Sodium Oxybate: Difference between revisions
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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 | '''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 | ||
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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 | | 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''' | | 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]] | ||