Sodium Oxybate - Revision history

MDElliottMD: Em-dash sweep: replace em-dash with comma per project rule; PendellsCorner verbatim quotes preserved.

2026-05-19T03:16:11Z

Em-dash sweep: replace em-dash with comma per project rule; PendellsCorner verbatim quotes preserved.

← Older revision		Revision as of 03:16, 19 May 2026
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	\| bioavailability = ~25% (high first-pass)		\| bioavailability = ~25% (high first-pass)
	\| pregnancy = Category C		\| pregnancy = Category C
	\| legal = Schedule III; REMS-restricted (Schedule I if outside the pharmaceutical channel — same molecule as illicit GHB)		\| legal = Schedule III; REMS-restricted (Schedule I if outside the pharmaceutical channel, same molecule as illicit GHB)
	\| mechanism = Agonist at the metabotropic GABAB receptor and the endogenous γ-hydroxybutyrate (GHB) receptor. Produces deep sleep with increased slow-wave architecture, suppression of REM intrusion, and cataplexy reduction.		\| mechanism = Agonist at the metabotropic GABAB receptor and the endogenous γ-hydroxybutyrate (GHB) receptor. Produces deep sleep with increased slow-wave architecture, suppression of REM intrusion, and cataplexy reduction.
	\| intro = Sodium oxybate is the sodium salt of [[GHB]], formulated as a high-purity oral solution dosed in grams. It is among the most effective treatments for cataplexy and excessive daytime sleepiness in narcolepsy. Because its half-life is so short, it must be taken in two doses separated by 2.5–4 h during the night. Pharmacy-distributed only through a REMS program; the same compound outside that channel is Schedule I.		\| intro = Sodium oxybate is the sodium salt of [[GHB]], formulated as a high-purity oral solution dosed in grams. It is among the most effective treatments for cataplexy and excessive daytime sleepiness in narcolepsy. Because its half-life is so short, it must be taken in two doses separated by 2.5–4 h during the night. Pharmacy-distributed only through a REMS program; the same compound outside that channel is Schedule I.
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	\| pregnancy_details =		\| pregnancy_details =
	\| monitoring = Sleep quality; daytime sedation; respiratory status (caution in sleep apnea or with concurrent CNS depressants).		\| monitoring = Sleep quality; daytime sedation; respiratory status (caution in sleep apnea or with concurrent CNS depressants).
	\| counseling = '''Take only in bed and only when ready to sleep''' — onset is rapid. Severe sedative interactions with alcohol or other CNS depressants. Significant sodium load (~1100 mg per 4.5 g/night) — consider Xywav for sodium-restricted patients.		\| counseling = '''Take only in bed and only when ready to sleep''', onset is rapid. Severe sedative interactions with alcohol or other CNS depressants. Significant sodium load (~1100 mg per 4.5 g/night), consider Xywav for sodium-restricted patients.
	\| anecdotes =		\| anecdotes =
	\| seealso = [[GHB]], [[GBL]], [[Modafinil]], [[Pitolisant]]		\| seealso = [[GHB]], [[GBL]], [[Modafinil]], [[Pitolisant]]

MDElliottMD: Sweep: "indications" -> "problems" sitewide terminology update (preserves MedTemplate param name)

2026-05-19T01:37:44Z

Sweep: "indications" -> "problems" sitewide terminology update (preserves MedTemplate param name)

← Older revision		Revision as of 01:37, 19 May 2026
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	'''Note:''' Sodium oxybate is the sodium salt of [[GHB]] (γ-hydroxybutyrate). As a regulated pharmaceutical (Schedule III with restricted REMS distribution), it has its own ~~indications~~ and dosing distinct from non-medical GHB use. See [[GHB]] for the broader pharmacology and recreational context.		'''Note:''' Sodium oxybate is the sodium salt of [[GHB]] (γ-hydroxybutyrate). As a regulated pharmaceutical (Schedule III with restricted REMS distribution), it has its own problems and dosing distinct from non-medical GHB use. See [[GHB]] for the broader pharmacology and recreational context.

	{{MedTemplate		{{MedTemplate

MDElliottMD: Create Sodium Oxybate scaffold (links to GHB)

2026-05-15T15:30:23Z

Create Sodium Oxybate scaffold (links to GHB)

New page

'''Note:''' Sodium oxybate is the sodium salt of [[GHB]] (γ-hydroxybutyrate). As a regulated pharmaceutical (Schedule III with restricted REMS distribution), it has its own indications and dosing distinct from non-medical GHB use. See [[GHB]] for the broader pharmacology and recreational context.

{{MedTemplate
| generic = Sodium Oxybate
| brand = Xyrem; Xywav (lower-sodium formulation with Ca/Mg/K salts)
| classes = GABAB Agonist; Endogenous GHB receptor agonist
| uses = <vote slug="cataplexy-use">Cataplexy in narcolepsy</vote>, <vote slug="excessive-daytime-sleepiness-use">Excessive daytime sleepiness in narcolepsy</vote>, <vote slug="idiopathic-hypersomnia-use">Idiopathic hypersomnia</vote>
| starting_dose = 2.25 g at bedtime + 2.25 g 2.5–4 h later; titrate weekly to 6–9 g/night total
| preparations = 0.5 g/mL oral solution
| fda_max = 9 g/night
| routes = Oral (must be taken in bed; effects within minutes)
| onset = 15–30 min (fasting)
| duration = ~3 h per dose (twice-nightly schedule required)
| halflife = 30–60 min
| bioavailability = ~25% (high first-pass)
| pregnancy = Category C
| legal = Schedule III; REMS-restricted (Schedule I if outside the pharmaceutical channel — same molecule as illicit GHB)
| mechanism = Agonist at the metabotropic GABAB receptor and the endogenous γ-hydroxybutyrate (GHB) receptor. Produces deep sleep with increased slow-wave architecture, suppression of REM intrusion, and cataplexy reduction.
| intro = Sodium oxybate is the sodium salt of [[GHB]], formulated as a high-purity oral solution dosed in grams. It is among the most effective treatments for cataplexy and excessive daytime sleepiness in narcolepsy. Because its half-life is so short, it must be taken in two doses separated by 2.5–4 h during the night. Pharmacy-distributed only through a REMS program; the same compound outside that channel is Schedule I.
| indications =
| dosing =
| effects =
| pk_absorption = ~25% oral bioavailability; markedly reduced by food.
| pk_distribution = Negligible plasma protein binding.
| pk_metabolism = Endogenous pathway via GHB dehydrogenase to succinic acid, then TCA cycle. No CYP involvement.
| pk_elimination = Almost entirely metabolic; ~5% renal.
| pharmacodynamics =
| interactions = <pharmaInteractions/>
| pregnancy_details =
| monitoring = Sleep quality; daytime sedation; respiratory status (caution in sleep apnea or with concurrent CNS depressants).
| counseling = '''Take only in bed and only when ready to sleep''' — onset is rapid. Severe sedative interactions with alcohol or other CNS depressants. Significant sodium load (~1100 mg per 4.5 g/night) — consider Xywav for sodium-restricted patients.
| anecdotes =
| seealso = [[GHB]], [[GBL]], [[Modafinil]], [[Pitolisant]]
| references = <references/>
}}

[[Category:Medicines]]