PEDIATRIC XYREM DOSING

How to prepare and administer your child's XYREM doses

Preparing and administering your child’s nightly XYREM doses

XYREM is a liquid that is taken at night divided into 2 doses: one at bedtime and another 2½ to 4 hours later. Both doses should be taken while your child is in bed.

Read the Instructions for Use in the Medication Guide for detailed instructions on how to take XYREM. Follow the steps shown below to prepare your child’s 2 nightly doses of XYREM.

In addition, help is always just a phone call away. You can always reach out to a Nurse Case Manager from the Certified Pharmacy, or your healthcare provider, if you have questions about how to give XYREM to your child.

XYREM offers flexible dosing that allows the doctor to find the dose that provides the desired effect and tolerability for each patient. Pediatric dosing is started and adjusted based on each patient's weight.




Setup

To prepare the dosage each night, you need:

  • 1 bottle of XYREM

    (the size and shape may vary, but the method of dispensing is always the same)

  • 2 empty pharmacy containers with child-resistant caps

  • 1 XYREM measuring syringe

  • 1 measuring cup able to measure ¼ cup of water (you will provide this item)

Before starting to prepare your child's doses, open each of the pharmacy containers and make sure both containers are empty and do not contain any medicine from the previous night's doses.
Before starting to prepare your child's doses, open each of the pharmacy containers and make sure both containers are empty and do not contain any medicine from the previous night's doses.

Preparing your child’s XYREM doses

Following these steps may help you establish a nightly XYREM routine. Be sure to read the Instructions for Use in the Medication Guide for detailed instructions on how to take XYREM.

Preparing Xyrem doses: measure dose

Measure each dose:

Hold the XYREM bottle down on the tabletop and firmly press the tip of the syringe into the opening on top of the XYREM bottle.

Now hold the bottle and syringe down with one hand and pull up on the plunger with the other hand to draw up your child's first nightly divided dose.*

For example, if your child has been prescribed a total nightly dosage of 3 grams divided into 2 doses of 1.5 grams, one for each pharmacy container.

See Instructions for Use in the Medication Guide.

*Note: Unequal dosages may be required for some patients to achieve optimal treatment.

Preparing Xyrem doses: empty dose

Empty each dose:

After you draw up each separate XYREM dose, remove the syringe from the opening of the XYREM bottle. Empty each dose into its own pharmacy container by pushing down on the plunger.

Empty each separate XYREM dose into 1 of the empty pharmacy containers by pushing down on the plunger.

See Instructions for Use in the Medication Guide.

Preparing Xyrem doses: add water

Add water & close lids:

HS change to: After emptying your child's first dose into its pharmacy container, use a measuring cup to pour about ¼ cup of water into the container. Then place the child-resistant cap onto the container and turn the cap to the right until it clicks and locks into its child-resistant position.

Repeat these steps when preparing the second dose

Be careful to add only water to each container and not more XYREM. All shipped bottles of XYREM contain the concentrated medicine. Water for mixing the medicine is not provided in the shipment.

See Instructions for Use in the Medication Guide.

Preparing Xyrem doses: close lids

Store Bottle:

Put the cap back on the XYREM bottle and store the bottle in a safe place out of the reach of children and pets. Rinse the syringe out with water and squirt the liquid down the drain.

See Instructions for Use in the Medication Guide.

Preparing Xyrem doses: store doses

Place nearby:

Before you give the first dose, put the second dose in a safe place, somewhere that is easy for you to reach. The doses should be out of the reach of children and pets. If for some reason you do not use a XYREM dose within 24 hours of mixing it with water, throw it away.

See Instructions for Use in the Medication Guide.

Preparing your child’s XYREM doses

Measure each dose:

Hold the XYREM bottle down on the tabletop and firmly press the tip of the syringe into the opening on top of the XYREM bottle.

Now hold the bottle and syringe down with one hand and pull up on the plunger with the other hand to draw up your child's first nightly divided dose.*

For example, if your child has been prescribed a total nightly dosage of 3 grams divided into 2 doses of 1.5 grams, you will need to draw up 2 separate doses of 1.5 grams each, one for each pharmacy container.

See Instructions for Use in the Medication Guide.

*Note: Unequal dosages may be required for some patients to achieve optimal treatment.

Preparing Xyrem doses: measure dose

Empty each dose:

After you draw up each separate XYREM dose, remove the syringe from the opening of the XYREM bottle. Empty each dose into its own pharmacy container by pushing down on the plunger.

See Instructions for Use in the Medication Guide.

Preparing Xyrem doses: empty dose

Add water & close lids:

After emptying your child's first dose into its pharmacy container, use a measuring cup to pour about ¼ cup of water into the container. Then place the child-resistant cap onto the container and turn the cap to the right until it clicks and locks into its child-resistant position.

Repeat these steps when preparing the second dose.

Be careful to add only water to each container and not more XYREM. All shipped bottles of XYREM contain the concentrated medicine. Water for mixing the medicine is not provided in the shipment.

See Instructions for Use in the Medication Guide.

Preparing Xyrem doses: add water

Store bottle:

Put the cap back on the XYREM bottle and store the bottle in a safe place out of the reach of children and pets. Rinse the syringe out with water and squirt the liquid down the drain.

See Instructions for Use in the Medication Guide.

Preparing Xyrem doses: close lids

Place nearby:

Before you give the first dose, put the second dose in a safe place, somewhere that is easy for you to reach. The doses should be out of the reach of children and pets. If for some reason you do not use a XYREM dose within 24 hours of mixing it with water, throw it away.

See Instructions for Use in the Medication Guide.

Preparing Xyrem doses: store doses

Giving the XYREM doses

If your child is prescribed XYREM, you should give the first dose once your child is in bed for the night and at least 2 hours after eating. Then 2½ to 4 hours later, or as directed by your child's healthcare provider, give the second dose while your child is still in bed. XYREM can cause sleep very quickly. Some people fall asleep within 5 minutes, and most people fall asleep within about 15 minutes. That is why your child needs to be in bed for each dose.