Xyrem

(oxybate)
sodium oxybate 500 MG/ML Oral Solution [Xyrem]

Dosage & administration

Dosage for Adult Patients

Total Nightly Dose

Take at Bedtime

Take 2.5 to 4 Hours Later

4.5 g per night

2.25 g

2.25 g

6 g per night

3 g

3 g

7.5 g per night

3.75 g

3.75 g

9 g per night

4.5 g

4.5 g


Dosage for Pediatric Patients (7 years of Age and Older)


Important Administration Information


Patients with Hepatic Impairment

Recommended starting dosage is one-half of the original dosage per night administered orally, divided into two doses .

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drug label

Xyrem prescribing information

Have more Xyrem questions?

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Need to report a Xyrem issue?

ONLINE FORM
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samples

Request Xyrem samples

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prior authorization

Xyrem Prior authorization resources

Complete Letter of Medical Necessity

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Coverage Authorization Request

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Coverage Authorization Appeals
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Benefits investigation

Patient Authorization Form - Online
Patient Authorization Form - English (Print Form)
Patient Authorization Form - Spanish (Print Form)
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Reimbursement help (FRM)

Receive Assistance from an FRM Regarding Reimbursement Information
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financial assistance

Xyrem Financial assistance options

Co-pay savings program

commercial only
Patient Authorization Form - Online
Patient Authorization Form - English (Print Form)
Patient Authorization Form - Spanish (Print Form)
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Bridge program

commercial only
Patient Authorization Form - Online
Patient Authorization Form - English (Print Form)
Patient Authorization Form - Spanish (Print Form)
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Quick Start Voucher - 1 month supply
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Foundation programs

under insured
no insurance
goverment insurance
65+
JazzCares Patient Assistance Application Program
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patient education

Xyrem Patient education

Getting started on Xyrem

Instructions For Use - Narcolepsy Adults
ASK PATIENT TO:
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Scan QR Code & Tap Link
Instructions For Use - Narcolepsy Children & Adolescents
ASK PATIENT TO:
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Scan QR Code & Tap Link

Patient toolkit

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Please note:
  • Access to a Field Reimbursement Manager (FRM) or Medical Science Liaison (MSL) varies by brand and may require talking with your rep first.
  • Samples are provided at the discretion of the brand.
  • We are unable to collect Protected Health Information (PHI), fill out forms, or submit them on your behalf.