Drug Action
A central nervous system depressant.
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Drug reference
A central nervous system depressant.
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Narcolepsy with cataplexy (under expert supervision) ▶BY MOUTH ▶Adult: Initially 2.25 g daily, dose to be taken on retiring and 2.25 g after 2.5–4 hours, then increased in steps of 1.5 g daily in 2 divided doses, dose adjusted according to response at intervals of 1–2 weeks; dose titration should be repeated if restarting after interval of more than 14 days, maximum 9 g daily in 2 divided doses
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DUE TO INTERACTIONS ▶Manufacturer advises reduce dose by 20 % with concurrent use of sodium valproate or valproic acid.
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Major depression. succinic semi- aldehyde dehydrogenase deficiency
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Body mass index of 40 kg/m2 or greater (higher risk of sleep apnoea). elderly. epilepsy. heart failure (high sodium content). history of depression. history of drug abuse. hypertension (high sodium content). respiratory disorders. risk of discontinuation effects including rebound cataplexy and withdrawal symptoms
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→Appendix 1: sodium oxybate
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▶Common or very common Abdominal pain upper. anxiety. appetite abnormal. arthralgia. asthenia. back pain. concentration impaired. confusion. depression. diarrhoea . dizziness. dyspnoea. fall. feeling drunk. headache. hyperhidrosis. hypertension. increased risk of infection. movement disorders. muscle spasms. nasal congestion. nausea. palpitations. peripheral oedema. sedation. sensation abnormal. skin reactions. sleep disorders. sleep paralysis. snoring. taste altered. tremor. urinary disorders. vertigo. vision blurred. vomiting. weight decreased ▶Uncommon Behaviour abnormal. faecal incontinence. hallucination. memory loss. psychosis. suicidal tendencies. thinking abnormal ▶Frequency not known Angioedema. dehydration. delusions. dry mouth. homicidal ideation. loss of consciousness. mood altered. respiratory depression. seizure. sleep apnoea
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Avoid.
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Manufacturer advises caution (risk of increased exposure). Dose adjustments Manufacturer advises initial dose reduction of 50%.
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Caution—contains 3.96 mmol Na+ per mL.
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Dilute each dose with 60 mL water; prepare both doses before retiring. Observe the same time interval (2–3 hours) each night between the last meal and the first dose.
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There can be variation in the licensing of different medicines containing the same drug. Oral solution CAUTIONARY AND ADVISORY LABELS 13, 19 ELECTROLYTES: May contain Sodium Nervous system ▶Sodium oxybate (Non-proprietary) Sodium oxybate 500 mg per 1 ml Sodium oxybate 500mg/ml oral solution sugar-free | 180 ml P £324.00–£360.00 DT = £360.00 b ▶Xyrem (UCB Pharma Ltd) Sodium oxybate 500 mg per 1 ml Xyrem 500mg/ml oral solution sugar-free | 180 ml P £360.00 DT = £360.00 b CNS STIMULANTS
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Patients or carers should be given advice on how to administer sodium oxybate oral solution. Driving and skilled tasks Leave at least 6 hours between taking sodium oxybate and performing skilled tasks (e.g. driving or operating machinery); effects of alcohol and other CNS depressants enhanced.
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Initially 2.25 g daily, dose to be taken on retiring
First-line fragment. Read the complete Indications and Dose section above.
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