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What is the difference between Xywav vs Xyrem?

Medically reviewed by Carmen Pope, BPharm. Last updated on Sep 25, 2024.

Official answer

by Drugs.com

Xywav is a low-sodium alternative to Xyrem, which was approved in 2020 after concerns about the high sodium content of Xyrem potentially contributing or being detrimental to conditions such as heart failure, high blood pressure, or poor kidney function.

  • The sodium content of Xyrem is 1640 mg/day at its highest dose of 9 gram per night.
  • This is the equivalent of 4 large containers of French fries.
  • This nightly dose of Xyrem exceeds the American Heart Association's ideal total daily sodium intake of no more than 1500 mg/day by 109%, without taking into account other sources of sodium from foods and liquids throughout the day.
  • Xyrem carries warnings about its high sodium content.

Xywav contains 92% less sodium than Xyrem and may be more suitable for people on a low salt diet or those who are at risk of high blood pressure, heart failure, or poor kidney function. See the sodium content tables for Xywav and Xyrem below.

  • Xywav only contains 131mg sodium in a daily 9g dose compared with Xyrem which contains 1640mg of sodium per 9g dose.
  • Xywav contains less sodium because it is made up of a mixture of oxybate salts: calcium oxybate, magnesium oxybate, potassium oxybate, as well as sodium oxybate. Xyrem only contains sodium oxybate salts, which is why it is so high in sodium.
  • Dosages of Xywav and Xyrem are interchangeable and doctors can prescribe Xywav at the same dosage as Xyrem.
Xywav dose Sodium content (nightly exposure)
4.5 g per night 65.5 mg
6 g per night 87.3 mg
7.5 g per night 109.1 mg
9 g per night 131 mg

Xyrem dose Sodium content (nightly exposure)
3 g per night 550 mg
4.5 g per night 820 mg
6 g per night 1100 mg
7.5 g per night 1400 mg
9 g per night 1640 mg

Related questions

References
  • Xywav (calcium, magnesium, potassium, and sodium oxybates) Xywav.com https://www.xywav.com/
  • Xywav (calcium, magnesium, potassium, and sodium oxybates) [Product information] Updated 03/2022. Jazz Pharmaceuticals, Inc. https://www.drugs.com/pro/xywav.html#s-34090-1
  • Xywav and sodium content. https://www.xywav.com/narcolepsy/lower-sodium-oxybate-treatment-option/#:~:text=XYWAV%20is%20the%20first%20and,low%E2%80%91sodium%20oxybate*&text=XYWAV%20contains%20131%20mg%20of%20sodium%20at%20the%20maximum%20recommended%20nightly%20dose.

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Is Xyrem a controlled substance / narcotic drug of abuse?

Yes, Xyrem is a controlled substance, and has a high potential to be abused. Xyrem contains sodium oxybate, also known as GHB, which is a known street drug of abuse. Xyrem is not a narcotic, the active ingredient sodium oxybate, is a central nervous system depressant. Continue reading

Does Xyrem cause weight gain or loss?

Xyrem (sodium oxybate), which is used to treat cataplexy or excessive daytime sleepiness (EDS) in patients 7 years of age and older with narcolepsy, can cause weight loss. Weight loss is reported to be an adverse reaction associated with Xyrem treatment, but it is also seen as a beneficial effect of the drug because narcolepsy is linked to weight gain and obesity. Continue reading

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Xyrem REMS refers to the program through which Xyrem can be prescribed by a doctor and through which Xyrem can be dispensed to a patient. Continue reading

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