Xywav Interactions: Alcohol, Medications, and Others

Before you start taking Xywav, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions. (To learn whether Xywav interacts with herbs or vitamins and supplements, see the “Are there other interactions with Xywav?” section below.)

If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.

The table below lists drugs that may interact with Xywav. Keep in mind that this table does not include all drugs that may interact with Xywav. For more information about some of these interactions, see the “Drug interactions explained” section below.

* To learn more about this interaction, see the “When should I avoid Xywav?” section below.

Note: Xywav has a boxed warning for the risk of CNS depression. This is the most serious warning from the Food and Drug Administration (FDA). To learn more, see the “Boxed warnings” section at the top of this article.

Certain health conditions or other factors could raise your risk of harm if you take Xywav. In such cases, your doctor may not prescribe Xywav for you. These are known as contraindications. The list below includes contraindications of Xywav.

If you take sedative hypnotics or consume alcohol: If you take sedative hypnotics or might consume alcohol while taking Xywav, your doctor likely won’t prescribe Xywav for you.

Examples of sedative hypnotics include:

• eszopiclone (Lunesta)
• zaleplon (Sonata)
• zolpidem (Ambien, Edluar)

Sedative hypnotics, alcohol, and Xywav are CNS depressants. This means they slow down the activity of your nerves, spinal cord, and brain. Doctors typically won’t prescribe Xywav with other medications that cause CNS depression.

In fact, Xywav has a boxed warning about the risk of CNS depression. This is the most serious warning from the FDA. To learn more, see the “Boxed warnings” section at the top of this article.

If you take sedative hypnotics or consume alcohol, talk with your doctor before taking Xywav. They can recommend other treatment options that may be safer for you.

If you have succinic semialdehyde dehydrogenase deficiency: If you have a rare genetic (inherited) condition called succinic semialdehyde dehydrogenase deficiency, your doctor likely won’t prescribe Xywav for you. This is because the condition could prevent your body from breaking down Xywav properly. This may cause the level of Xywav to build up in your system, which raises your risk of side effects from the drug.

If you have succinic semialdehyde dehydrogenase deficiency, talk with your doctor before taking Xywav. They can recommend other treatment options that may be safer for you.

If you’ve had an allergic reaction: If you’ve had an allergic reaction to Xywav or any of its ingredients, your doctor likely won’t prescribe Xywav for you. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better options for you.

Before you start taking Xywav, talk with your doctor if any of the factors above apply to you. Your doctor can determine whether Xywav is safe for you to take.

It’s not safe to drink alcohol during your Xywav treatment. Due to the risk of harm, your doctor is unlikely to prescribe the drug for you if you might drink alcohol while taking Xywav.

For details, see the “When should I avoid Xywav?” section above.

Learn more about certain drug interactions that can occur with Xywav.

Interaction with opioids

Xywav can interact with opioids, which are used to treat pain.

Examples of opioid medications include:

• fentanyl (Actiq, Fentora, others)
• hydrocodone (Hysingla ER)
• morphine (Mitigo, MS Contin, others)
• oxycodone (Oxycontin, Xtampza ER, others)
• tramadol (ConZip, Qdolo)

What could happen

Xywav and opioids can both cause CNS depression, so taking these drugs together can raise your risk of this side effect.

With CNS depression, the activity of your nerves, spinal cord, and brain is slowed. The CNS manages many body functions, including movement, awareness, and thinking.

CNS depression may lead to serious side effects or be fatal in severe cases. Examples of these side effects include respiratory depression (slow or shallow breathing) and loss of consciousness.

Keep in mind that Xywav has a boxed warning about the risk of CNS depression. This is the most serious warning from the FDA. To learn more, see the “Boxed warnings” section at the top of this article.

What you can do

Before starting Xywav, tell your doctor about any opioids you take. In most cases, they’ll avoid prescribing these medications together.

In some cases, such as after a procedure, you may need to take an opioid for short-term pain relief. In this case, your doctor may have you temporarily stop taking Xywav while you’re taking the opioid. Doing so will help reduce your risk of severe CNS depression.

If you have questions about taking Xywav with opioids, talk with your doctor or pharmacist.

Interaction with muscle relaxers

Xywav can interact with muscle relaxers, which are used to treat muscle spasms.

Examples of muscle relaxers include:

• carisoprodol (Soma)
• cyclobenzaprine (Amrix)
• metaxalone
• methocarbamol (Robaxin)
• tizanidine (Zanaflex)

What could happen

Both Xywav and muscle relaxers can cause CNS depression. Taking these medications together can further increase your risk of this side effect.

You can learn more about Xywav’s risk of CNS depression in the “Boxed warnings” section at the top of this article.

What you can do

Before you start Xywav treatment, tell your doctor about any muscle relaxers you take. They’ll typically avoid prescribing these medications together.

In some cases, such as after an injury, you may need to take a muscle relaxer. If so, your doctor may temporarily stop your Xywav treatment while you’re taking the muscle relaxer. This will help lower your risk of severe CNS depression.

If you have questions about taking Xywav with muscle relaxers, talk with your doctor or pharmacist.

Interaction with certain seizure drugs

Xywav can interact with certain seizure drugs. Examples include:

• carbamazepine (Carbatrol, Tegretol, others)
• divalproex (Depakote, Depakote ER)
• levetiracetam (Keppra, Spritam)

What could happen

Taking Xywav with certain seizure drugs can increase your risk of side effects from either medication.

Specifically, taking Xywav with divalproex (Depakote, Depakote ER) may cause your body to break down Xywav more slowly than it should. This can raise the level of Xywav in your body, increasing your risk of side effects from the drug.

Other seizure drugs may raise your risk of CNS depression with Xywav. This is because both Xywav and certain seizure drugs may cause this side effect when taken alone. So taking these medications together can raise your risk of this side effect.

You can learn more about Xywav’s risk of CNS depression in the “Boxed warnings” section at the top of this article.

What you can do

Before starting Xywav, tell your doctor about any seizure medications you take. They can tell you whether it’s safe to take these drugs together.

If you take Xywav with divalproex, your doctor may prescribe a lower Xywav dosage for you. This helps reduce your risk of side effects from Xywav. You should not take a higher dose of either medication than your doctor prescribes.

If you have questions about taking Xywav with certain seizure drugs, talk with your doctor or pharmacist.

Xywav may have other interactions. They could occur with supplements, foods, vaccines, or even lab tests. See below for details. Note that the information below does not include all other possible interactions with Xywav.

Does Xywav interact with supplements?

Before you start taking Xywav, talk with your doctor and pharmacist about any herbs or vitamins and supplements you take. Sharing this information with them may help you avoid possible interactions.

If you have questions about interactions that may affect you, talk with your doctor or pharmacist.

Xywav and herbs

There are currently no reports of Xywav interacting with herbs. But this doesn’t mean that interactions with herbs won’t be recognized in the future.

For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products while taking Xywav.

Xywav and vitamins

There are currently no reports of Xywav interacting with vitamins. But this doesn’t mean that vitamin interactions won’t be recognized in the future.

For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products while taking Xywav.

Does Xywav interact with food?

No specific foods have been reported to interact with Xywav.

However, it’s important to note that you should take Xywav at least 2 hours after eating. Taking Xywav with food could decrease the drug’s level in your body, making it less effective. To learn more about how to take Xywav, see this article.

Does Xywav interact with vaccines or lab tests?

There are currently no reports of Xywav interacting with vaccines or lab tests. If you have questions about receiving certain vaccines or having lab tests done during your Xywav treatment, talk with your doctor.

Does Xywav interact with cannabis or CBD?

Cannabis (commonly called marijuana) and cannabis products, such as cannabidiol (CBD), have been reported to interact with Xywav.

Xywav and cannabis products are central nervous system (CNS) depressants. This means they slow down the activity of your nerves, spinal cord, and brain. In rare cases, both drugs can cause serious side effects, including respiratory depression (slow or shallow breathing) and loss of consciousness. Combining Xywav and cannabis products raises this risk even further.

Xywav has a boxed warning about the risk of CNS depression. This is the most serious warning from the FDA. To learn more, see the “Boxed warnings” section at the top of this article.

Before you start treatment with Xywav, tell your doctor and pharmacist if you use cannabis. By sharing this information with them, you may help prevent possible interactions.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Certain medical conditions or other health factors may raise the risk of interactions with Xywav. Before taking Xywav, talk with your doctor about your health history. They’ll determine whether Xywav is right for you.

Health conditions or other factors that might interact with Xywav include:

Succinic semialdehyde dehydrogenase deficiency: If you have this rare genetic condition, your doctor likely won’t prescribe Xywav for you. This is because the condition could prevent your body from breaking down Xywav properly. This may cause the level of Xywav to build up in your system, which raises your risk of side effects from the drug.

Liver problems: Before taking Xywav, tell your doctor if you have a liver problem, such as liver failure. Your doctor may prescribe a lower Xywav dosage for you.

Breathing problems: Before starting Xywav treatment, tell your doctor if you have a breathing problem, such as sleep apnea. Xywav may cause respiratory depression. As a result, the drug may worsen any breathing problems you already have.

If you have breathing problems, your doctor can determine whether Xywav is a safe treatment option for you.

Mental health conditions: In rare cases, taking Xywav may lead to depression or suicidal thoughts and behaviors. This risk may be higher for people who’ve had suicidal thoughts or a mental health condition, such as depression or anxiety, before. Your doctor can determine whether Xywav is right for you.

Pregnancy: It’s not known whether Xywav is safe to take during pregnancy. If you’re pregnant or planning a pregnancy, talk with your doctor before taking Xywav.

Breastfeeding: It’s not known whether it’s safe to take Xywav while breastfeeding. The drug passes into breast milk, but it isn’t known whether the drug may cause side effects in a child who’s breastfed. If you’re breastfeeding or planning to do so, talk with your doctor about your options.

Allergic reaction: If you’ve had an allergic reaction to Xywav or any of its ingredients, your doctor will likely not prescribe Xywav. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better choices for you.

Taking certain steps can help you avoid interactions with Xywav. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:

• Whether you drink alcohol or use cannabis.
• Other medications you take, as well as any vitamins, supplements, and herbs. Your doctor or pharmacist can help you fill out a medication list.
• What to do if you start taking a new drug during your Xywav treatment.

It’s also important to understand Xywav’s label and other paperwork that may come with the drug. Colored stickers that describe interactions may be on the label. And the paperwork (sometimes called the patient package insert or medication guide) may have other details about interactions. (If you did not get paperwork with Xywav, ask your pharmacist to print a copy for you.)

If you have trouble reading or understanding this information, your doctor or pharmacist can help.

Taking Xywav exactly as prescribed can also help prevent interactions.

If you still have questions about Xywav and its possible interactions, talk with your doctor.

Questions you may want to ask your doctor include:

• Does my risk of interactions depend on my Xywav dosage?
• Should I tell you if I start or stop another medication while I’m taking Xywav?
• Do other drugs that treat my condition, such as Xyrem, have similar interactions to Xywav?

To learn more about Xywav, see these articles:

• All About Xywav
• Dosage Details for Xywav
• Xywav and Cost: What You Need to Know

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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.