child narcolepsy 2

“How do I manage my child’s XYREM treatment?”

Advise caregivers and pediatric patients about the importance of setting a consistent nighttime routine.

Certain lifestyle adjustments may be needed for caregivers and pediatric patients to prepare and take XYREM properly.

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

Sample Nighttime Routine for Caregivers of Pediatric Patients*

Xyrem nighttime routine for caregivers of pediatric patients chart
  • *For illustrative purposes only. Times may vary based on your patients' nighttime schedules.
  • †For patients who sleep more than 8 hours per night, the first dose of XYREM may be given at bedtime or after an initial period of sleep.
  • ‡Anyone who takes XYREM should not do anything dangerous or that requires them to be fully awake for at least 6 hours after taking XYREM.

Remember to counsel caregivers and patients about the serious risks associated with XYREM, including the risk of concomitant use with potentially interacting agents.2

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

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.