[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Wake-promoting agents and narcolepsy drugs](https://durgical.com/en/pharmacology/classes/wake-promoting-agents-and-narcolepsy-drugs/) › Sodium oxybate

# Sodium oxybate

## Wake-promoting agents and narcolepsy drugs?

Wake-promoting agents and narcolepsy drugs

The sodium salt of GHB, taken at night for cataplexy and daytime sleepiness in narcolepsy. A strong CNS depressant: never with alcohol or sedatives.

Updated Nov 1, 2026

## Quick facts

**Group**
[Wake-promoting agents and narcolepsy drugs](https://durgical.com/en/pharmacology/classes/wake-promoting-agents-and-narcolepsy-drugs/)

**Target**
GABA-B receptor

**Key effects**
Nausea and vomiting · Dizziness and somnolence

**Monitor**
Breathing during sleep · Mood

**ATC**
N07XX04

No doses: the clinician sets them by the current guideline.

On this page

- The basics Mechanism of action
- Indications
- Adverse effects
- Pharmacokinetics
- Memory aid

- Safety Contraindications
- Key interactions
- What is monitored
- Administration and safety
- Pregnancy and breastfeeding
- Nursing care

- Study Test yourself

- Connections Connections

## Mechanism of action

Sodium oxybate is gamma-hydroxybutyrate (GHB), a natural metabolite of GABA. How it helps narcolepsy is not known; its effects are thought to come through GABA-B receptors during the night, with less cataplexy and less daytime sleepiness as a result.

- Taken at bedtime; GHB acts on GABA-B receptors
- A second dose follows later in the night
- Fewer cataplexy attacks and less daytime sleepiness

## Indications

- Cataplexy and excessive daytime sleepiness in narcolepsy [Narcolepsy →](https://durgical.com/en/conditions/narcolepsy/)

## Adverse effects

### Common

- Nausea and vomiting
- Dizziness and somnolence
- Bed-wetting
- Tremor

### Serious (rare, important)

- CNS and respiratory depression (boxed warning), with seizures, coma and death in misuse
- Depression and suicidality
- Confusion, anxiety and sleepwalking
- High sodium load in heart failure, hypertension or kidney disease

## Contraindications

- Alcohol or sedative hypnotics
- Succinic semialdehyde dehydrogenase deficiency

## Key interactions

**Alcohol, sedative hypnotics, opioids and other CNS depressants**
Deep sedation and respiratory depression

**Divalproex (valproate)**
Higher GHB exposure; the starting dose is reduced

## What is monitored

- Breathing during sleep, especially with sleep apnoea or lung disease
- Mood, suicidal thoughts and night-time behaviour
- Sodium intake in heart failure, hypertension or kidney disease

## Administration and safety

- Dispensed only through a restricted (REMS) programme in the United States
- The solution is diluted and prepared before bedtime; two doses are taken in bed during the night
- First dose well after the last meal, because food lowers its effect
- Controlled medicine (Schedule III); illicit GHB is a drug of abuse

## Pregnancy and breastfeeding

Human data are inadequate; it passes into breast milk.

## Nursing care

- Ask about alcohol, sedatives, sleep apnoea and depression before starting
- Teach to take each dose in bed and lie down right away
- Teach to avoid driving and hazardous tasks for several hours after a dose
- Store it locked away from others

## Pharmacokinetics

**Absorption**
Rapid, about 88% bioavailable; food delays it and lowers peak levels

**Metabolism**
Mainly to carbon dioxide and water through the Krebs cycle

**Half-life**
Short, about half an hour to one hour

## Memory aid

Sodium oxybate: «GHB in bed, twice a night, no booze» – it works at night so the day stays awake.

## Test yourself

Think of the answer, then tap the question to see it.

## What is sodium oxybate chemically?

The sodium salt of gamma-hydroxybutyrate (GHB), a GABA metabolite.

## Which two combinations are contraindicated?

Alcohol and sedative hypnotics.

## Which narcolepsy symptom besides sleepiness does it treat?

Cataplexy.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/sodium-oxybate/)

[More Pharmacology questions →](https://durgical.com/en/practice/?f=pharmacology)

## Connections

## Related drugs 3

- [Modafinil](https://durgical.com/en/pharmacology/modafinil/)
- [Pitolisant](https://durgical.com/en/pharmacology/pitolisant/)
- [Valproic acid](https://durgical.com/en/pharmacology/valproic-acid/)

## Related conditions 1

- [Narcolepsy](https://durgical.com/en/conditions/narcolepsy/)

[← Back to the class: Wake-promoting agents and narcolepsy drugs](https://durgical.com/en/pharmacology/classes/wake-promoting-agents-and-narcolepsy-drugs/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [DailyMed - SODIUM OXYBATE solution](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=5a9e9045-f04d-46eb-8396-2495c6090a31) (DailyMed (U.S. National Library of Medicine), 2026); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=N07XX04) (WHO Collaborating Centre for Drug Statistics Methodology, 2026).

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Representative model, for educational purposes only.

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License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/sodium-oxybate/