Short answer: Sodium oxybate (Xyrem) is the sodium salt of GHB (gamma-hydroxybutyrate), used to treat cataplexy and daytime sleepiness in narcolepsy. FDA-approved oxybate products are Schedule III and available only through a restricted central pharmacy program. GHB outside that program is Schedule I, and it has been used in drug-facilitated sexual assault.
Key takeaways
- What it is: Sodium oxybate is a cns depressant (ghb salt) and a Schedule III controlled substance in the US.
- Main uses: Narcolepsy; idiopathic hypersomnia.
- Timing: effects start in 15 to 30 minutes and last 2 to 4 hours.
- Most dangerous mix: Alcohol, which can cause deep sedation, slowed breathing, death.
- Naloxone: it does not reverse this drug, but give it whenever opioids could be involved.
- Dependence risk: High.
- Legal route: only with a prescription from a DEA-registered clinician, filled by a licensed pharmacy.
What is sodium oxybate?
Sodium oxybate is approved for cataplexy (sudden muscle weakness triggered by emotions) and excessive daytime sleepiness in people 7 and older with narcolepsy. Xywav, with less sodium, is also approved for idiopathic hypersomnia in adults. Lumryz is taken once at bedtime.
GHB occurs naturally in small amounts in the brain. Taken at night, oxybate deepens slow-wave sleep, which improves daytime alertness and reduces cataplexy.
Quick facts
| Fact | Sodium oxybate |
|---|---|
| Generic name | Sodium oxybate (GHB sodium salt); calcium, magnesium, potassium, and sodium oxybates (Xywav) |
| Brand names | Xyrem, Xywav, Lumryz |
| Street names (illicit GHB) | G, liquid ecstasy, Georgia home boy, gina |
| Drug class | Central nervous system depressant |
| US legal status | FDA-approved oxybates: Schedule III with restricted distribution; illicit GHB: Schedule I |
| Approved uses | Cataplexy and excessive daytime sleepiness in narcolepsy; idiopathic hypersomnia (Xywav) |
| Forms | Oral solution; extended-release granules (Lumryz) |
| Onset | 15 to 30 minutes |
| Half-life | 30 to 60 minutes |
How long does sodium oxybate last?
- Starts working: 15 to 30 minutes
- Effects last: 2 to 4 hours
- Half-life: 30 to 60 minutes
It is cleared within about 6 hours in blood and 12 hours in urine, so testing after a suspected drugging must happen quickly.
Timing varies with the dose, the form, how it is taken, liver and kidney function, age, and other drugs taken at the same time.
What are the biggest risks of sodium oxybate?
The FDA requires boxed warnings, its strongest, on sodium oxybate products, including:
- Central nervous system depression: seizures, slowed breathing, decreased consciousness, coma, and death can occur at recommended doses, and are more likely with alcohol or other sedatives.
- Abuse and misuse: illicit GHB use has been associated with seizures, breathing problems, coma, and death.
- Available only through a restricted REMS program.
Common side effects include nausea, dizziness, vomiting, bedwetting, headache, and sleepwalking.
Illicit GHB has a very steep dose-response curve: a small increase can move a person from euphoria to unconsciousness. It is colorless and nearly tasteless in drinks, which is why it has been used to sedate people for sexual assault. Related chemicals GBL and 1,4-butanediol turn into GHB in the body.
What should you never mix with sodium oxybate?
| Combined with | What happens | Label guidance |
|---|---|---|
| Alcohol | Deep sedation, slowed breathing, death | Contraindicated |
| Sedative-hypnotics (sleeping pills) | Additive CNS depression | Contraindicated |
| Opioids, benzodiazepines, gabapentinoids | Slowed breathing, coma | Avoid |
| Valproate | Raises oxybate levels | Reduce oxybate dose by at least 20% |
| Topiramate | Confusion, coma reported | Use caution |
Check any combination with the DoseUses combination checker or ask a pharmacist.
What are the signs of a sodium oxybate overdose, and what should you do?
GHB overdose causes vomiting, confusion, agitation, slow heart rate, low body temperature, seizures, slowed or irregular breathing, and sudden deep unconsciousness. People may wake abruptly hours later.
If someone may have overdosed
- Call 911 if the person is unresponsive, hard to wake, or breathing slowly.
- For advice when the person is awake and stable, call Poison Help at 1-800-222-1222 (US, free, 24 hours).
- If opioids could be involved, including pills not from a pharmacy, give naloxone if you have it. Naloxone does not reverse sodium oxybate, but it will not harm the person.
- Stay with the person and place them on their side if they are drowsy or vomiting.
What is sodium oxybate withdrawal like, and how long does it last?
Regular, frequent GHB use (often every few hours, day and night) causes severe physical dependence. Withdrawal can be life-threatening and needs medical care. Withdrawal after prescribed nightly oxybate is uncommon but has been reported.
- 1 to 6 hoursRapid onsetAnxiety, tremor, sweating, insomnia, fast heartbeat.
- Days 1 to 6Severe withdrawalConfusion, hallucinations, delirium, agitation, and seizures can occur.
- 1 to 2 weeksRecoverySymptoms ease; insomnia and anxiety may linger.
See the withdrawal timelines and the full sodium oxybate withdrawal guide.
Is sodium oxybate legal?
In the United States, sodium oxybate is a Schedule III controlled substance. The only legal way to get it is with a prescription from a clinician registered with the Drug Enforcement Administration (DEA), filled by a licensed pharmacy. Depending on state law, that can be a physician, nurse practitioner, or physician assistant.
- Refills: a Schedule III prescription can be refilled up to five times within six months of the date it was written. After that, a new prescription is needed.
- Telehealth: federal flexibilities let DEA-registered clinicians prescribe Schedule II to V medicines after a telemedicine visit, without a prior in-person exam, through December 31, 2026. A permanent DEA rule was under final review in late 2026. State rules can be stricter.
- Monitoring: prescribers and pharmacists in most states check a prescription drug monitoring program, a database of controlled-substance prescriptions, before prescribing or dispensing.
Outside the United States
| Country | Status |
|---|---|
| United Kingdom | GHB Class B since 2022; sodium oxybate prescribed |
| Canada | Schedule III; Xyrem by prescription |
| European Union | Sodium oxybate approved for narcolepsy and, in some countries, alcohol dependence |
| International | GHB: Schedule II of the 1971 Convention |
Frequently asked questions about sodium oxybate
Is Xyrem the same as GHB?
Yes. Xyrem is the sodium salt of GHB, made to pharmaceutical standards and dosed precisely.
Why can't I get Xyrem at a regular pharmacy?
Because of its risks and history of misuse, it is only dispensed through a restricted program by certified pharmacies that ship directly to patients.
How long does GHB stay in the body?
It is cleared within about 6 hours in blood and 12 hours in urine, so testing after a suspected drugging must happen quickly.
Can you drink alcohol with sodium oxybate?
No. The combination can stop breathing and is contraindicated.
Sources
- Xyrem (sodium oxybate) prescribing information, DailyMed, US National Library of Medicine.
- Controlled Substance Schedules, DEA Diversion Control Division.
- 21 CFR 1306.22, Refilling of prescriptions (Schedules III and IV), Electronic Code of Federal Regulations.
- Prescribing controlled substances via telehealth, US Department of Health and Human Services.
- BeSafeRx: Your Source for Online Pharmacy Information, US Food and Drug Administration.
- Safe Pharmacy, National Association of Boards of Pharmacy.
- International drug control conventions, United Nations Office on Drugs and Crime.
This guide summarizes the sourced DoseUses Sodium oxybate profile, written from FDA labels, DEA rules, and federal health agencies. It is educational and is not medical advice. Last updated October 5, 2026.
