XYWAV® (calcium, magnesium, potassium, and sodium oxybates) oral solution, 0.5 g/mL total salts (equivalent to 0.413 g/mL of oxybate) and XYREM® (sodium oxybate) oral solution, 0.5 g/mL are prescription medicines used to treat the following symptoms in people 7 years of age or older with narcolepsy:
- sudden onset of weak or paralyzed muscles (cataplexy)
- excessive daytime sleepiness (EDS)
Important Safety Information
WARNING: Taking XYWAV or XYREM with other Central Nervous System (CNS) depressants such as medicines used to make you or your child fall asleep, including opioid analgesics, benzodiazepines, sedating antidepressants, antipsychotics, sedating anti-epileptic medicines, general anesthetics, muscle relaxants, alcohol, or street drugs, may cause serious medical problems, including trouble breathing (respiratory depression), low blood pressure (hypotension), changes in alertness (drowsiness), fainting (syncope), and death.
The active ingredient of XYWAV and XYREM is a form of gamma‑hydroxybutyrate (GHB). Abuse or misuse of illegal GHB alone or with other drugs that cause changes in alertness (or consciousness) have caused serious side effects. These effects include seizures, trouble breathing (respiratory depression), changes in alertness (drowsiness), coma, and death. Call your doctor right away if you or your child has any of these serious side effects.
Because of these risks, you have to go through the XYWAV and XYREM REMS to have your or your child’s prescription for XYWAV or XYREM filled.
Do not take XYWAV or XYREM if you take or your child takes other sleep medicines or sedatives (medicines that cause sleepiness), drinks alcohol, or has a rare problem called succinic semialdehyde dehydrogenase deficiency.
Keep XYWAV or XYREM in a safe place to prevent abuse and misuse. Selling or giving away XYWAV or XYREM may harm others, and is against the law. Tell your doctor if you have ever abused or been dependent on alcohol, prescription medicines, or street drugs.
Anyone who takes XYWAV or XYREM should not do anything that requires them to be fully awake or is dangerous, including driving a car, using heavy machinery, or flying an airplane, for at least 6 hours after taking XYWAV or XYREM. Those activities should not be done until you know how XYWAV or XYREM affects you or your child.
Falling asleep quickly, including while standing or while getting up from the bed, has led to falls with injuries that have required some people to be hospitalized.
XYWAV and XYREM can cause serious side effects, including the following:
- Breathing problems, including slower breathing, trouble breathing, and/or short periods of not breathing while sleeping (sleep apnea). People who already have breathing or lung problems have a higher chance of having breathing problems when they take XYWAV or XYREM.
- Mental health problems, including confusion, seeing or hearing things that are not real (hallucinations), unusual or disturbing thoughts (abnormal thinking), feeling anxious or upset, depression, thoughts of killing yourself or trying to kill yourself, increased tiredness, feelings of guilt or worthlessness, and/or difficulty concentrating. Tell your doctor if you or your child have or had depression or have tried to harm yourself or themselves. Call your doctor right away if you have or your child has symptoms of mental health problems or a change in weight or appetite.
- Sleepwalking. XYWAV and XYREM can cause sleepwalking, which can cause injuries. Call your doctor if this occurs.
For XYREM: Tell your doctor if you are or your child is on a salt-restricted diet or if you have or your child has high blood pressure, heart failure, or kidney problems. XYREM contains a lot of sodium (salt) and may not be right for you or your child.
For adults, the most common side effects of XYWAV include:
- Headache
- Nausea
- Dizziness
- Decreased appetite
- Parasomnia (a sleep disorder that can include abnormal dreams, abnormal rapid eye movement (REM) sleep, sleep paralysis, sleep talking, sleep terror, sleep‑related eating disorder, sleepwalking, and other abnormal sleep-related events)
- Diarrhea
- Excessive sweating (hyperhidrosis)
- Anxiety
- Vomiting
For adults, the most common side effects of XYREM include:
- Nausea
- Sleepiness
- Dizziness
- Vomiting
- Bedwetting
- Tremor
For children, the most common side effects of XYREM (which also contains oxybate like XYWAV) include:
- Nausea
- Bedwetting
- Vomiting
- Headache
- Weight decrease
- Decreased appetite
- Dizziness
- Sleepwalking
XYWAV and XYREM can cause physical dependence and craving for the medicine when they are not taken as directed. These are not all the possible side effects of XYWAV or XYREM.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1‑800‑FDA‑1088.
Please see full Prescribing Information, including BOXED Warning, and Medication Guide for XYREM.
Please see full Prescribing Information, including BOXED Warning, and Medication Guide for XYWAV.
