GAMMA-HYDROXYBUTYRATE (GHB)

OTHER NAME(S):

4-Hydroxybutanoate, 4-Hydroxy Butyrate, 4-hydroxybutyric acid, Acide 4-hydroxybutanoïque, Acide Gamma-Hydroxybutyrique, Acide Gamma-Hydroxy-Butyrique, Cherry Meth, Ecstasy Liquide, Fantasy G, Gamma Hydrate, Gamma-Hydroxybutyrate, Gamma-Hydroxy-Butyrate, Gamma Hydroxy-Butyrate de Sodium, Gamma Hydroxybutyrate Sodium, Gamma Hydroxybutyric Acid, Gamma-Hidroxibutirato, Gamma-OH, GHB, Grievous Bodily Harm, Liquid Ecstacy, Liquid X, Oxybate de Sodium, Oxybutyrate de Sodium, Scoop, Sodium 4-hydroxybutyrate, Sodium gamma-hydroxybutyrate, Sodium Oxybate, Sodium Oxybutyrate, Vita-G.

Overview

Overview Information

Gamma hydroxybutyrate (GHB) is a chemical found in the brain and other areas of the body. It can also be made in a laboratory.

GHB used to be available as a dietary supplement in the U.S., but it was taken off the market in 1990 because of safety concerns. It is now a Schedule I controlled substance, making it illegal to produce, sell, or possess. A prescription form of GHB called sodium oxybate (Xyrem) is still available for treating excessive daytime sleepiness (narcolepsy). It is a Schedule III controlled substance, which means that it requires a prescription and close monitoring by a medical doctor.

The prescription form of GHB is used for excessive daytime sleepiness (narcolepsy). It has also been used for alcohol use disorder and opioid withdrawal.

How does it work?

GHB acts on several nerve pathways in the brain.

Uses

Uses & Effectiveness?

Effective for

  • Excessive daytime sleepiness (narcolepsy). Taking GHB helps people with narcolepsy sleep at night so they are less likely to feel sleepy during the day. GHB also reduces other symptoms that sometimes go along with narcolepsy.

Possibly Effective for

  • Alcohol use disorder. Taking GHB seems to reduce symptoms of alcohol withdrawal and prevent relapse in people who already completed detox.
  • Withdrawal from heroin, morphine, and other opioid drugs. Taking GHB seems to reduce withdrawal symptoms in heroin addicts and methadone-maintained addicts.

Insufficient Evidence for

More evidence is needed to rate the effectiveness of GHB for these uses.

Side Effects

Side Effects & Safety

When taken by mouth: The prescription form of GHB (sodium oxybate) is LIKELY SAFE for adults who are taking it under close medical supervision for excessive daytime sleepiness (narcolepsy). Side effects may include nausea, vomiting, dizziness, drowsiness, and loss of bladder control. GHB is UNSAFE and illegal for use as a dietary supplement. It can cause many serious side effects including hallucinations, confusion, memory loss, slowed heart rate, slowed breathing, seizures, coma, and death. Long-term use can lead to addiction and withdrawal symptoms when it is stopped.

GHB adds to the effects of alcohol and many drugs that cause sleepiness.

When given by IV: GHB is POSSIBLY SAFE when given by IV under close medical supervision, short-term.

Special Precautions & Warnings:

Pregnancy and breast-feeding: GHB is UNSAFE.Don't use GHB if you are pregnant or breast-feeding. It's been linked with life-threatening side effects.

Slow heart rate (bradycardia): GHB should be avoided since it can slow the heart rate.

Seizure disorder (Epilepsy): GHB might cause seizures in people with epilepsy. Avoid use.

Surgery: GHB can affect the central nervous system. There is a concern that it might cause too much sleepiness if it is used along with anesthesia and other nerve-numbing medications used during and after surgery. Stop using GHB at least 2 weeks before a scheduled surgery. Talk to your doctor before stopping sodium oxybate (Xyrem).

Interactions

Interactions?

Major Interaction

Do not take this combination

!

  • Alcohol (Ethanol) interacts with GAMMA-HYDROXYBUTYRATE (GHB)

    Concomitant use may increase the risk of serious CNS and respiratory depression (3678,102834). Ethanol may also inhibit the clearance of GHB (3682,102831). Research also shows that concomitant use can increase the risk of other adverse events, including gastrointestinal disturbances , hypotension, and decreased oxygen saturation (93831).

  • Amphetamines interacts with GAMMA-HYDROXYBUTYRATE (GHB)

    Amphetamines are drugs that can speed up your nervous system. GHB can slow down your nervous system. Taking GHB along with amphetamines can lead to serious side effects.

  • Haloperidol (Haldol) interacts with GAMMA-HYDROXYBUTYRATE (GHB)

    GHB can affect the brain. Haloperidol (Haldol) can also affect the brain. Taking haloperidol (Haldol) along with GHB might cause serious side effects.

  • Medications for mental conditions (Antipsychotic drugs) interacts with GAMMA-HYDROXYBUTYRATE (GHB)

    GHB can affect the brain. Medications for mental conditions also affect the brain. Taking GHB along with medications for mental conditions might increase the effects and serious side effects of GHB. Do not take GHB if you are taking medications for a mental condition.
    Some of these medications include fluphenazine (Permitil, Prolixin), haloperidol (Haldol), chlorpromazine (Thorazine), prochlorperazine (Compazine), thioridazine (Mellaril), trifluoperazine (Stelazine), and others.

  • Medications used to prevent seizures (Anticonvulsants) interacts with GAMMA-HYDROXYBUTYRATE (GHB)

    Medications used to prevent seizures affect chemicals in the brain. GHB is changed in the body to one of these brain chemicals called GABA. Taking GHB along with medications used to prevent seizures might decrease the effects of GHB.
    Some medications used to prevent seizures include phenobarbital, primidone (Mysoline), valproic acid (Depakene), gabapentin (Neurontin), carbamazepine (Tegretol), phenytoin (Dilantin), and others.

  • Muscle relaxants interacts with GAMMA-HYDROXYBUTYRATE (GHB)

    Muscle relaxants can cause drowsiness. GHB can also cause drowsiness. Taking GHB along with muscle relaxants might cause too much drowsiness and serious side effects. Do not take GHB if you are taking muscle relaxants.
    Some of these muscle relaxants include carisoprodol (Soma), pipecuronium (Arduan), orphenadrine (Banflex, Disipal), cyclobenzaprine, gallamine (Flaxedil), atracurium (Tracrium), pancuronium (Pavulon), succinylcholine (Anectine), and others.

  • Naloxone (Narcan) interacts with GAMMA-HYDROXYBUTYRATE (GHB)

    GHB can affect the brain. Taking naloxone (Narcan) along with GHB might decrease the effects of GHB on the brain.

  • Ritonavir (Norvir) interacts with GAMMA-HYDROXYBUTYRATE (GHB)

    Ritonavir (Norvir) and saquinavir (Fortovase, Invirase) are commonly used together for HIV/AIDS. Taking both of these medications plus GHB might decrease how quickly the body gets rid of GHB. This could cause serious side effects.

  • Saquinavir (Fortovase, Invirase) interacts with GAMMA-HYDROXYBUTYRATE (GHB)

    Saquinavir (Fortovase, Invirase) and ritonavir (Norvir) are commonly used together for HIV/AIDS. Taking both these medications plus GHB might decrease how fast the body gets rid of GHB. This could cause serious side effects.

  • Sedative medications (Benzodiazepines) interacts with GAMMA-HYDROXYBUTYRATE (GHB)

    GHB (BD) might cause sleepiness and drowsiness. Medications that cause sleepiness and drowsiness are called sedatives. Taking GHB along with sedative medications might cause serious side effects. Do not take GHB if you are taking sedative medications.
    Some of these sedative medications include clonazepam (Klonopin), diazepam (Valium), lorazepam (Ativan), and others.

  • Sedative medications (CNS depressants) interacts with GAMMA-HYDROXYBUTYRATE (GHB)

    GHB might cause sleepiness and drowsiness. Medications that cause sleepiness are called sedatives. Taking GHB along with sedative medications might cause serious side effects. Do not take GHB if you are taking sedative medications.
    Some sedative medications include clonazepam (Klonopin), lorazepam (Ativan), phenobarbital (Donnatal), zolpidem (Ambien), and others.

Moderate Interaction

Be cautious with this combination

!

  • Medications for pain (Narcotic drugs) interacts with GAMMA-HYDROXYBUTYRATE (GHB)

    Some medications for pain can cause sleepiness and drowsiness. GHB might also cause sleepiness and drowsiness. Taking GHB along with some medications for pain might cause severe side effects. Do not take GHB if you are taking medications for pain.
    Some medications for pain include meperidine (Demerol), hydrocodone, morphine, OxyContin, and many others.

Dosing

Dosing

The following doses have been studied in scientific research:

BY MOUTH:

  • For excessive daytime sleepiness (narcolepsy): A dose of 25 mg/kg at bedtime, repeated 3 hours later, or a total of with sedative properties.
  • For alcohol use disorder:50 to 150 mg/kg divided into 3 to 6 doses per day. GHB should be used only under close medical supervision.
BY IV:
  • For alcohol use disorder: 50-100 mg/kg divided into 4 doses per day has been used. GHB should be used only under close medical supervision.

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View References

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