Sodium oxybate (Xyrem): Background
• Chemical name: Gamma-hydroxybutyrate (sodium salt)
• Generic name: Sodium oxybate
• Brand name: Xyrem
Indication:
Sodium oxybate is considered as an orphan drug used for the treatment of cataplexy in patients with narcolepsy. An orphan drug can be defined as one that is used to treat an orphan disease. Sodium oxybate is the only drug approved for the treatment of cataplexy with narcolepsy, and is a first-line treatment for patients with narcolepsy.
Mechanism of action:
The exact mechanism of the anti-cataplectic action of sodium oxybate is unknown. Oral GHB alters sleep architecture in healthy volunteers and in patients with narcolepsy, primarily by improving the continuity of sleep.
Sodium oxybate (Xyrem) is the sodium salt of the CNS depressant g-hydroxybutyric acid (GHB), and is therefore a CNS depressant itself. GHB is an endogenous GABA metabolite and acts as a neurotransmitter by binding to GHB receptors. GHB is found throughout the central nervous system (CNS) and in the periphery. At low doses, it appears to activate excitatory GHB receptors. At pharmacological doses, sodium oxybate (GHB) appears to act primarily by stimulating or activating inhibitory GABA-B receptors; it may also induce both dopamine and serotonin release as well as modulate GABA-A and GABA-C receptors (see figure below).
For more information regarding sodium oxybate, visit the official Xyrem website by Jazz Pharmaceuticals.
References
1) Robinson, Keating. Sodium oxybate- a review of its use in the management of narcolepsy. CNS Drugs 2007
2) Wang Y.G et al. Safety Overview of Postmarketing and Clinical Experience of Sodium Oxybate (Xyrem): Abuse, Misuse, Dependence, and Diversion. Journal of Clinical Sleep Medicine 2009; 5(4): 365 – 380
3) Fuller DE et al. The Xyrem Risk Management Program. Drug Safety 2004; 27(5): 293 – 306
4) JK Aronson. Rare diseases and orphan drugs. Br J Clin Pharmacol. 2006 March; 61(3): 243–245.
5) Canadian Pharmacists Association 2012. e-CPS. Xyrem (sodium oxybate).
Images:
http://bouldersleeptherapy.com/disorders/narcolepsy.php/
autoimmunediseasesa2z.com
www3.unil.ch
2) Wang Y.G et al. Safety Overview of Postmarketing and Clinical Experience of Sodium Oxybate (Xyrem): Abuse, Misuse, Dependence, and Diversion. Journal of Clinical Sleep Medicine 2009; 5(4): 365 – 380
3) Fuller DE et al. The Xyrem Risk Management Program. Drug Safety 2004; 27(5): 293 – 306
4) JK Aronson. Rare diseases and orphan drugs. Br J Clin Pharmacol. 2006 March; 61(3): 243–245.
5) Canadian Pharmacists Association 2012. e-CPS. Xyrem (sodium oxybate).
Images:
http://bouldersleeptherapy.com/disorders/narcolepsy.php/
autoimmunediseasesa2z.com
www3.unil.ch