Xyrem (sodium Oxbate) is a prescribed drug that is used to treat the symptoms of narcolepsy. It can interact with alcohol as well as other medications that cause drowsiness. For instance, Xyrem can interact with zolpidem (Ambien).
Xyrem can be used to treat these ailments in children and adults with narcolepsy:
Xyrem is a liquid solution you swallow. It is a source of active ingredient sodium oxybate. (An active ingredient is what makes a drug perform.)
An interaction could be caused by a substance that causes another substance to produce an opposite effect than was expected. Interactions can also occur when you suffer from certain health conditions.
Read on to learn more about the potential interactions Xyrem could have. For more details about Xyrem, including information about its applications, check out this article.
Before you begin taking Xyrem for the first time, inform your pharmacist and doctor regarding any prescriptions, over-the counter or other medications you are taking. Informing them about this information can help to avoid interactions. (To find out if Xyrem interacts with herbs, supplements and vitamins, refer to the “Are there other interactions with Xyrem?” section below.)
If you have any concerns regarding drug interactions that could affect you, speak to your physician or pharmacist.
The following table lists a variety of drugs that can interact with Xyrem. Be aware that this table doesn’t include all drugs that might have interactions with Xyrem. For more details on certain interactions, check out the “Drug interactions explained” section below.
* Sedatives are also known as sedative hypnotics or prescribed sleep aids. To find out more about Xyrem’s interactions these medications, read the “When should I avoid Xyrem?” section below.
Certain medical conditions or other factors may increase your risk of harm if take Xyrem. In these cases your doctor might not recommend Xyrem to you. These are referred to as contraindications. The following list includes the Xyrem contraindications.
If you have succinic semialdehyde dehydrogenase deficiency. If you suffer from an uncommon genetic (inherited) condition known as succinic semialdehyde hydroxygenase deficiency taking Xyrem could increase the chance of experiencing adverse negative effects from the drug. This is because this condition can lead to Xyrem to build within your body. Instead of prescribing Xyrem your doctor may suggest alternative treatments that are more safe for you.
If you are taking the sedatives or drink alcohol. Xyrem is a central nervous system (CNS) depressant. This means it could slow the brain’s signals that control vital bodily functions. This could lead to respiratory depression (slowed breathing). CNS depressants may also cause sleepiness (severe sleepiness).
It is not recommended to take Xyrem along with other CNS depressants, like alcohol or sedatives. (These are substances that induce drowsiness and also include sleep aids such as the zolpidem.) Combining these substances or drugs with Xyrem could result in excessive sedation or a dangerously slow breathing. If you use sedatives, or drink alcohol or consume alcohol, your doctor will not recommend Xyrem for you. They may suggest alternative treatment options that could be more appropriate for you.
Before you begin taking Xyrem consult your doctor to determine if any of the issues that are listed above pertain to you. Your doctor will determine if it is safe to take.
* Xyrem comes with an enclosed warning about the possibility of CNS depression. The most severe warning comes in the form of a boxed warning issued by the Food and Drug Administration (FDA). For more information, go to “Boxed warnings” at the beginning of this article.
It is not recommended to drink alcohol during Xyrem treatment.
Xyrem as well as alcohol are both central nervous systems (CNS) depressants. This means that they both inhibit the brain’s signals to are used to manage vital bodily functions. This means that the drug may cause respiratory depression (slowed breathing). In addition, both Xyrem and alcohol may cause the condition of sedation (severe Drowsiness). Combining alcohol and Xyrem could increase the chance of excessive sedation respiratory depression, or both.
If you are concerned about drinking alcohol while you are taking Xyrem treatment, consult your pharmacist or doctor. They might recommend a different treatment for you.
* Xyrem comes with an enclosed warning about the possibility of CNS depression. Boxed warnings are the most important warning issued by the Food and Drug Administration (FDA). For more information, refer to “Boxed warnings” at the beginning of this article.
Find out more about specific interactions between drugs that can be caused by Xyrem.
Interactions with benzodiazepines
Xyrem may interact with benzodiazepines, that are used to treat anxiety that is short-term as well as other signs of mental health issues. In some instances, a benzodiazepine could be prescribed to people relax and prepare prior to undergoing an operation that is medically necessary.
Examples of benzodiazepines are:
What is the possibility of what could occur?
Xyrem and benzodiazepines may cause sleepiness. Therefore, taking these two drugs together could increase your risk of having this side effect. It could also make this adverse reaction more serious.
What you can do
If you are taking Xyrem and you need to take an benzodiazepine for a brief duration the doctor may recommend that you take a break from Xyrem. However, if you are taking a benzodiazepine medication regularly your doctor might prescribe an Xyrem dose that is lower for you. It is not recommended to take any higher dose of any medication than what the doctor recommends.
If you’re taking Xyrem and a benzodiazepine in combination and you are experiencing a problem, inform your doctor immediately if you experience an extreme drowsiness, which is not the normal drowsiness that you experience when you suffer from your condition.
If you have any questions regarding the use of Xyrem with benzodiazepines talk with your physician or pharmacist.
Interaction with opioids
Xyrem may be a drug that interacts with opioids. This is a category of drugs that includes prescription painkillers as well as illegal substances like heroin.
Examples of opioids prescribed to treat extreme pain are:
What is the possibility of what could occur?
Xyrem is a central nervous system (CNS) depressant. This means it may reduce certain brain signals that are used to manage vital body functions. This means that the drug can trigger respiratory depression (slowed breathing). CNS depressants can also trigger sleepiness (severe Drowsiness).
Opioids also function as CNS depressants. Combining these two drugs could result in excessive sedation or a dangerously slow breathing. These effects are similar as those that occur in an overdose of opioids that could be life-threatening.
* Xyrem comes with an unboxed warning regarding the possibility of CNS depression. Boxed warnings are the most important warning issued by the Food and Drug Administration (FDA). For more information, go to “Boxed warnings” at the beginning of this article.
What you can do
If you are taking Xyrem and require an opioid-based painkiller for a brief duration the doctor may recommend that you discontinue taking Xyrem. However, if you are taking an opioid medication frequently, your doctor might recommend a lower dose of Xyrem for you. You shouldn’t take any higher dose of any medication than your doctor recommends.
If you are taking Xyrem and an opioid in combination Your doctor may recommend keeping the naloxone (Narcan, RiVive, others) nasal (nose) spray in your bag to protect yourself. The drug is used in a situation of emergency to counter the effect of opioids as well as to restore regular breathing. Naloxone can be prescribed by your doctor or you can ask for it from your pharmacy at no cost without prescription. For more information on Naloxone, speak to your physician or pharmacist.
If you have additional questions regarding the use of Xyrem along with opioids, speak with your physician or pharmacist.
Interactions with divalproex (Depakote, Depakote ER)
Xyrem may interfere with divalproex (Depakote, Depakote ER). This drug is used for treating epilepsy as well as certain mental health issues, such as bipolar disorder.
What can happen?
The use of Xyrem with divalproex could increase the amount of Xyrem in your body, which can increase the risk of adverse effects.
Xyrem is a central nervous system (CNS) depressant. These medications can slow or affect the brain’s functions, such as those related to memory and thinking. Combining divalproex with Xyrem could increase the risk of adverse side effects or cause them to become more severe. In research, taking both divalproex and Xyrem caused it to be harder for people to focus and recall things.
What you can do
If you are taking Xyrem and Depakote your doctor may prescribe a dosage of Xyrem that is lower than the usual. You shouldn’t take an increased dose of either of the medications than your doctor recommends.
If you are taking Xyrem together with Depakote together, inform your doctor immediately when you experience any new or more severe adverse reactions to Xyrem.
If you have any questions concerning the use of Xyrem with Depakote consult your pharmacist or doctor.
Xyrem could also cause other reactions. They can occur when you take supplements, food items as well as vaccines or laboratory tests. Check out the following for more information. Please note that the information provided below does not cover any other interactions that could occur with Xyrem.
Do Xyrem interfere with other supplements?
Before you begin taking Xyrem for the first time, speak to your pharmacist and doctor about any herbal supplements, supplements and vitamins you are taking. Informing them of this information can help you avoid any possible interactions.
If you have any questions regarding interactions that could affect you discuss it with your pharmacist or doctor.
Interactions between herbs and Xyrem
Xyrem could interfere with an herb known as St. John’ wort which is used to alleviate symptoms of depression and other disorders. The combination of Xyrem together with St. John’s wort may cause excessive sedation or worsened effects of Xyrem.
Additionally, Xyrem and some herbs could trigger certain adverse effects, including sleepiness. For instance, some people use chamomile or valerian supplements to aid in sleeping. If you are taking these herbs during your Xyrem treatment you could have a higher chance of feel drowsy. This side effect may be more severe than when you take Xyrem by itself.
This is why it’s important to consult your physician or pharmacist prior to taking any of these medications that contain Xyrem.
Xyrem and vitamins
There are no reports yet of Xyrem interfering with vitamins. However, this doesn’t mean vitamin interactions will not be spotted in the near future.
This is why it’s essential to talk with your doctor or pharmacist prior to using any of these drugs when you are taking Xyrem.
Do Xyrem interfere with food?
There’s been no reported instances of Xyrem interaction with specific food items. However, it is important to wait at least two hours after having eaten before taking your first dose of Xyrem. If you take Xyrem before eating (or too shortly after eating) can lower the levels of the drug within your body. This could cause Xyrem less efficient.
Is Xyrem interfer with vaccines?
There are no reported cases of Xyrem interaction with vaccines. If you have any questions regarding the vaccinations you will receive during your Xyrem treatment consult your doctor.
Does Xyrem interfere with laboratory tests?
There are no reports of Xyrem interaction with laboratory tests. If you have concerns about the need for certain lab tests done during the treatment process with Xyrem discuss it with the healthcare professional who ordered the test.
Does Xyrem have an interaction CBD or cannabis?
Cannabis (commonly known as marijuana) and cannabis-related products such as cannabidiol (CBD) have been specifically linked to Xyrem.
Xyrem and cannabis are both central nervous system (CNS) depressants. This means that they both reduce certain brain-related signals that are used to manage important bodily functions, like breathing and thinking. This means that both can trigger respiratory depression (slowed breathing) and sleepiness (severe tiredness). Combining cannabis and Xyrem can increase the risk of these problems.
Xyrem comes with a boxed caution about the possibility of CNS depression. This is the most severe warning issued by the FDA. For more information, refer to “Boxed warnings” at the top of this article.
Note: Cannabis is illegal at the federal level however it is legal in several states to different levels.
Some medical conditions and other factors can increase the risk of interaction with Xyrem. Before you take Xyrem discuss with your doctor regarding your medical background. They’ll decide if Xyrem is the right choice for you.
Other conditions, health issues or other aspects that could affect Xyrem include:
Breathing issues. Xyrem may cause respiratory depression (slowed breathing) or difficulty breathing. If you have breathing problems, like sleep apnea, then taking Xyrem could make your condition worse.
Succinic semialdehyde dehydrogenase insufficiency. Taking Xyrem is not recommended for those with this condition. For more information, refer to the “When should I avoid Xyrem?” section above.
Liver issues. If you suffer from a liver issue like liver failure or liver failure, the Xyrem level could increase within your body. This could increase your chance of experiencing adverse effects of the medication. Because of the risk of this, doctors typically suggest a lesser dose of Xyrem to those suffering from liver issues. To find out more, consult with your physician.
A low-salt diet. Before starting Xyrem treatment, inform your doctor if you are on an eating plan that is low in salt. This could mean the use of a low salt diet to treat heart failure or high blood pressure or kidney issues.
Xyrem contains a large quantity of salt. You might want to think about the amount of salt you consume to track your daily intake of salt. To find out the quantity of salt contained in each dose of Xyrem check out the prescribing information for the drug.
Pregnancy. It’s not known whether Xyrem is safe to use during pregnancy. If you’re planning or pregnant to become pregnant, consult your doctor prior to taking Xyrem.
breastfeeding. It’s not known whether it’s safe to use Xyrem during breastfeeding. The drug can be found in breast milk, but it’s not certain if it will cause adverse effects in a child that is breastfeeding. If you’re breastfeeding or plan to breastfeed, speak with your doctor about options.
Allergy reaction. If you’ve had an allergic reaction to Xyrem or any of its ingredients your doctor will probably not recommend Xyrem. This is because taking the drug may cause a second allergic reaction. Ask your physician about alternative treatments that might be a better choice for you.
Following a few steps can assist you in avoiding interactions with Xyrem. Before beginning treatment, speak with your pharmacist and doctor. The topics to talk about with them are:
- No matter if you consume alcohol or use cannabis.
- Other medications you are taking along with any supplements, vitamins, and herbal supplements. Your pharmacist or doctor may assist you in filling out the medication list.
- What should you do if begin taking a new medication while you are undergoing Xyrem treatment.
It’s also important to know the label for Xyrem as well as other documentation that could be included along with the medication. The colored stickers that explain interactions could be found included on the label. Also, the documentation (sometimes known as the insert for the patient’s package or the medication guide) could contain additional information regarding interactions. (If you didn’t receive the paperwork for Xyrem, request your pharmacist to print one for you.)
If you are having trouble comprehending or reading the information provided, your physician or pharmacist can assist you.
The exact dosage of Xyrem can also help avoid interactions.
If you’re still unsure about Xyrem and the possible interactions, speak to your doctor.
Questions you might be able to ask your doctor are:
- What is the best schedule for me to take Xyrem along with my other medications to prevent interactions?
- Do higher doses of Xyrem increase my chance of interaction with other medications?
- Are alternative options to Xyrem that won’t interfere with alcohol?
To find out more about Xyrem’s capabilities, read these articles:
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Disclaimer: This information is not intended to be substitute for the experience and expertise of licensed healthcare professionals. Always consult with your physician or other healthcare professional prior to using any medicine. The information about drugs in this article is subject to changes and is not intended to provide all possible directions, uses or precautions, warnings or reactions to drugs or allergic reactions. adverse reactions. In the absence of any warnings or other details regarding the drug in question does not mean that the medication or combination is safe or effective for all patients or specific applications.
Article source and credits to https://www.healthline.com/health/drugs/xyrem-interactions