Xyrem is usually taken at night in two doses to treat certain symptoms of narcolepsy. Specific dosages may vary depending on factors like your individual symptoms and other medications you may be taking.
Xyrem is a prescription drug used to treat symptoms of narcolepsy in adults and certain children. These symptoms include cataplexy and excessive sleepiness during the daytime.
The active ingredient in Xyrem is sodium oxybate. Xyrem belongs to a group of drugs called central nervous system (CNS) depressants.
This article describes the dosages of Xyrem, as well as its strength and how to take it.
Your doctor will likely start you on a low dosage and adjust it over time to reach the right amount for you. They’ll prescribe the smallest dosage that provides the desired effect.
The following information describes dosages that are commonly used or recommended for Xyrem. But be sure to take the dosage your doctor prescribes for you. They’ll determine the best dosage to fit your needs. In some cases, doctors may adjust your dosage from those shown here.
Xyrem form
Xyrem is available as an oral liquid solution.
Xyrem strength
Xyrem comes in one strength of 0.5 grams (g) per milliliter (mL).
The typical starting Xyrem dosage for adults with narcolepsy is 4.5 g divided into two doses. If necessary, your doctor might increase your nightly dosage by 1.5 g per week.
The recommended maintenance (long-term) dosage of Xyrem is 6 to 9 g per night divided into two doses. The maximum dosage of Xyrem is 9 g total per night.
Doctors prescribe Xyrem in two divided doses. The first dose is taken at bedtime and the second dose is taken 2.5 to 4 hours later. Your doctor may split your total nightly dose equally. But some people may benefit from taking unequal doses of Xyrem based on their doctor’s recommendation.
Xyrem is used to help treat symptoms of narcolepsy in children ages 7 years and older. The dose of Xyrem in children depends on their body weight in kilograms (kg). One kg equals about 2.2 pounds (lbs).
Doctors prescribe Xyrem in two divided doses. The first dose is taken at bedtime and the second dose is taken 2.5 to 4 hours later.
Each dose in the following summary table is taken at bedtime and then again 2.5 to 4 hours later. Some children may require unequal doses of Xyrem based on their doctor’s recommendation.
| Body weight range | Starting dose per day | Maximum dose per day |
|---|---|---|
| 20 kg to less than 30 kg | 1 g or less | 3 g |
| 30 kg to less than 45 kg | 1.5 g or less | 3.75 g |
| 45 kg or more | 2.25 g or less | 4.5 g |
Your child’s doctor may increase the dose of Xyrem every week, up to 0.5 g per dose.
For more information about Xyrem’s dosage for children, talk with your child’s doctor or pharmacist.
Xyrem is available as an oral liquid solution. You’ll prepare both doses of Xyrem before bedtime. Using the provided syringe, measure the prescribed amount of Xyrem and place the solution into one of the empty containers provided by the pharmacy. Then add 1/4 cup or 60 mL of water to the solution. Prepare the second dose the same way.
Take your first dose of Xyrem 2 hours after eating, while in bed, and lie down immediately. Your next dose is 2.5 to 4 hours later. You may need to set an alarm to wake up for your second dose.
Missed dose
If you miss a dose of Xyrem, skip the missed dose, and take your next dose at its usual time. If you’re not sure whether you should take a missed dose, talk with your doctor or pharmacist.
If you need help remembering to take your dose of Xyrem on time, try using a medication reminder. This can include setting an alarm or downloading a reminder app on your phone.
Is Xyrem used long term?
Yes, Xyrem is usually used as a long-term treatment. If you and your doctor determine it’s safe and effective for your condition, you’ll likely take it long term.
Below are answers to some commonly asked questions about Xyrem’s dosage.
How does Xyrem’s dosing compare with Lumryz’s dosing?
Xyrem and Lumryz have different dosages. Xyrem is taken twice at bedtime while Lumryz is taken once at bedtime. This is because Lumryz is an extended-release drug that’s slowly released into your body over a period of time. Xyrem is an immediate-release drug, so it’s released into your body as soon as you take it. For Xyrem to be effective, you have to take a dose at bedtime and then again 2.5 to 4 hours later.
Both Xyrem and Lumryz contain the same active ingredient, sodium oxybate, and they’re used to treat symptoms of narcolepsy. They both come in packets that you’ll mix with water to form a liquid that you’ll drink. The doses of Xyrem and Lumryz are also similar. However, Lumryz is only approved for use in adults, while Xyrem can be used in adults and children ages 7 years and older.
To learn more about how the dosing of Xyrem and Lumryz compare, talk with your doctor or pharmacist.
Can Xyrem be used for insomnia? If so, what’s the dosage?
No, Xyrem isn’t approved for insomnia (difficulty sleeping). It’s only used to treat symptoms of narcolepsy, which is a long-term neurological sleep disorder.
Because Xyrem isn’t used for insomnia, the drug manufacturer doesn’t provide recommended dosages for this use.
However, some medications in the group of drugs called CNS depressants are approved for treating insomnia. (Xyrem is also a CNS depressant.) For example, Ambien (zolpidem) is a drug that’s used to treat insomnia.
To learn more about your treatment options for insomnia, talk with your doctor.
Do not take more Xyrem than your doctor prescribes, as this can lead to harmful effects.
Symptoms of overdose
Symptoms caused by an overdose can include:
- changes in your level of consciousness
- loss of control of passing urine and stool
- confusion
- agitation
- loss of coordination
- coma
- vomiting
- headache
- excessive sweating
- difficulty with certain motor skills
- blurry vision
- seizure
- difficulty breathing
- slow heart rate
- drop in body temperature
What to do in case you take too much Xyrem
Call your doctor right away if you think you’ve taken too much Xyrem. You can also call 800-222-1222 to reach America’s Poison Centers or use its online resource. But if you have severe symptoms, immediately call 911 (or your local emergency number) or go to the nearest emergency room.
Taking Xyrem can lead to physical dependence. This is when your body gets used to a drug and needs it to function as usual.
If you suddenly stop taking Xyrem, you may experience withdrawal symptoms. These are side effects that can occur when you stop taking a drug that your body has become dependent on.
Examples of withdrawal symptoms include:
- insomnia (difficulty sleeping)
- restlessness or agitation
- nausea
- sleepiness
- anxiety
- delusions (false beliefs)
- lethargy
- dizziness
- sweating
- fast heart rate
- headache
- hallucinations
- delirium
- confusion
- muscle cramps
- tremor
It’s important that you don’t stop taking Xyrem without first talking with your doctor. Before ending your Xyrem treatment, your doctor may lower your dosage slowly over time. This can help reduce your risk of withdrawal symptoms after you stop treatment.
If you have withdrawal symptoms after you’ve stopped taking Xyrem, talk with your doctor. They can recommend ways to ease these symptoms.
Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.