What is Sodium Oxybate
Sodium oxybate is the sodium salt of gamma hydroxybutyric acid (GHB), a naturally occurring central nervous system transmitter with sedative and anesthetic properties.
In Europe, sodium oxybate has been used for various medical purposes including narcolepsy, intravenous anesthesia, alcohol dependence, and opiate dependence. In the U.S., sodium oxybate is used for the treatment of cataplexy or excessive daytime sleepiness (EDS) in patients with narcolepsy.
Sodium oxybate differs from modafinil and other stimulant treatments for narcolepsy in that it significantly decreases cataplexy episodes in addition to EDS; the drug is frequently prescribed along with stimulant therapies for narcolepsy. A median decrease in the total number of weekly cataplexy episodes of nearly 70% has been reported in clinical trials in adult patients receiving a dose of 9 grams/night.
Historically, GHB was commonly used as a dietary supplement for enhancing athletic performance and as a sleep aid. As a result of serious adverse events associated with GHB use as a dietary supplement, the FDA intervened in 1991 to prohibit the marketing of GHB.
Commonly known by slang terms such as Liquid Ecstasy or Liquid E, GHB can produce euphoria, making it a popular but dangerous party drug of abuse. GHB has not been approved for any medical use and has gained notoriety as a date rape drug due to its sedative and amnestic properties.
Brand Name
Xyrem
Indications & Dosage
- cataplexy
- narcolepsy
For the treatment of cataplexy and excessive daytime sleepiness in patients with narcolepsy
Side Effects
- abdominal pain
- agitation
- anorexia
- anxiety
- apnea
- arthralgia
- blurred vision
- cataplexy
- Cheyne-Stokes respiration
- coma
- complex sleep-related behaviors
- confusion
- delirium
- depression
- diarrhea
- dizziness
- drowsiness
- edema
- euphoria
- hallucinations
- headache
- hyperhidrosis
- hypertension
- impaired cognition
- irritability
- libido increase
- memory impairment
- muscle cramps
- nausea
- nocturia
- nystagmus
- obtundation
- paranoia
- paresthesias
- peripheral edema
- physiological dependence
- psychological dependence
- psychosis
- respiratory depression
- seizures
- serotonin syndrome
- sleep paralysis
- somnambulism
- suicidal ideation
- tolerance
- tremor
- urinary incontinence
- vomiting
- weight loss
- withdrawal
- xerostomia
Monitoring Parameters
- LFTs
- neurologic function
- serum potassium
- serum sodium
Contraindications
- alcoholism
- behavioral changes
- breast-feeding
- cardiac disease
- CNS depression
- coadministration with other CNS depressants
- complex sleep-related behaviors
- depression
- driving or operating machinery
- ethanol ingestion
- geriatric
- heart failure
- hepatic disease
- hypertension
- hypoxemia
- labor
- neonates
- obesity
- obstetric delivery
- pregnancy
- pulmonary disease
- renal disease
- respiratory depression
- respiratory insufficiency
- seizure disorder
- seizures
- sleep apnea
- substance abuse
- succinic semialdehyde dehydrogenase deficiency
- suicidal ideation
- surgery
Interactions
- Acetaminophen; Aspirin, ASA; Caffeine
- Acetaminophen; Butalbital
- Acetaminophen; Butalbital; Caffeine
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetaminophen; Caffeine
- Acetaminophen; Caffeine; Dihydrocodeine
- Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
- Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
- Acetaminophen; Dextromethorphan; Doxylamine
- Acetaminophen; Tramadol
- Alprazolam
- Amitriptyline; Chlordiazepoxide
- Amobarbital
- Amphetamine
- Amphetamine; Dextroamphetamine
- Amphetamine; Dextroamphetamine Salts
- Anxiolytics; Sedatives; and Hypnotics
- Aspirin, ASA; Butalbital; Caffeine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Aspirin, ASA; Caffeine; Dihydrocodeine
- Aspirin, ASA; Caffeine; Orphenadrine
- Aspirin, ASA; Carisoprodol
- Aspirin, ASA; Carisoprodol; Codeine
- Atropine; Difenoxin
- Atropine; Diphenoxylate
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- Baclofen
- Barbiturates
- Belladonna Alkaloids; Ergotamine; Phenobarbital
- Benzhydrocodone; Acetaminophen
- Benzodiazepines
- Benzphetamine
- Bupropion
- Bupropion; Naltrexone
- Buspirone
- Butabarbital
- Caffeine
- Caffeine; Ergotamine
- Cannabidiol
- Capsaicin; Metaxalone
- Carisoprodol
- Cenobamate
- Cetirizine
- Cetirizine; Pseudoephedrine
- Chlordiazepoxide
- Chlordiazepoxide; Clidinium
- Chlorpromazine
- Chlorzoxazone
- Clobazam
- Clonazepam
- Clorazepate
- Cocaine
- Codeine; Phenylephrine; Promethazine
- Codeine; Promethazine
- COMT inhibitors
- Cyclobenzaprine
- Dantrolene
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Deutetrabenazine
- Dexmethylphenidate
- Dextroamphetamine
- Dextromethorphan; Promethazine
- Diazepam
- Doxylamine
- Doxylamine; Pyridoxine
- Dronabinol
- Droperidol
- Esketamine
- Estazolam
- Ethanol
- Fluphenazine
- Flurazepam
- food
- Gabapentin
- General anesthetics
- Green Tea
- Hydroxyzine
- Iohexol
- Iopamidol
- Iopromide
- Ioversol
- Isosulfan Blue
- Lasmiditan
- Lemborexant
- Levocetirizine
- Lisdexamfetamine
- Lofexidine
- Lopinavir; Ritonavir
- Lorazepam
- Lumateperone
- Meperidine; Promethazine
- Mephobarbital
- Mesoridazine
- Metaxalone
- Methamphetamine
- Methohexital
- Methylphenidate
- Midazolam
- Monoamine oxidase inhibitors
- Nabilone
- Non-Ionic Contrast Media
- Ombitasvir; Paritaprevir; Ritonavir
- Opiate Agonists
- Orphenadrine
- Oxazepam
- Ozanimod
- Pemoline
- Pentobarbital
- Perphenazine
- Perphenazine; Amitriptyline
- Phendimetrazine
- Phenobarbital
- Phenothiazines
- Phentermine
- Phentermine; Topiramate
- Phenylephrine; Promethazine
- Phenytoin
- Pregabalin
- Primidone
- Procarbazine
- Prochlorperazine
- Promethazine
- Quazepam
- Rasagiline
- Ritonavir
- Saquinavir
- Secobarbital
- Skeletal Muscle Relaxants
- St. John’s Wort, Hypericum perforatum
- Temazepam
- Thiethylperazine
- Thiopental
- Thioridazine
- Tramadol
- Triazolam
- Trifluoperazine
- Trimethobenzamide
- Valproic Acid, Divalproex Sodium
