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XYWAV® Narcolepsy Homepage

Transitioning from XYREM

Your doctor can transition you from
XYREM® (sodium oxybate) oral solution
to low‑sodium oxybate, XYWAV

Person working with elephant (made of salt) in the room

Ready to address the high‑sodium elephant in the room?

It may be time to ask your doctor about XYWAV. At the maximum recommended 9 g nightly dose, XYWAV has 131 mg of sodium vs ~1640 mg with XYREM, a high-sodium oxybate. This means that XYWAV has 92% (~1509 mg) less sodium than XYREM.

Because XYWAV has significantly less sodium compared to XYREM, choosing XYWAV over XYREM can help reduce the risk for developing cardiovascular disease

Elephant made of salt

In a study that assessed the real-world experience of 85 people with type 1 and type 2 narcolepsy who transitioned from high‑sodium XYREM to low‑sodium XYWAV, participants completed weekly lookback diaries and questionnaires for 5 periods over 21 weeks. They were asked “Why are you transitioning?”:

  • Over a third—38.8%—said they transitioned to avoid current cardiovascular conditions
  • Almost all—92.9%—said that they transitioned for long‑term health benefits due to the lower sodium content of XYWAV compared to XYREM

A possible limitation of the study was that 16% of patients left the study early. It is not known if they left because they were not satisfied with XYWAV treatment, which could have impacted the results to appear more favorable to XYWAV.

Taking XYREM?
Interested in lowering your daily sodium intake?
Talk to your doctor about XYWAV.


Same active ingredient.
Lower-sodium formulation.

  • Both XYWAV and XYREM contain oxybate (0.413 g/mL of oxybate)
  • XYWAV contains 92% less sodium than XYREM
  • The lower-sodium formulation required adding minerals that are not found in XYREM. This is why XYWAV will taste different than XYREM*
*Sucralose is a US Food and Drug Administration-approved non-nutritive artificial sweetener. XYWAV oral solution contains sucralose as an inactive ingredient to mask the bitter taste of the active ingredients. At the recommended dose ranges for XYWAV, the amount of sucralose is less than 10% of the Acceptable Daily Intake (ADI) established by the FDA for a 60‑kg adult.
XYWAV mineral content for a 9 g dose: calcium=687 mg; magnesium=182 mg; potassium=642 mg; sodium=131 mg

If your doctor decides it's appropriate to transition you to XYWAV:

Your doctor is recommended to initially prescribe XYWAV at the same dose and regimen as your XYREM treatment.

Take XYWAV exactly as your doctor instructs. If needed, your doctor may adjust your dosage or dosing routine.

Your doctor won't need to re-enroll you in XYWAV and XYREM REMS, since you're already enrolled.

When I transitioned from XYREM to XYWAV, my doctor just told me to start on the dose I was on... I basically just picked up where I left off.


Diagnosed with narcolepsy type 1.

After transitioning from XYREM to XYWAV some people may require changes to their dosage based on efficacy and tolerability.Watch Oscar and others share their stories to help educate and inspire people with narcolepsy.

Compensated for his time. Results may vary.

Your doctor will likely:

  • Adjust your dosage or dosing routine to meet your needs
  • Decide how long you should wait between taking your 2 nightly doses (within a time frame of 2½ to 4 hours apart)
  • Work with you to develop a management plan
preparing and taking xywav
XYWAV® bottle

Although the new XYWAV bottle is smaller than the XYREM bottle, both bottles contain the same amount of medicine: 180 mL. Also, because XYWAV contains calcium, magnesium, and potassium, it will taste different than XYREM.

I was on XYREM for a couple of years. And then I read about XYWAV and how it had a 92% reduction in sodium from XYREM. I was immediately intrigued, so I asked my doctor about transitioning to XYWAV.”


Diagnosed with narcolepsy type 1.

Compensated for her time. Results may vary.

Talk to your doctor about transitioning from XYREM

Learn more

XYWAV® (calcium, magnesium, potassium, and sodium oxybates) oral solution, 0.5 g/mL total salts (equivalent to 0.413 g/mL of oxybate) is a prescription medicine used to treat:

  • the following symptoms in people 7 years of age or older with narcolepsy:
    • sudden onset of weak or paralyzed muscles (cataplexy)
    • excessive daytime sleepiness (EDS)
  • idiopathic hypersomnia (IH) in adults.

Important Safety Information

WARNING: Taking XYWAV with other central nervous system (CNS) depressants such as medicines used to make you or your child fall asleep, including opioid analgesics, benzodiazepines, sedating antidepressants, antipsychotics, sedating anti-epileptic medicines, general anesthetics, muscle relaxants, alcohol, or street drugs, may cause serious medical problems, including trouble breathing (respiratory depression), low blood pressure (hypotension), changes in alertness (drowsiness), fainting (syncope), and death.

The active ingredient of XYWAV is a form of gamma-hydroxybutyrate (GHB). Abuse or misuse of illegal GHB alone or with other drugs that cause changes in alertness (or consciousness) has caused serious side effects. These effects include seizures, trouble breathing (respiratory depression), changes in alertness (drowsiness), coma, and death. Call your doctor right away if you or your child has any of these serious side effects.

Because of these risks, you have to go through the XYWAV and XYREM REMS to have your or your child's prescription for XYWAV filled.

Do not take XYWAV if you take or your child takes other sleep medicines or sedatives (medicines that cause sleepiness), drinks alcohol, or has a rare problem called succinic semialdehyde dehydrogenase deficiency.

Keep XYWAV in a safe place to prevent abuse and misuse. Selling or giving away XYWAV may harm others, and is against the law. Tell your doctor if you have ever abused or been dependent on alcohol, prescription medicines, or street drugs.

Anyone who takes XYWAV should not do anything that requires them to be fully awake or is dangerous, including driving a car, using heavy machinery, or flying an airplane, for at least 6 hours after taking XYWAV. Those activities should not be done until you know how XYWAV affects you or your child.

XYWAV can cause serious side effects, including the following:

  • Breathing problems, including slower breathing, trouble breathing, and/or short periods of not breathing while sleeping (sleep apnea). People who already have breathing or lung problems have a higher chance of having breathing problems when they use XYWAV.
  • Mental health problems, including confusion, seeing or hearing things that are not real (hallucinations), unusual or disturbing thoughts (abnormal thinking), feeling anxious or upset, depression, thoughts of killing yourself or trying to kill yourself, increased tiredness, feelings of guilt or worthlessness, or difficulty concentrating. Tell your doctor if you or your child have or had depression or have tried to harm yourself or themselves. Call your doctor right away if you have or your child has symptoms of mental health problems or a change in weight or appetite.
  • Sleepwalking. XYWAV can cause sleepwalking, which can cause injuries. Call your doctor if this occurs.

The most common side effects of XYWAV in adults include nausea, headache, dizziness, anxiety, insomnia, decreased appetite, excessive sweating (hyperhidrosis), vomiting, diarrhea, dry mouth, parasomnia (a sleep disorder that can include abnormal dreams, abnormal rapid eye movement (REM) sleep, sleep paralysis, sleep talking, sleep terror, sleep-related eating disorder, sleepwalking, and other abnormal sleep-related events), somnolence, fatigue, and tremor.

The most common side effects of XYREM (which also contains oxybate like XYWAV) in children include nausea, bedwetting, vomiting, headache, weight decrease, decreased appetite, dizziness, and sleepwalking.

XYWAV can cause physical dependence and craving for the medicine when it is not taken as directed. These are not all the possible side effects of XYWAV.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit, or call 1-800-FDA-1088.

Please see full Prescribing Information, including BOXED Warning, and Medication Guide.

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