our coupons for Xywav vs. Xyrem

Price Card Drug Icon
Xywav3 bottles / 180ml of 0.5g/ml
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Price Card Drug Icon
Sodium Oxybate3 bottles / 180ml of 500mg/ml
$6,075.79$21,239.97
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