Do you also feel uncontrollably sleepy during the day? Or do you feel like you are going to faint and fall to the ground when you laugh or are surprised? In medical terms, we call this condition Narcolepsy. So, a special medicine that is given to treat this condition is Sodium Oxybate. It comes in the form of a solution. Today, we will talk about this medicine in simple terms, how to use it, things to be careful about, and side effects.
What really happens with this medicine?
Simply put, this medicine called sodium oxybate controls your narcolepsy.
- Daytime Sleepiness: This medication works by affecting your brain and reducing uncontrollable daytime sleepiness. This helps you get a good night's sleep.
- Cataplexy: Some people experience sudden muscle weakness, such as when laughing or being surprised. This is called cataplexy. This medicine can also reduce the occurrence of such episodes.
This is a prescription medication that must be prescribed by a doctor. It is not a medication that you can take on your own.
Things you should tell your doctor before taking medication
If you have any of the conditions listed below, be sure to tell your doctor before starting this medication. This medication is not suitable for everyone. It can be dangerous with some conditions.
| Your condition or habit | Why should you inform the doctor? |
|---|---|
| If you drink alcohol | Taking this medication with alcohol is extremely dangerous. It can cause life-threatening effects, such as respiratory arrest. |
| Depression, suicidal thoughts, or other mental illnesses | This medication may exacerbate some mental conditions, so it is essential that the doctor is aware of this. |
| Respiratory diseases (e.g. Sleep Apnea) or lung diseases | The medicine can slow breathing. This is dangerous for someone who already has breathing problems. |
| Liver or kidney disease | Because this organ is involved in the process of removing medication from the body, it may be necessary to change the dosage of the medication. |
| If you have heart disease, high blood pressure, or are on a low-salt diet | This medicine contains a high amount of sodium (salt), so it may affect people with these conditions. |
| A rare condition called succinic semialdehyde dehydrogenase deficiency | This is a very rare genetic condition. People with this condition are not given this medicine. |
| If you are pregnant, trying to get pregnant, or are a breastfeeding mother | You should discuss with your doctor the possible effects on your unborn child or nursing baby. |
How should I use this medicine?
The way to use this medicine is a little different, so follow these instructions exactly.
- Follow your doctor's instructions: Always take the exact dose as prescribed by your doctor. Read the instructions on the medicine label carefully.
- Accurate measurement: Use the special oral syringe or measuring cup that comes with the medicine to measure it. Do not use household teaspoons or soup spoons. They will not give you an accurate measurement.
- Preparing the medicine: You should mix the prescribed amount of medicine with a little water and drink it. Your doctor will explain how to do this.
- Take on an empty stomach: This medicine should be taken at least 2 hours after eating.
- The two-dose regimen: This is the most important. You will be told to take two doses at night.
1. First dose: At bedtime,Go to bed and drink it while you are in bed.
2. Second dose: Take it 2.5 to 4 hours after the first dose. You may need to set an alarm for this.
- What if I miss a dose? If you miss a dose, skip it. Just take the next dose at the scheduled time. Never take two doses at the same time.
What if you take too much medicine? (Overdose)
If you think you have taken too much medicine, it is an emergency. Immediately call the National Poisons Information Centre at the Colombo National Hospital, or go to the Emergency Department (ETU) of the nearest hospital.
Very important: This medicine is for you only. Never share it with anyone else. This is a medicine that can be misused, so giving or selling it to someone else is a punishable offense.
Things to be especially careful about when taking medication
You need to think a lot about your safety while using this medicine.
- Immediate sleepiness: This medicine makes you feel very sleepy almost immediately after taking it. That's why it's recommended to take the first dose right before going to bed. Don't do anything else after taking the medicine.
- Driving and machinery: Do not drive, operate machinery, or do anything else that requires alertness for at least 6 hours after taking the medicine.
- Avoid alcohol completely: Avoid drinking alcohol completely while taking this medication. Taking both together can cause dangerous conditions such as respiratory arrest.
- Sleep-related behaviors: This is a special thing that you see with this drug. Imagine, you take the drug and fall asleep. But without even realizing it, you get out of bed, cook, call someone, or drive a car ('sleep-driving'). But the next morning you don't remember any of this. This is very dangerous. If you see something like this happening to you or your family, tell your doctor immediately.
- Mental changes: If you or your family notice any changes in your behavior, new or increased depression, suicidal thoughts, extreme anxiety, or memory loss, inform your doctor immediately.
What are the possible side effects of this medicine?
Like any medicine, this one can have side effects. Some of them are serious, some of them are common.
| Type of side effect | Symptoms |
|---|---|
| Serious side effects that require immediate medical attention | |
| Allergic reactions | Skin rash, itching, swelling of the face, lips, tongue or throat. |
| Central nervous system depression (CNS Depression) | Slow or shallow breathing, difficulty breathing, extreme dizziness, loss of consciousness. |
| Mental and behavioral changes | Anxiety, restlessness, hallucinations, suicidal thoughts, increased depression. |
| Sleep apnea | Snoring loudly, choking/stopping and resuming breathing during sleep, feeling excessively sleepy during the day. |
| Sleepwalking | Sleepwalking or engaging in other activities without you even realizing it. |
| Common side effects that should be reported to the doctor if they persist | |
| Other | Bedwetting, dizziness, headache, loss of appetite, nausea, vomiting. |
Can there be problems with other medications?
Yes. This medicine can interact with other medicines.
Avoid: Avoid alcohol and other sleeping pills completely while taking this medication. Taking them together can stop your breathing and can even be life-threatening.
In addition, problems can also occur with the following medications:
- Medicines for allergies, coughs, and colds (Antihistamines)
- Some medications for depression (e.g. Amitriptyline, Fluoxetine, Sertraline)
- Some medications for epilepsy (e.g. Phenobarbital)
- General anesthetics
- Medicines given to relax muscles during surgery
- Painkillers (especially morphine)
- Medicines like Divalproex sodium, Valproic acid
This list is not complete. Therefore, tell your doctor about all medications, vitamins, herbal remedies, and supplements you are taking.
Take-Home Message
- Always take this medicine exactly as prescribed by your doctor, in the correct dose, and at the correct time. Especially follow the two-dose regimen at night.
- Do not take this with alcohol or other sleeping pills for any reason. It is very dangerous.
- Be aware of unusual behaviors such as sleepwalking and sleep driving. If this occurs, inform your doctor immediately.
- If you experience changes in your mental state, behavior, or suicidal thoughts, seek medical advice immediately.
- Store this in a safe place out of reach of others. Never share it with others.
👩🏽⚕️ Additional questions (FAQs)
💬 What is Sodium Oxybate (Sodium Oxybate / Xyrem) used for?
This is a controlled substance (GHB) that is not available in regular pharmacies and is a CNS depressant that is released under extremely strict regulations! It is used to treat a serious disease called 'Narcolepsy'. That is, patients who suddenly fall into uncontrollable sleep (Cataplexy) while walking/driving a vehicle, and patients who suffer from excessive daytime sleepiness (EDS).
💬 How does this medicine (Sodium Oxybate) help with narcolepsy?
The thing is, you don't take this medicine during the day, but before you go to bed at night (and wake up again in the middle of the night)! What this does is force the patient into a deep, deep sleep (Slow-wave sleep) at night (GABA-B Receptor Activation). When you sleep properly at night, the uncontrollable sleepiness (EDS) and cataplexy that suddenly come on during the day are completely cured.
💬 What are the extremely dangerous side effects (Black Box Warning) of this drug (Xyrem)?
This is a drug that is directly in the 'Street Drugs / Date Rape Drug - GHB' category! If you take this with alcohol/sleeping pills, there is a high chance of respiratory depression and death/coma! Also, if you continue to take this, you can get severe depression, sleepwalking, and psychosis (therefore, this is only released through an officially registered REMS program).
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