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Xywav 0.5 g/mL Oral Solution

Price range: $3,766.00 through $11,298.00

Looking for Xywav medication? Learn about Xywav for narcolepsy symptoms, excessive daytime sleepiness, cataplexy, uses, benefits, and treatment details.

Description

Buy Xywav 0.5 g/mL Oral Solution Online

xywav medication (calcium, magnesium, potassium, and sodium oxybates) oral solution 0.5 g/mL is a prescription central nervous system depressant FDA-approved to treat cataplexy and excessive daytime sleepiness in patients 7 years and older with narcolepsy, and excessive daytime sleepiness in adults with idiopathic hypersomnia. Due to xywav prescription risks of CNS depression and misuse, Xywav is available only through the restricted XYWAV and XYREM REMS program.

Key Facts

Fact Details
Active Ingredients Calcium oxybate, magnesium oxybate, potassium oxybate, sodium oxybate
Concentration 0.5 g/mL total salts (equivalent to 0.413 g/mL oxybate)
Sodium Content 131 mg at the 9 g nightly dose (92% less sodium than high-sodium oxybates)
Indications Narcolepsy (cataplexy/EDS) in patients ≥7 years; Idiopathic hypersomnia in adults
DEA Schedule Schedule III controlled substance
Distribution Central certified pharmacy only; NOT available at retail pharmacies
REMS Program XYWAV and XYREM REMS required for prescribing and dispensing

Table of Contents

  • What Is Xywav Medication?

  • What Is Xywav Used For?

  • How Does Xywav Work?

  • Key Product Features

  • Technical Specifications

  • Product Benefits: Verified, Manufacturer-Described, and Potential

  • Who Is Xywav For? (And Who Should Avoid It)

  • Understanding the XYWAV and XYREM REMS Program

  • What to Check Before Considering Xywav

  • Important Safety Information Overview

  • Xywav vs. Other Oxybate Treatments

  • Common Questions About Xywav

  • Conclusion

What Is Xywav Medication?

Xywav (pronounced “ZYE-wave”) is a prescription oral solution containing a unique combination of oxybate salts—calcium, magnesium, potassium, and sodium oxybate. It belongs to a class of medications called central nervous system (CNS) depressants and is FDA-approved for specific sleep disorders.

The active moiety of Xywav is oxybate (also known as gamma-hydroxybutyrate, or GHB), which is a Schedule I controlled substance when xywav 0.5 gm/ml oral solution used illicitly. However, Xywav itself is a Schedule III controlled substance with recognized medical uses when prescribed and used appropriately under medical supervision.

What this means: Xywav is a carefully regulated medication that affects brain chemistry to improve sleep architecture. It is not a stimulant; rather, it works overnight to improve sleep quality, which in turn reduces daytime sleepiness.

What Is Xywav Used For?

Xywav is FDA-approved for two primary indications:

1. Narcolepsy (Patients 7 Years and Older)

Xywav is indicated for the treatment of:

  • Cataplexy: Sudden, temporary loss of muscle control triggered by strong emotions

  • Excessive Daytime Sleepiness (EDS): Overwhelming urge to sleep that interferes with daily functioning

Source: Xywav Prescribing Information

2. Idiopathic Hypersomnia (IH) – Adults Only

Xywav is the first and only FDA-approved treatment for idiopathic hypersomnia in adults. Idiopathic hypersomnia is characterized by excessive oxybate sodium daytime sleepiness despite adequate or extended sleep, with no identifiable underlying cause.

Important distinction: While Xywav treats symptoms in both conditions, its use in children is limited to narcolepsy only. The safety and effectiveness of Xywav for IH in pediatric patients have not been established.

How Does Xywav Work?

The exact mechanism of action for Xywav in treating narcolepsy and idiopathic hypersomnia is not fully understood. However, it is believed to work by:

  • Modulating neurotransmitter activity in the brain, particularly affecting GABA (gamma-aminobutyric acid) pathways

  • Improving sleep architecture and promoting deep, restorative sleep at night

  • Reducing the frequency of cataplexy attacks and improving daytime wakefulness

What this means: Rather than keeping you awake during the day like a stimulant, Xywav works at night to help your brain achieve more stable sleep patterns. This reduces the disruptive daytime symptoms associated with narcolepsy and IH. [Source: Mechanism of action not fully determined; based on clinical observations]

Key Product Features xywav narcolepsy

Feature Description
Low-Sodium Formulation Contains 131 mg sodium at 9 g nightly dose—92% less sodium than high-sodium oxybates
Cardiovascular-Conscious Only 9% of the ACC/AHA recommended daily sodium limit of <1,500 mg
Dosing Flexibility May be taken once or twice nightly depending on condition and tolerability
Oral Liquid Solution Standardized 0.5 g/mL concentration for accurate dosing
REMS-Enrolled Distribution Centralized pharmacy ensures controlled, safe dispensing

Technical Specifications

Specification Details
Generic Name Calcium, magnesium, potassium, and sodium oxybates
Brand Name Xywav®
Manufacturer Jazz Pharmaceuticals, Inc.
Concentration 0.5 g/mL total salts (0.413 g/mL oxybate)
Dosage Range (Adults) 4.5 g to 9 g per night, divided into 1 or 2 doses
Dosage Range (Pediatric) Weight-based; 6 g to 9 g per night, divided into 2 doses
Route of Administration Oral (liquid)
DEA Schedule Schedule III
REMS Program XYWAV and XYREM REMS
Storage Requirements Store at room temperature; discard unused diluted solution after 24 hours

[Verify all dosage information with current prescribing information and individual physician guidance.]

Product Benefits: Verified, Manufacturer-Described, and Potential

✅ Verified Benefits (Supported by FDA-Approved Indications)

  • Reduction in cataplexy frequency in patients with narcolepsy

  • Reduction in excessive daytime sleepiness (measured by Epworth Sleepiness Scale) in narcolepsy patients

  • Reduction in excessive daytime sleepiness in adults with idiopathic hypersomnia (measured by ESS and IHSS)

  • Pediatric efficacy established through adequate and well-controlled studies of sodium oxybate

Source: Clinical trial data from Phase 3 randomized withdrawal studies; verified through FDA approval process.

📋 Manufacturer-Described Benefits (Based on Product Claims)

  • Cardiovascular-conscious formulation due to reduced sodium content

  • 92% less sodium than high-sodium oxybates at equivalent doses

  • First and only FDA-approved treatment for idiopathic hypersomnia in adults

Source: Xywav Prescribing Information and manufacturer communications. Verify sodium comparisons with independent sources.

🔬 Potential Benefits (Based on Clinical Experience)

  • Improved overall sleep architecture and consolidation of nighttime sleep

  • Reduced reliance on daytime stimulants for wakefulness

  • Better quality of life through symptom management

Note: These potential benefits are based on clinical experience and patient-reported outcomes, not verified in controlled studies for Xywav specifically. Individual results may vary significantly.

Who Is Xywav For? (And Who Should Avoid It)

Xywav May Be Appropriate For:

  • Adults (18+) diagnosed with idiopathic hypersomnia

  • Adults and children (7+) diagnosed with narcolepsy with cataplexy or excessive daytime sleepiness

  • Patients who can safely comply with the REMS program requirements

  • Patients who have not achieved adequate symptom control with other treatments

  • Patients who can consistently follow twice-nightly dosing schedules

Xywav Is NOT Intended For:

  • Children under 7 years with any condition (safety not established)

  • Children with idiopathic hypersomnia (not approved)

  • Patients with succinic semialdehyde dehydrogenase deficiency (contraindicated)

  • Patients with known hypersensitivity to any component of the formulation

  • Patients unable or unwilling to enroll in and comply with REMS requirements

  • Patients who consume alcohol or sedative hypnotics concurrently

  • Individuals with uncontrolled substance use disorders (requires careful evaluation)

Important Medical Considerations Before Starting Xywav:

Condition Consideration
Liver impairment Requires dosage reduction; recommend starting at half the original dose
Respiratory conditions May increase risk of respiratory depression; use with caution
Sleep apnea May worsen existing sleep-disordered breathing
Depression or suicidal ideation Requires careful monitoring; may exacerbate symptoms
History of substance use disorder Requires careful evaluation and monitoring

[Source: Xywav Prescribing Information; verify individual suitability with treating physician.]

Understanding the XYWAV and XYREM REMS Program

Because of the risks of central nervous system depression and potential for misuse, Xywav is available only through a restricted distribution xywav label program called the XYWAV and XYREM REMS (Risk Evaluation and Mitigation Strategy).

How the REMS Program Works:

  1. Enrollment Required: Patients must enroll in the REMS program before receiving Xywav. Enrollment is a one-time process with documentation confirming safe use.

  2. Specialized Prescribers: Only healthcare providers who are specially certified in the REMS program can prescribe Xywav.

  3. Centralized Pharmacy: Xywav is dispensed only by a central certified pharmacy, not through local retail pharmacies. The medication is shipped directly to the patient’s specified address.

  4. Required Counseling: Patients must complete counseling calls with both a nurse case manager and a pharmacist before receiving their first shipment. A signature is required upon delivery.

  5. Ongoing Monitoring: The REMS program includes ongoing monitoring and follow-up to ensure safe use.

Enrollment and Shipping Process:

  1. Complete REMS enrollment forms (3 required documents)

  2. Complete JazzCares Patient Authorization Form

  3. Receive counseling calls from JazzCares Nurse Case Manager and Certified Pharmacy pharmacist

  4. Prescription submitted by certified healthcare provider

  5. Medication shipped to patient’s address with signature required

  6. Ongoing support available via JazzCares team, certified pharmacy, and optional myWAV App

Source: XYWAV and XYREM REMS Program documentation

What to Check Before Considering Xywav

Verification Item Action Required
Diagnosis confirmation Ensure diagnosis of narcolepsy or IH is confirmed by a sleep specialist
Medical history evaluation Discuss all medical conditions, especially breathing disorders, liver issues, and mental health history
Current medications review Report all medications, including sedatives, antidepressants, opioids, and divalproex sodium
Alcohol use Must abstain from alcohol; concurrent use is contraindicated
Pregnancy/breastfeeding status Discuss with healthcare provider; insufficient data on safety
REMS eligibility Confirm ability to enroll in and comply with REMS program
Insurance coverage Verify coverage and explore financial assistance options via JazzCares

Red Flags Before Purchasing:

  • No REMS enrollment: If offered without REMS enrollment, this is a serious red flag indicating potential counterfeit or illegal distribution

  • Available at local pharmacy: Xywav is ONLY available through the central certified pharmacy

  • Unusually low price: Prescription medications in REMS programs have regulated pricing; extreme discounts may indicate counterfeit product

  • No prescription required: Xywav is a Schedule III controlled substance requiring a valid prescription

  • Package does not include REMS documentation: All legitimate Xywav shipments include REMS program information

Important Safety Information Overview

⚠️ BOXED WARNING: Central Nervous System Depression

XYWAV is a CNS depressant. Clinically significant respiratory depression and obtundation may occur at recommended doses. After first initiating treatment and until certain that XYWAV does not impair judgment, thinking, or motor skills, caution patients against hazardous activities requiring complete mental alertness—including operating automobiles or machinery—for at least 6 hours after taking XYWAV.

⚠️ BOXED WARNING: Abuse and Misuse

The active moiety of XYWAV is oxybate (GHB), a Schedule I controlled substance. Abuse or misuse of GHB is associated with CNS adverse reactions including seizure, respiratory depression, decreased level of consciousness, coma, and death. XYWAV is available only through the restricted XYWAV and XYREM REMS program.

Most Common Adverse Reactions (≥5%):

Adverse Reaction Reported In
Nausea Narcolepsy and IH studies
Headache Narcolepsy and IH studies
Dizziness Narcolepsy and IH studies
Anxiety Narcolepsy and IH studies
Insomnia Narcolepsy and IH studies
Decreased appetite Narcolepsy and IH studies
Hyperhidrosis Narcolepsy and IH studies
Vomiting Narcolepsy and IH studies
Diarrhea Narcolepsy and IH studies
Dry mouth Narcolepsy and IH studies
Parasomnia Narcolepsy and IH studies
Somnolence Narcolepsy and IH studies
Fatigue Narcolepsy and IH studies
Tremor Narcolepsy and IH studies

Source: Xywav clinical trial data; full list in Prescribing Information

Warnings & Precautions Include:

  • Respiratory depression and sleep-disordered breathing

  • Depression and suicidality (requires immediate evaluation)

  • Other behavioral/psychiatric reactions (hallucinations, paranoia, psychosis, aggression, confusion, anxiety)

  • Parasomnias including sleepwalking

  • Drug interactions particularly with other CNS depressants, divalproex sodium, and alcohol

  • Dependence and tolerance (withdrawal symptoms may occur)

Note on pediatric adverse reactions: In pediatric clinical trials with XYREM (same active moiety), the adverse reaction profile was similar to that in adults, with additional reactions including enuresis (19%) and weight decreased (13%).

This safety summary is educational only. Full prescribing information and professional medical guidance are essential. Discuss all risks, benefits, and alternatives with a qualified healthcare provider before initiating treatment.

Xywav vs. Other Oxybate Treatments

Feature Xywav Xyrem (Sodium Oxybate) Generic Sodium Oxybate
Active Ingredients Calcium, magnesium, potassium, and sodium oxybates Sodium oxybate Sodium oxybate
Sodium Content (9g dose) 131 mg ~1,640 mg ~1,640 mg
Approved for Narcolepsy Yes (≥7 years) Yes (≥7 years) Yes (≥7 years)
Approved for IH Yes (adults only) No No
Cardiovascular Profile Low-sodium formulation High-sodium High-sodium
REMS Program XYWAV and XYREM REMS XYWAV and XYREM REMS Varies; may require REMS depending on manufacturer
Dosing Flexibility Once or twice nightly Twice nightly Twice nightly

Comparison Note: Xywav offers a lower-sodium alternative to traditional sodium oxybate treatments. This may be a consideration for patients with cardiovascular risk factors or dietary sodium restrictions. However, all oxybate treatments require REMS enrollment and careful medical supervision.

1. What is Xywav medication used for?

Xywav is FDA-approved to treat cataplexy and excessive daytime sleepiness in patients 7 years and older with narcolepsy, and excessive daytime sleepiness in adults with idiopathic hypersomnia. It is the first and only treatment approved specifically for idiopathic hypersomnia.

2. What is the Xywav medication cost?

The cost of Xywav varies based on insurance coverage, pharmacy, and financial assistance eligibility. Jazz Pharmaceuticals offers financial assistance programs through JazzCares, including the Xywav Coupon Program and Patient Assistance Program for eligible patients. Contact JazzCares at 1-833-533-JAZZ for specific cost information.

3. What does the Xywav medication packaging look like?

Xywav is dispensed only from a central certified pharmacy in specialized packaging designed for safe delivery. The liquid solution is provided in pharmacy-prepared dosing containers. Standard retail pharmacy packaging does not apply, as Xywav is not available at local pharmacies.

4. What is in the Xywav medication bottle?

The Xywav oral solution contains 0.5 g/mL of total salts (calcium oxybate, magnesium oxybate, potassium oxybate, and sodium oxybate), equivalent to 0.413 g/mL of oxybate. Each dose must be diluted with approximately 1/4 cup (60 mL) of water before administration.

5. What are Xywav medication side effects?

Common side effects (≥5%) include nausea, headache, dizziness, anxiety, insomnia, decreased appetite, hyperhidrosis, vomiting, diarrhea, dry mouth, parasomnia, somnolence, fatigue, and tremor. Serious risks include CNS depression, respiratory depression, misuse/abuse, depression/suicidality, and behavioral/psychiatric reactions. See full safety information above.

6. How does Xywav differ from stimulant medications?

Unlike stimulants that promote wakefulness during the day, Xywav is a CNS depressant that works at night to improve sleep architecture and reduce disruptive sleep-wake cycles. It is taken in one or two doses at night and typically causes sleep within 5-15 minutes.

7. Why do I need to enroll in the XYWAV and XYREM REMS program?

The REMS program is mandated by the FDA to manage serious risks of CNS depression and misuse associated with oxybate medications. Enrollment ensures patients receive appropriate counseling, are monitored for safe use, and understand risks before starting treatment.

8. Can I get Xywav at my local pharmacy?

No. Xywav is only available through a central certified pharmacy and must be shipped directly to patients. It is NOT dispensed at local retail pharmacies due to REMS program requirements.

9. What should I do if I miss a dose of Xywav?

If you miss a dose, simply skip it. Never take more than one dose to make up for a missed dose. Follow your prescribed dosing schedule and consult your healthcare provider or pharmacist for guidance.

10. Can I take Xywav if I have a history of depression?

Xywav may worsen depression and has been associated with suicidal ideation and suicidality. Patients with a history of depression or suicidal thoughts require careful monitoring. A full discussion of mental health history is essential before prescribing Xywav.

11. What is idiopathic hypersomnia?

Idiopathic hypersomnia is a chronic sleep disorder characterized by excessive daytime sleepiness despite adequate sleep duration, with no identifiable underlying cause. It differs from narcolepsy in that cataplexy is not a feature, and sleep attacks tend to be less sudden. Xywav is the only FDA-approved treatment for this condition.

12. Is Xywav safe for children?

Xywav is FDA-approved for narcolepsy (cataplexy and EDS) in patients 7 years of age and older. Safety and effectiveness in children under 7 years have not been established. Xywav is NOT approved for idiopathic hypersomnia in children. Pediatric use is supported by adequate and well-controlled studies of sodium oxybate in pediatric patients 7-17 years.

Additional information

QUANTITY

1 Bottle (180 mL), 3 Bottles (540 mL / 1-month supply)

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