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Sodium Oxybate Coupon - Sodium Oxybate 180ml of 500mg/ml bottle of oral solution

sodium oxybate

Generic Xyrem
Used for Narcolepsy
Used for Narcolepsy

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).

Reviewed by:
reviewer
Allison Gourley, PharmD
reviewer
Cydnee Ng, PharmD
Last reviewed on May 4, 2023
BasicsWarningsSide effectsPros & consPharmacist tipsFAQsDosageInteractionsCostContraindicationsAlternativesLatest newsImagesReferencesPricesMedicare
Sodium oxybate is a controlled substance, which means that it's more likely to be misused or cause dependence. There are federal and state laws that limit the amount of medication that can be prescribed or dispensed within a certain period of time.
basics-icon

What is Sodium oxybate?

What is Sodium oxybate used for?

  • Excessive daytime sleepiness (EDS) or cataplexy in people with narcolepsy

How Sodium oxybate works

Sodium oxybate is a central nervous system (CNS) depressant. It's not entirely clear how the medication works. But researchers think that it works on proteins in the brain known as gamma-aminobutyric acid (GABA) receptors to help with cataplexy and EDS in people with narcolepsy.

Are you looking for information on Xywav (calcium oxybate / magnesium oxybate / potassium oxybate / sodium oxybate) instead?

Drug Facts

Common BrandsXyrem, Lumryz
Drug ClassCNS depressant
Controlled Substance ClassificationSchedule III
Generic StatusLower-cost generic available
AvailabilityPrescription only
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$21258.20(save 67.87%)
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What are the risks and warnings for Sodium oxybate?

Sodium oxybate can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

risk-warning

Potential for misuse

  • Risk factors: Personal or family history of substance or alcohol use disorder | History of mental health conditions | Taking more of sodium oxybate than prescribed

    Sodium oxybate is a schedule III controlled substance because it has a risk of misuse. This can lead to serious, life-threatening problems, such as seizure, extremely slowed breathing, and overdose. Misuse of sodium oxybate can sometimes also lead to addiction. Because of these risks, the FDA requires this medication to be distributed under the Xyrem REMS and Lumryz REMS programs. You, your provider, and the pharmacy must all enroll in this program to make sure you're taking this medication safely.

    risk-warning

    Changes in mental alertness and potentially deadly slowed breathing

    • Risk factors: Drinking alcohol | Taking other CNS depressants | History of breathing problems (e.g., sleep apnea)

      Sodium oxybate can slow your breathing down to the point where it's life-threatening. This can look like shortness of breath, slow and shallow breathing, and bluish-colored lips, fingers, or toes. If this change in your breathing isn't recognized and treated right away, it can lead to death. Get medical help right away if you or a loved one notices that you have symptoms of extremely slowed breathing.

      Sodium oxybate can slow down your brain activity. This can make you very sleepy and have trouble thinking, focusing, and reacting. Don't drive or perform any activities that require you to be alert until you know how this medication affects you, and especially for at least 6 hours after taking it.

      Changes in mental alertness and slowed breathing can happen at any time while you're taking sodium oxybate and even at recommended doses. But your risk is higher if you drink alcohol or take other CNS depressants, such as opioids, muscle relaxants, or antipsychotics, while you're taking sodium oxybate. Speak to your provider if you have concerns about these risks.

      risk-warning

      Behavior changes, including depression and suicidal thoughts

      • Risk factors: History of mental health conditions

        Some people taking sodium oxybate had behavioral changes like confusion, seeing or hearing things that aren't there, paranoia, and aggression. Some people also reported having depression and thoughts of hurting themselves. Let your provider know if you have a history of mental health problems. They might want to follow up with you more often to make sure your mental health is okay while you're taking sodium oxybate. Tell your provider if you start to behave in ways that aren't normal for you or have new or worsening depression. Call a provider right away if you have thoughts of wanting to hurt yourself.

        risk-warning

        Sleep disorders (e.g., sleep walking)

        Some people taking sodium oxybate experienced sleepwalking (having confused behavior or wandering throughout the night) or other similar sleep disorder. This can raise the risk of injuring yourself. Make sure your family and loved ones know about this side effect so they can watch out for your safety. Tell your provider if you have sleepwalking episodes or if you wander throughout the night.

        risk-warning

        Contains high amount of sodium

        • Risk factors: Heart failure | High blood pressure | Kidney problems | Low sodium diet

          Sodium oxybate contains a high amount of sodium (salt). This can be especially dangerous for people who are sensitive to salt intake, such as those with congestive heart failure, high blood pressure, or kidney problems. Tell your provider about your full medical history before starting sodium oxybate.

          basics-icon

          What are the side effects of Sodium oxybate?

          The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

          Common Side Effects

          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%)

          Other Side Effects

          • Stomach pain
          • Diarrhea
          • Dry mouth
          • Poor appetite
          • Weight loss
          • Muscle spasms
          • Not recognizing familiar places (disorientation)
          • Sleepwalking in adults

          Serious Side Effects

          Contact your healthcare provider immediately if you experience any of the following.
          • Extremely slowed breathing
          • Accidentally taking too much (overdose): slowed breathing, severe drowsiness, confusion, not responding to sound or touch, slow heart rate, seizures, blurry vision, vomiting

          Source: DailyMed

          The following side effects have also been reported

          Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

          Check with your doctor immediately if any of the following side effects occur:

          More common

          Bedwetting

          sleep walking

          Less common

          Burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings

          changes in behavior

          choking or gasping sounds

          daytime sleepiness or tiredness

          headache

          lack of appetite

          loud or frequent snoring

          rapid weight gain

          seeing, hearing, or feeling things that are not there

          thoughts of killing oneself

          trouble sleeping

          unusual weight gain or loss

          waking to urinate at night

          Incidence not known

          Being forgetful

          blurred vision

          decrease in the amount of urine

          dizziness

          fever

          hives, itching, skin rash

          hoarseness

          increase urge to urinate at night

          irritation

          joint pain, stiffness, or swelling

          nervousness

          noisy, rattling breathing

          pounding in the ears

          redness of the skin

          swelling of the face, fingers, hands, feet, or lower legs

          tightness in the chest

          trouble breathing or swallowing

          weight gain

          Get emergency help immediately if any of the following symptoms of overdose occur:

          Symptoms of overdose

          Agitation

          bluish lips or skin, not breathing

          chest pain or discomfort

          clumsiness

          confusional, agitated combative state

          drowsiness

          generalized slowing of mental and physical activity

          inability to hold bowel movement or urine

          increased sweating

          lightheadedness, dizziness, or fainting

          loss of consciousness

          muscle aches or weakness

          seizures

          shakiness and unsteady walk

          shivering

          slow or irregular heartbeat

          trembling or other problems with muscle control or coordination

          unusual tiredness or weakness

          weak or feeble pulse

          Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

          More common

          Diarrhea

          difficulty passing urine (dribbling)

          increased frequency, urgency, or burning on urination

          increased sweating

          nausea

          vomiting

          Less common

          Dry mouth

          Incidence not known

          Difficulty with moving

          Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

          Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

          pros-and-cons

          Pros and cons of Sodium oxybate

          thumbs-up

          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

          thumbs-down

          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

          pharmacist-tips

          Pharmacist tips for Sodium oxybate

          pharmacist

          • Make sure to keep sodium oxybate in its original bottle until you're ready to use it.

            • Take your sodium oxybate dose(s) at your bedside at least 2 hours after eating. Food can affect how fast your body absorbs the medication and how well it works.

              • Lie down in bed right after taking sodium oxybate to avoid falling and injuring yourself. You'll probably fall asleep very soon after taking the medication (within 5 to 15 minutes).

                • Sodium oxybate can cause drowsiness that can last for many hours. Don't drive or operate machinery until you know how this medication affects you, especially during the 6 hours after taking it.

                  • Let your provider know if you experience sleep walking or mood changes (e.g., depression, difficulty concentrating, suicidal thoughts) while taking sodium oxybate.

                    • After you're finished with the medication bottle, pour any unused medication down the sink. You can throw away the empty bottle in the trash, but make sure to cross out your name or other personal information.

                      • If you, your child, or someone you know overdoses on sodium oxybate, get medical attention or call a Poison Control Center right away at 1-800-222-1222.

                        For the immediate-release version (Xyrem and generic)

                        • Review the Xyrem instructions on how to prepare and take the medication properly. Ask your provider or pharmacist if you have any questions.

                          • Prepare your two doses before bedtime by mixing each dose with 60 mL (1/4 cup) of water in the provided containers. After you mix sodium oxybate with water, take it within 24 hours.

                            • You'll need to space out your two doses by 2.5 to 4 hours. Don't take two doses at once because this can cause serious side effects. Set an alarm so that you'll wake up to take your second dose of the night.

                              • If you miss your second dose of sodium oxybate, skip the missed dose and wait until the next night to take your next two doses.

                                For the extended-release version (Lumryz)

                                • Review the Lumryz instructions on how to prepare and take the medication safely. Ask your provider or pharmacist if you have any questions.

                                  • Before bedtime, mix your Lumryz dose with 1/3 cup of water. Only use the mixing cup that was provided to you; don't use a household cup, and don't mix it with hot water. After you mix your dose with water, take it within 30 minutes; don't let it sit out for longer than that.

                                    faqs

                                    Frequently asked questions about Sodium oxybate

                                    What happens if I don't take sodium oxybate at bedtime?
                                    Sodium oxybate can make you fall asleep very quickly, usually within 5 to 15 minutes. Taking the medication at a time other than bedtime, while standing up, or while doing tasks can lead to falls and accidental injuries. For this reason, it's best to get into bed before you take your dose(s) of sodium oxybate.
                                    Does sodium oxybate have a lot of sodium in it?
                                    Yes, sodium oxybate contains a high amount of sodium (salt). Make sure to tell your provider if you have a medical condition that requires you to limit your sodium, such as heart failure, high blood pressure, or kidney problems. Having too much sodium in the body can worsen these conditions. If you have one of these medical conditions and need to take sodium oxybate, your provider might recommend that you lower your sodium intake even further while taking this medication.
                                    What's the difference between Xyrem and Xywav?
                                    Xyrem and Xywav are both FDA-approved medications that treat sudden muscle weakness (cataplexy) and excessive daytime sleepiness in people with narcolepsy. They have similar side effects (e.g., nausea, dizziness) and have risks of slowed breathing and misuse. Because of these risks, they both require enrollment in a REMS safety program. While both medications contain sodium oxybate, Xywav has additional ingredients (calcium, potassium, and magnesium oxybates). The manufacturer of Xywav states that Xywav contains much less — 92% less — sodium per nightly dose than Xyrem. This might be a better option for people who need to limit their sodium intake for their health. Compare between Xyrem and Xywav, and speak with your provider about which medication best fits your needs.
                                    Is it safe to drink alcohol with sodium oxybate?
                                    Avoid drinking alcohol with sodium oxybate. This combination can raise your risk of serious side effects, including extremely slowed breathing, loss of consciousness, coma, or even death.
                                    Is sodium oxybate safe to use during pregnancy?
                                    There isn't enough information available to know if sodium oxybate is safe to take during pregnancy. In animal studies, sodium oxybate caused harm to unborn babies during pregnancy, including stillbirths and growth problems. If you're currently pregnant or planning on becoming pregnant, speak to your provider about the risks and benefits of taking this medication to you and your unborn baby.
                                    What is a REMS program, and why is there one for sodium oxybate?
                                    A Risk Evaluation and Mitigation Strategy (REMS) program is an extra safety requirement from the FDA for certain medications that have serious risks. The FDA requires a REMS program for sodium oxybate because it can make you very sleepy, slow your breathing, and affect your ability to think, focus, and react. There's also a risk for misuse (when a medication is used for non-medical reasons for its desirable physical or emotional effects) with this medication. The Xyrem REMS and Lumryz REMS programs require that you, your provider, and the pharmacy must all be enrolled in the program to make sure you're taking this medication safely.
                                    What's the difference between Xyrem and Lumryz?
                                    The Xyrem brand and its generic are immediate-release versions of sodium oxybate. They're taken as two doses each night: the first dose right at bedtime and the second 2.5 to 4 hours later. Lumryz is a newly-approved, extended-release version of sodium oxybate. It's the first and only once-at-bedtime medication for people with narcolepsy. With Lumryz, you don't need to wake up to take a second dose. If you often sleep through your second dose of Xyrem or the generic, talk with your provider about possibly switching to the new extended-release version when it becomes available. Keep in mind that immediate-release sodium oxybate (Xyrem and its generic) is approved for children over 7 years of age, whereas extended-release Lumryz is only approved for adults. They also have slightly different mixing instructions, so check out the Pharmacist Tips section for instructions on how to prepare your dose.
                                    Can sodium oxybate be used for fibromyalgia?
                                    Sodium oxybate isn't FDA approved to treat fibromyalgia. In fact, the FDA looked into this and rejected its use for fibromyalgia based off of concerns that sodium oxybate could be misused. If you're looking for a treatment for fibromyalgia, talk with your provider about safe and effective options.
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                                    dosage

                                    Sodium oxybate dosage forms

                                    The average cost for 3 bottles of 180ml of 500mg/ml of Sodium oxybate is $6830.28 with a free GoodRx coupon. This is 67.87% off the average retail price of $21258.20.
                                    bottle of oral solution
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                                    180ml of 500mg/ml3 bottles$6830.28$2276.76

                                    Typical dosing for Sodium oxybate

                                    • Immediate-release sodium oxybate (Xyrem and generic)

                                      • Adults: The typical starting dose is 2.25 grams by mouth at bedtime and 2.25 grams taken 2.5 to 4 hours later. Your provider will raise your dose every week to the usual dose of 6 to 9 grams by mouth per night, split into two doses.

                                      • Children age 7 years and older: Dosing will depend on your child's weight. The dose should be taken by mouth twice per night (at bedtime and 2.5 to 4 hours later). Your child's provider will raise your child's dose every week to a maximum dose of 6 to 9 grams per night.

                                    • Extended-release sodium oxybate (Lumryz)

                                      • Adults: The typical starting dose is 4.5 grams by mouth as a single dose each night at bedtime. Your provider will raise your dose every week to the usual dose of 6 to 9 grams per night.

                                      • Children: Talk to your child's provider because it's not known if this version is safe or will work well for them.

                                    Your dose might differ if you have liver problems or if you're taking divalproex (Depakote).

                                    interactions

                                    Interactions between Sodium oxybate and other drugs

                                    Sodium oxybate may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Sodium oxybate. Please note that only the generic name of each medication is listed below.

                                    Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

                                    Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

                                    drug-cost

                                    How much does Sodium oxybate cost?

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                                    Xyrem (brand)
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                                    Sodium oxybate (generic)
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                                    contraindications-icon

                                    Sodium oxybate contraindications

                                    Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Sodium oxybate will not be safe for you to take.
                                    alternatives

                                    What are alternatives to Sodium oxybate?

                                    There are a number of medications that your doctor can prescribe in place of Sodium oxybate. Compare a few possible alternatives below.
                                    Sodium oxybate
                                    Used for:

                                    • Excessive daytime sleepiness (EDS) or cataplexy in people with narcolepsy

                                    $6830.28 Lowest GoodRx priceView Prices
                                    Wakix (pitolisant)
                                    Used for:
                                    View Prices
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                                    This medicine is Colorless Bottle Of Oral Solution.

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                                    References

                                    Best studies we found

                                    Allen, M. J., et al. (2023). GABA receptor. StatPearls.

                                    Avadel Pharmaceuticals. (n.d.). Lumryz™ REMS (Risk Evaluation and Mitigation Strategy).

                                    Avadel Pharmaceuticals. (2023). Avadel Pharmaceuticals announces final FDA approval of Lumryz™ (sodium oxybate) for extended-release oral suspension as the first and only once-at-bedtime oxybate for cataplexy or excessive daytime sleepiness in adults with narcolepsy. Globe Newswire.

                                    View All References (13)

                                    Avadel Pharmaceuticals. (2023). Lumryz (sodium oxybate) for extended-release oral suspension, CIII [package insert].

                                    Avadel Pharmaceuticals. (2023). Lumryz- Instructions for use.

                                    Häuser, W., et al. (2014). Review of pharmacological therapies in fibromyalgia syndrome. Arthritis Research & Therapy.

                                    Hikma Pharmaceuticals PLC. (2023). Hikma launches authorized generic of Xyrem® (sodium oxybate) in the US.

                                    Jazz Pharmaceuticals, Inc. (n.d.). Preparing & taking Xyrem.

                                    Jazz Pharmaceuticals. (n.d.). Jazz Pharmaceuticals announces U.S. FDA approval of Xywav™ (calcium, magnesium, potassium, and sodium oxybates) oral solution for cataplexy or excessive daytime sleepiness associated with narcolepsy. PR Newswire.

                                    Jazz Pharmaceuticals. (n.d.). Xywave and XyREMS.

                                    Jazz Pharmaceuticals, Inc. (2023). Xyrem- sodium oxybate solution [package insert]. DailyMed.

                                    Maski, K., et al. (2021). Treatment of central disorders of hypersomnolence: An American Academy of Sleep Medicine clinical practice guideline. Journal of Clinical Sleep Medicine.

                                    MedlinePlus. (n.d.). Drug use and addiction.

                                    MedlinePlus. (n.d.). Succinic semialdehyde dehydrogenase deficiency.

                                    Mirabile, V. S., et al. (2023). Cataplexy. StatPearls.

                                    U.S. Food and Drug Administration. (2016). FDA Drug Safety Communication: Warning against use of Xyrem (sodium oxybate) with alcohol or drugs causing respiratory depression.

                                    GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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