Oxybate Medication Comparison
Comparison of Xyrem, Xywav, and Lumryz for Sleep Disorders (2026)
| Feature | Xyrem | Xywav | Lumryz |
|---|---|---|---|
| Active Ingredient | Sodium Oxybate | Mixed Salts Oxybate | Sodium Oxybate |
| Dosing | Twice Nightly | Twice Nightly* | Once Nightly |
| Sodium (per 9g) | 1,640 mg | 131 mg | 1,640 mg |
| FDA Indications | Narcolepsy 1 & 2 | Narcolepsy 1 & 2; IH | Narcolepsy 1 & 2; IH |
| Preparation | Dilute with water | Dilute with water | Granules in water |
Cardiovascular Health
Xywav is the clinical choice for patients with hypertension or heart risk. It reduces sodium intake by 92% compared to traditional oxybates, which is critical for long-term health.
Sleep Continuity
Lumryz removes the “middle-of-the-night” alarm. By using extended-release technology, it provides a full night’s therapeutic coverage with a single bedtime dose.
Idiopathic Hypersomnia
Only Xywav (*as once nightly dose) and Lumryz are currently FDA-approved for IH.
Standard of Care
Xyrem remains the foundational treatment. However, many clinicians are transitioning patients to either low-sodium or once-nightly options to improve quality of life.
Critical Safety Information
- CNS Depression: Oxybates are powerful sedatives. Do not engage in hazardous activities (driving/machinery) for at least 6 hours after dosing.
- Alcohol Contraindication: Alcohol must never be consumed with any oxybate.
- REMS Program: All oxybates are dispensed only through a restricted central pharmacy program.
- Mental Health: Monitor for new or worsening depression, anxiety, or sleepwalking.