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Drugs & Medications

Xyrem

GENERIC NAME(S): SODIUM OXYBATE

WARNINGS:

Sodium oxybate is a very powerful central nervous system (CNS) depressant with a high risk of abuse. It must be used only for the purpose that your doctor prescribes. It is against the law to use this drug for any other purposes. Abuse and even approved use can result in seizures, severe difficulty breathing, confusion, depression, loss of consciousness, and even death. It must not be used with alcohol or other CNS depressants (see also Drug Interactions section).

Only patients who take part in the Xyrem Success Program may receive treatment with this medication. Before you receive your prescription, you must register with this program, and your doctor's office must provide educational materials to you. Your doctor must go over this material with you and instruct you how to use this medication safely and effectively. Only doctors enrolled in the Xyrem Success Program may prescribe sodium oxybate, and only the central pharmacy (not your local pharmacy) may dispense it.

Who should not take Xyrem?
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Uses

This medication is used to treat narcolepsy, a condition that causes severe daytime sleepiness. It can decrease symptoms such as daytime sleepiness, unwanted daytime naps/sleep attacks, and nighttime awakening. It also reduces the number of sudden short attacks of weak/paralyzed muscles (known as cataplexy) that can also occur in patients with narcolepsy. Sodium oxybate is a central nervous system depressant. It is also known as gamma hydroxybutyrate (GHB).

How to use Xyrem

Read the Medication Guide provided by your pharmacist before you start using sodium oxybate and each time you get a refill. If you have any questions, consult your doctor or pharmacist.

Take this medication by mouth in 2 separate doses at bedtime (at least 2 hours after eating) as directed by your doctor. Prepare your 2 doses as instructed in the Medication Guide. The doses must be diluted with 2 ounces (60 milliliters) of water. Take the first dose at bedtime while in bed. Set an alarm clock to awaken you for the second dose in 4 hours. If you wake up before the alarm and it has been at least 2-and-a-half hours after the first dose, then take the second dose while sitting in bed, and turn off the alarm. If you have children or pets in the house, be sure to use the child-resistant caps that come with the medication cups.

The dosage is based on your medical condition, response to treatment, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). Your doctor will gradually increase your dose over 1 to 2 weeks to lessen the risk of side effects. This process will continue until your doctor has found the right dose for you. Follow your doctor's directions carefully. Do not increase your dose, take it more frequently, or use it for longer than prescribed.

Use this medication regularly to get the most benefit from it. To help you remember, take it at the same times each night.

This medication may cause withdrawal reactions, especially if it has been used regularly for a long time or in high doses. In such cases, withdrawal symptoms (such as anxiety, psychosis, fast heartbeat, trouble sleeping) may occur if you suddenly stop using this medication. To prevent withdrawal reactions, your doctor may reduce your dose gradually. Consult your doctor or pharmacist for more details, and report any withdrawal reactions immediately.

Tell your doctor if your condition persists or worsens.

Side Effects

See also Warning section.

Drowsiness, dizziness, nausea, vomiting, stomach pain, diarrhea, increased sweating, or headache may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: mental/mood changes (e.g., confusion, psychosis, hallucinations, agitation, depression, rare thoughts of suicide), bedwetting, weakness, ringing in the ears, sleepwalking.

Get medical help right away if you have any very serious side effects, including: difficult/slow/shallow breathing (especially during sleep).

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US -

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

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before taking sodium oxybate, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: a certain rare metabolic condition (succinic semialdehyde dehydrogenase deficiency), liver disease, kidney disease, breathing problems (e.g., sleep apnea), personal/family history of regular use/abuse of drugs/alcohol, heart problems (e.g., heart failure, high blood pressure), mental/mood problems (e.g., depression, family/personal history of suicidal thoughts/attempts).

Sleep disorders may decrease your ability to react quickly. Though sodium oxybate helps keep you awake during the day, you still may not be able to safely perform task that require alertness (e.g., driving, flying). This drug may also make you dizzy. For these reasons, do not drive, use machinery, or do any other activity that requires alertness until you know how this medication affects you. Always use great care when doing these activities, and avoid them completely during the first 6 hours after you take this medication. Avoid alcoholic beverages because they increase the risk of serious side effects.

This medication contains sodium. Consult your doctor for more information if you are on a salt-restricted diet or if you have a condition that could be worsened by increased salt intake (e.g., congestive heart failure, high blood pressure)

Caution is advised when using this drug in the elderly because they may be more sensitive to the effects of the drug, especially the reduced ability to drive/use machinery.

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

It is not known whether this drug passes into breast milk. Consult your doctor before breast-feeding.

Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

The risk of serious side effects (such as slow/shallow breathing, severe drowsiness/dizziness) may be increased if this medication is taken with other products that may also affect breathing or cause drowsiness. Therefore, tell your doctor or pharmacist if you are taking other products such as alcohol, medicine for sleep or anxiety (eszopiclone, zaleplon, zolpidem, benzodiazepines such as diazepam/temazepam, barbiturates such as pentobarbital), muscle relaxants, and narcotic pain relievers (such as codeine).

Overdose

If overdose is suspected, contact a poison control center or emergency room immediately. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: lack of response, slow/shallow breathing, inability to control urine/stool.

Notes

Do not share this medication with others. It may harm them, and it is against the law.

Keep all medical appointments. It is recommended that you visit your doctor at least every 3 months while taking this medication.

Missed Dose

If you miss a dose, take it as soon as you remember if it is before bedtime. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

Storage

Store at room temperature away from light and moisture. Prepare each dose just before bedtime. Use or properly discard prepared doses within 24 hours. Do not store in the bathroom. Keep all medications away from children and pets.

See also How to Use section. Properly discard this product when it is expired or no longer needed. Read the Medication Guide for details. To discard, the FDA recommends pouring into a drain. However, consult your pharmacist or local waste disposal company.

Information last revised April 2014. Copyright(c) 2014 First Databank, Inc.

Images

XYREM 500 MG/ML ORAL SOLUTION
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XYREM 500 MG/ML ORAL SOLUTION

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This medicine is a clear solution.

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Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, expect as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

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