In an adult study assessing the respiratory-depressant effects of Xyrem at doses up to 9 g per night in 21 patients with narcolepsy, no dose-related changes in oxygen saturation were demonstrated in the group as a whole. One of the four patients with preexisting, moderate-to-severe sleep apnea had significant worsening of the apnea/hypopnea index during treatment. Xyrem has a high potential for abuse because it can cause changes in the activity of the brain and can also cause changes in your breathing, even at regular dosages or if you are taking other interacting medicines. Fatal side effects, such as breathing problems, seizures, loss of consciousness, or death can occur if you misuse this medicine, take it with alcohol, or take it with other drugs that cause drowsiness or slow your breathing. van den Brink W, Addolorato G, Aubin HJ, Benyamina A, Caputo F, Dematteis M, etal. (July 2018). "Efficacy and safety of sodium oxybate in alcohol-dependent patients with a very high drinking risk level". Addiction Biology. 23 (4): 969–986. doi: 10.1111/adb.12645. PMID 30043457. S2CID 51716274.

Xyrem is a Schedule III controlled substance. The active ingredient of Xyrem, sodium oxybate or gamma-hydroxybutyrate (GHB), is a Schedule I controlled substance. Abuse of illicit GHB, either alone or in combination with other CNS depressants, is associated with CNS adverse reactions, including seizure, respiratory depression, decreases in the level of consciousness, coma, and death. The rapid onset of sedation, coupled with the amnestic features of Xyrem, particularly when combined with alcohol, has proven to be dangerous for the voluntary and involuntary user (e.g., assault victim). Because illicit use and abuse of GHB have been reported, physicians should carefully evaluate patients for a history of drug abuse and follow such patients closely, observing them for signs of misuse or abuse of GHB (e.g., increase in size or frequency of dosing, drug-seeking behavior, feigned cataplexy) [see Drug Abuse and Dependence ( 9.2)].

Jazz Pharma (JAZZ) Announces that Lonza has Terminated Their Sodium Oxybate Supply Agreement". Street Insider. March 25, 2010.

Sodium oxybate is the sodium salt of γ-hydroxybutyric acid (GHB). The clinical trials for narcolepsy were conducted just as abuse of GHB as a club drug and date rape drug became a matter of public concern; in 2000 GHB was made a Schedule I controlled substance, while sodium oxybate, when used under an FDA NDA or IND application, was classified as a Schedule III controlled substance for medicinal use under the Controlled Substances Act, with illicit use subject to Schedule I penalties. [7]

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The exact way Xyrem works for narcolepsy is not known but it is thought to be metabolized to a neurotransmitter called GABA which then binds to GABAB and GHB receptors. This leads to changes in the activity of the brain, enhancing delta waves which are a type of high-amplitude brain wave generally associated with slow-wave sleep (during the third stage of sleep). Maintenance dose: The dose may be increased by 1 g (OR 0.5 g/dose) orally per night at 1 to 2-week intervals up to 6 g/day.

a b c d e f g h i j k l m n o p q r "Xyrem- sodium oxybate solution". DailyMed . Retrieved 14 November 2020.Take the first nightly dose of Xyrem at least 2 hours after eating [see Clinical Pharmacology ( 12.3)]. Take the second nightly dose 2.5 to 4 hours after the first dose. The same goes for anyone who is considering using OxyRem For Women alongside medication or other brands of supplement. Where to Buy OxyRem For Women Xyrem ( sodium oxybate) Oral Solution is a prescription medicine approved by the U.S. Food and Drug Administration (FDA) with an orphan disease designation to treat cataplexy (a condition where patients suddenly lose muscle tone, including voluntary muscle control, while awake) and excessive daytime sleepiness in patients with narcolepsy. a b Danzon PM (Spring 2000). "Making sense of drug prices" (PDF). Regulation. 23 (1): 56–63. Archived from the original (PDF) on 2012-10-11 . Retrieved 2010-10-05.

The prescription for Xyrem can only be filled by the central certified pharmacy, not your local pharmacy. This is the only pharmacy in the United States permitted to fill the prescription and send it directly to patients. This pharmacy also allows the patient access to a pharmacist 24 hours a day, 7 days a week to answer questions about Xyrem; provides an overnight delivery service (includes Saturdays) but only the patient or a designated adult can sign for the delivery; follows up your prescription with a nurse case manager two days after delivery to answer questions.The mechanism of action of sodium oxybate is unknown. [2] [3] GHB is a normal metabolite of GABA that interacts with the GABA B receptor. [2]