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“Tell me, how do I manage my XYREM treatment?”

Advise your XYREM patients about the importance of setting a consistent nighttime routine.

Certain lifestyle adjustments may be needed for your adult patients to prepare and take XYREM properly.

  • Patients should adopt a bedtime routine consistent with XYREM dosing and administration requirements.
  • XYREM should be taken in 2 doses, between 2.5 to 4 hours apart.1
  • Both doses should be prepared prior to bedtime.1
  • Patients should be reminded to not eat for at least 2 hours before their first dose.1
    • Food reduces the bioavailability of XYREM.1
  • Patients should take both doses while in bed and lie down immediately after dosing.1
    • XYREM may cause sleep abruptly, without first feeling drowsy.1
  • Patients should be encouraged to take both doses to obtain the desired effect and advised to never take both XYREM doses at the same time.

Sample Nighttime Routine for Adults1*

Xyrem nighttime routine for adults chart

*For illustrative purposes only. Times may vary based on your patients’ nighttime schedules.

Remember to counsel your patients about the serious risks associated with XYREM, including the risk of concomitant use with alcohol, other CNS depressants, or other potentially interacting agents.2

Set treatment expectations by explaining to your patients that it may take time to see progress, and that frequent follow-up is important for making dosage adjustments and managing adverse reactions.

Important Safety Information


XYREM is contraindicated for use in combination with alcohol or sedative hypnotics. Use of other CNS depressants may potentiate the CNS-depressant effects of XYREM.

Concomitant use of XYREM with divalproex sodium resulted in a 25% mean increase in systemic exposure to XYREM (AUC ratio range of 0.8 to 1.7) and in a greater impairment on some tests of attention and working memory. An initial XYREM dose reduction of at least 20% is recommended if divalproex sodium is prescribed to patients already taking XYREM. Prescribers are advised to monitor patient response closely and adjust dose accordingly if concomitant use of XYREM and divalproex sodium is warranted.