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What's the difference between Xywav and Xyrem?

Medically reviewed by Carmen Pope, BPharm. Last updated on Nov 4, 2022.

Official answer


Xywav is a low-sodium alternative to Xyrem, approved in 2020 after concerns about the high sodium content of Xyrem potentially contributing to heart disease.

  • Xywav contains 92% less sodium than Xyrem and may be more suitable for people on a low salt diet or those who are at risk of high blood pressure. Xyrem carries warnings about its high sodium content.
  • Xywav only contains 131mg sodium in a daily 9g dose compared with Xyrem which contains 1640mg of sodium per 9g dose. The American Heart Association recommends no more than 2,300 mg of sodium a day, preferably less than 1,500 mg per day.
  • Xywav contains the same amount of oxybate as Xyrem, but as a mixture of calcium, magnesium, potassium, and sodium oxybate salts, instead of solely sodium oxybate salts, which make up Xyrem.
  • Doctors can initiate Xywav at the same dosage as Xyrem.

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