gamma-hydroxybutyrate; sodium oxybate (Xyrem, Xywav, Anetamin, Somsanit, Lumryz, date rape drug)
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Introduction
Street Drug. Prescription form is Na+ oxybate,
Tradenames: Xyrem, Xywav, Anetamin, Somsanit, Lumryz
Occurrence
- naturally-occurring substance
- found in the central nervous system, wine, beef, small citrus fruits, & almost all animals in small amounts
Pathology
- 4-hydroxybutyricaciduria is an inborn error of GABA & gamma-hydroxybutyrate metabolism
Indications
- cataplexy in patients with narcolepsy
- idiopathic hypersomnia (FDA-approved)[6]
- fibromylagia
- used in treatment of insomnia in schizophrenics
- used in treatment of alcoholism & alcohol withdrawal
available through a restricted distribution program[7]
Contraindications
- euphoria & disinhibition (date rape drug)
- used by body builders to increase growth hormone during sleep (no evidence it works)
Dosage
- Lumryz (extended release): once nightly, 6 g, 7.5 g, & 9 g effective
- available June 2023[7]
- earlier formulations: twice-nightly with 2nd dose 2.5-4 hours after 1st
Adverse effects
- most common: (> 5%)
- less common
- serious
- coma
- death
- central nervous system depressant
- potential for abuse & misuse[7]
- respiratory support[4]
Drug interactions
- concurrent use of alcohol or sedatives may result in reduced level of consciousness or respiratory depression
Laboratory
Mechanism of action
- CNS depressant
- agonist at its own recepor, GHB receptor[3], which is excitatory
- weak agonist at GABA-B receptor, which is inhibitory[3]
- may reduce fibromyalgia-associated pain, fatigue, & alpha sleep anomaly
More general terms
Additional terms
References
- ↑ Prescriber's Letter 8(2):11 2001
- ↑ Prescriber's Letter 12(1): 3 2005 Fibromylagia Update Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=210103&pb=PRL (subscription needed) http://www.prescribersletter.com
- ↑ 3.0 3.1 3.2 Wikipedia: gamma-Hydroxybutyrate http://en.wikipedia.org/wiki/Gamma-Hydroxybutyric_acid
- ↑ 4.0 4.1 Medical Knowledge Self Assessment Program (MKSAP) 15, American College of Physicians, Philadelphia 2009
- ↑ FDA MedWatch: 12/17/2012 Xyrem (sodium oxybate): Drug Safety Communication - Warning Against Use With Alcohol or Drugs Causing Respiratory Depression. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm332430.htm
- ↑ 6.0 6.1 George J First Drug OK'd for Idiopathic Hypersomnia. Sleep drug Xywav gains a new indication MedPage Today August 12, 2021 https://www.medpagetoday.com/neurology/sleepdisorders/94024
- ↑ 7.0 7.1 7.2 7.3 Brooks M FDA OKs Once-Nightly Sodium Oxybate for Narcolepsy. Medscape. May 2, 2023 https://www.medscape.com/viewarticle/991464?
Database
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=10413
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=10412
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=23663870
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=3037032
- PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=9793764