The Basics

What is Sodium Oxybate?

Used to treat two symptoms of narcolepsy: sudden muscle weakness and excessive daytime sleepiness.

Brand names for Sodium Oxybate

Xyrem

How Sodium Oxybate is classified

Anesthetics, Hypnotics and Sedatives, GABA Modulators

Sodium Oxybate During Pregnancy

Sodium Oxybate pregnancy category

Category CNote that the FDA has deprecated the use of pregnancy categories, so for some medications, this information isn’t available. We still think it’s useful to list historical info, however, given what a common proxy this has been in the past.

What we know about taking Sodium Oxybate while pregnant

N/A

Taking Sodium Oxybate While Breastfeeding

What are recommendations for lactation if you're taking Sodium Oxybate?

Sodium oxybate is the sodium salt of gamma-hydroxybutyric acid (GHB). GHB is an endogenous substance and low amounts are normally found in breastmilk. Large doses of GHB have been used as a substance of abuse. Infants have been successfully breastfed by mothers taking sodium oxybate therapeutically for narcolepsy. With the typical 2 doses per night treatment regimen, nursing should usually be withheld from the time of the first dose to 4 to 6 hours after the second dose and breastfeeding can be continued during the day.[1] No information is available on the use or safety of GHB as a drug of abuse during breastfeeding.

Maternal / infant drug levels

Sodium oxybate is the sodium salt of gamma-hydroxybutyric acid (GHB). GHB is an endogenous substance and low amounts are normally found in breastmilk. Large doses of GHB have been used as a substance of abuse. Infants have been successfully breastfed by mothers taking sodium oxybate therapeutically for narcolepsy. With the typical 2 doses per night treatment regimen, nursing should usually be withheld from the time of the first dose to 4 to 6 hours after the second dose and breastfeeding can be continued during the day.[1] No information is available on the use or safety of GHB as a drug of abuse during breastfeeding.

Possible effects of Sodium Oxybate on milk supply

Relevant published information was not found as of the revision date.

Possible alternatives to Sodium Oxybate

Amphetamine, Methylphenidate.

List of References

Lactation sources: Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/1. Swick TJ. Postnatal treatment of women with narcolepsy who choose to breastfeed-time for a reappraisal? Sleep Med. 2017;36:178-9. PMID: 28684017
2. Busardo FP, Bertol E, Mannocchi G et al. Determination of GHB levels in breast milk and correlation with blood concentrations. Forensic Sci Int. 2016;265:172-81. PMID: 26968013
3. Barker EC, Puchowicz M, Letterio J et al. GHB levels in breast milk of women with narcolepsy with cataplexy treated with sodium oxybate. Sleep Med. 2017;36:172-7. PMID: 28668666
4. Busardo FP, Pichini S. GHB concentration in breast milk of narcoleptic women treated with sodium oxybate. How important it is to be careful when interpreting values. Sleep Med. 2017;40:129. PMID: 28821387
5. Gashlin LZ, Sullo D, Lawrence RA et al. Treatment of narcolepsy with sodium oxybate while breastfeeding: A case report. Breastfeed Med. 2016;11:261-3. PMID: 27057786

Disclaimer: This material is provided for educational purposes only and is not intended for medical advice, diagnosis, or treatment. Consult your healthcare provider with any questions.

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