Sodium Oxybate (Xyrem) Administration:
Counseling points & instructions for Patients
CAUTION: Be very careful not to leave your Xyrem in a place where children or pets can get to it.
The Xyrem carton contains 1 bottle of medicine, 2 dosing cups with child-resistant caps, 1 liquid measuring device, and printed product information. (See package insert for illustrations).
The following provides detailed instructions on how to properly administer Xyrem doses. Corresponding figures are listed beside each step where applicable; all figures are provided at the bottom of the page.
Step 1: Remove the Xyrem bottle and the measuring device from the box (Figure 1).
Step 2: Remove the measuring device from the wrapper (Figure 2).
Step 3: Remove the bottle cap by pushing down while turning the cap counterclockwise (to the left) (Figure 3).
After removing the cap, set the bottle upright on a tabletop.
Step 4: While holding the bottle in its upright position, insert the tip of the measuring device into the centre opening on top of the bottle and press down firmly (Figure 4).
Step 5: While holding the bottle and measuring device down with one hand, draw up the prescribed dose with the other hand by pulling on the plunger (Figure 5).
- Notes:
- Xyrem is a liquid and your individual prescription contains a description of your dose in grams (g) of Xyrem. Use the description in grams Xyrem to determine the proper dose on the measuring device.
- Medicine will not flow into the measuring device unless you keep the bottle in its upright position.
- Prepare both doses before bedtime. Place the caps provided on the dosing cups and turn each cap clockwise (to the right) until it clicks and locks into its child-resistant position.
- Recap the Xyrem bottle and store it in a safe and secure place (locked up if appropriate), out of the reach of children. Rinse out the liquid measuring device with water. (Figure 7)
Step 7: Right before going to sleep, place your second dose in a secure location (locked up if appropriate) near your bed. You may need to set an alarm so you wake up to take your second dose no earlier than 2½ hours and no later than 4 hours after your first dose. If you wake up before the alarm and it has been at least 2.5 hours, turn off your alarm and take your second dose.
- Remove the cap from the first dosing cup by pressing down on the child-resistant locking cap and turning the cap counterclockwise (to the left) (Figure 8).
- Drink the entire first dose while sitting in bed, recap the cup, and then lie down right away (Figure 9).
Step 8: When you wake up 2½ to 4 hours later, remove the cap from the second dosing cup. While sitting in bed, drink all of the second dose; recap the second cup and then lie down to continue sleeping.
Things to keep in mind:
- XYREM is a liquid taken at night
- Patients should divide the recommended starting dose into 2 equal doses
- Prepare both nighttime doses prior to bedtime
- The second dose should be taken 2 ½ to 4 hours after the first dose
- Food significantly decreases the bioavailability of XYREM
- Should be taken at least 2 hours after eating
- Patients should not drive or operate machinery for at least 6 hours after taking XYREM
References
1. Valeant Canada Ltd. Xyrem (sodium oxybate) Product Monograph. Sept 2009. Accessed June 3, 2012 from http://webprod3.hc-sc.gc.ca/dpd-bdpp/dispatch-repartition.do?lang=eng
2. Xyrem (oral solution) Sodium Oxybate Medication Guide. Jazz Pharmaceuticals Accessed June 1, 2012 from http://www.xyrem.com/images/Xyrem_Med_Guide_09212011.pdf
Images:
http://www.xyrem.com/healthcare-professionals/direct-your-patients
Xyrem oral solution (sodium oxybate) Medication Guide. Jazz Pharmaceuticals, Inc. 2011
http://bouldersleeptherapy.com/disorders/narcolepsy.php/
autoimmunediseasesa2z.com
www3.unil.ch
2. Xyrem (oral solution) Sodium Oxybate Medication Guide. Jazz Pharmaceuticals Accessed June 1, 2012 from http://www.xyrem.com/images/Xyrem_Med_Guide_09212011.pdf
Images:
http://www.xyrem.com/healthcare-professionals/direct-your-patients
Xyrem oral solution (sodium oxybate) Medication Guide. Jazz Pharmaceuticals, Inc. 2011
http://bouldersleeptherapy.com/disorders/narcolepsy.php/
autoimmunediseasesa2z.com
www3.unil.ch