A narcolepsy and cataplexy medicine
Sodium oxybate
A strong, controlled night-time medicine for narcolepsy with cataplexy, taken in two doses overnight.
What is Sodium oxybate?
Sodium oxybate is a strong night-time medicine for narcolepsy with cataplexy. It is taken at night in two doses — one at bedtime and one a few hours later — to improve night-time sleep and, in turn, reduce daytime sleepiness and cataplexy. It is a controlled drug closely related to GHB, with a real potential for misuse and dependence. It is dangerous to combine with alcohol or other sedatives because together they can dangerously slow breathing. It also contains a lot of sodium (salt), which matters for blood pressure and the heart.
Education and reference only. This is a plain-language guide to Sodium oxybate — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Sodium oxybate is a medicine used to treat narcolepsy with cataplexy, where people have overwhelming daytime sleepiness and sudden emotion-triggered muscle weakness. It is taken at night and works by deepening and improving night-time sleep, which then reduces daytime symptoms. It is closely related to the substance GHB, is a controlled drug, and is supplied as a liquid taken by mouth. It is started and closely supervised by a specialist sleep service.
How it works
Sodium oxybate acts on the brain to promote deep, consolidated night-time sleep. By improving the quality of sleep at night, it reduces excessive daytime sleepiness and the frequency of cataplexy attacks during the day. Because it strongly affects the brain and breathing, it must be taken exactly as directed, only at night, and never combined with alcohol or other sedating medicines, which can dangerously slow breathing.
Company & origin
Originated / developed by: Jazz Pharmaceuticals.
A controlled night-time medicine used in the UK for narcolepsy with cataplexy.
Practical use
How to take Sodium oxybate
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take it only at night in two doses, as directed: one at bedtime and one a few hours later, prepared and placed safely by the bed beforehand.
- Take each dose while in bed and lie down straight away, as it works quickly and makes you sleep.
- Never drink alcohol or take other sedating medicines with it, as together they can dangerously slow your breathing.
- Store it securely out of reach of others, as it is a controlled drug with potential for misuse, and never share it.
- Do not stop the medicine suddenly without advice, and tell your specialist if you have high blood pressure, heart or kidney problems because of its salt content.
Weighing it up
Advantages & disadvantages of Sodium oxybate
Advantages
- Can substantially reduce both excessive daytime sleepiness and cataplexy in narcolepsy with cataplexy.
- Improves the quality of night-time sleep, which drives the daytime benefit.
- Offers an option for people whose symptoms are not controlled by other treatments.
Disadvantages
- It is a strong controlled drug, closely related to GHB, with potential for misuse and dependence.
- Dangerous with alcohol or other sedatives, which can severely slow breathing.
- Contains a lot of sodium (salt) and can cause nausea, dizziness, bed-wetting, sleepwalking and confusion.
Practical use
Good to know
Sodium oxybate is a powerful, closely supervised medicine. It is taken in two doses overnight — one at bedtime and one a few hours later — so it is prepared and placed safely by the bed beforehand, and you must be able to stay lying down and asleep after each dose. It is a controlled drug closely related to GHB and has a genuine potential for misuse and dependence, so it is stored securely and never shared. The most serious safety point is that combining it with alcohol or other sedating medicines (including some painkillers and sleeping tablets) can dangerously slow or stop breathing. It also contains a large amount of sodium (salt), which matters for people with high blood pressure, heart failure or kidney problems. Do not stop suddenly without advice, and report breathing problems, confusion, sleepwalking, bed-wetting, low mood or worsening symptoms.
Who should not take it / use with caution
- People who drink alcohol close to the dose or take other strong sedatives should not use it.
- It is generally avoided in untreated breathing problems during sleep and in those with certain rare metabolic disorders.
- Used with great caution in heart failure, high blood pressure or kidney problems because of its salt content, and where misuse is a concern.
Monitoring
- Reviewing how well daytime sleepiness and cataplexy are controlled and whether the medicine is still needed.
- Watching for breathing problems, confusion, sleepwalking, bed-wetting and mood changes.
- Checking blood pressure and considering the high salt load, particularly in heart or kidney conditions.
Side effects
- Nausea, dizziness, headache and bed-wetting are among the more common effects.
- Sleepwalking, confusion on waking, low mood or anxiety in some people.
- Dangerously slow or shallow breathing, especially with alcohol or other sedatives, which is a medical emergency.
Key interactions
- Must not be combined with alcohol, which dangerously increases its sedating and breathing-slowing effects.
- Adds to the effect of other sedating medicines, such as sleeping tablets, strong painkillers and some anxiety medicines.
- Caution with other medicines that depress the nervous system; tell your prescriber everything you take.
Available as: Oral liquid taken by mouth at night.
Answers
Sodium oxybate: frequently asked questions
What is sodium oxybate used for?
It is a strong night-time medicine for narcolepsy with cataplexy, taken in two doses overnight to improve sleep and reduce daytime sleepiness and cataplexy.
Why can't I drink alcohol with it?
Combining it with alcohol or other sedatives can dangerously slow or stop your breathing, so alcohol must be avoided.
Why is it a controlled drug?
It is closely related to GHB and has a real potential for misuse and dependence, so it must be stored securely, never shared, and taken exactly as directed.
Why do I take it in two doses at night?
It works quickly and wears off during the night, so a bedtime dose and a second dose a few hours later keep its effect through the night.
Does it contain a lot of salt?
Yes, it has a high sodium content, which matters if you have high blood pressure, heart failure or kidney problems, so tell your specialist.
Authoritative sources
- BNF
- NICE CKS
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