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Sodium oxybate + calcium oxybate + potassium oxybate + magnesium oxybate is an oral mixed-oxybate-salts **small molecule** central nervous system depressant marketed as **Xywav**. The active moiety is oxybate, also known as gamma-hydroxybutyrate, a metabolite of GABA whose therapeutic effects are thought to be mediated primarily through **GABA-B receptor** activity with downstream effects on noradrenergic, dopaminergic, and thalamocortical neurons involved in sleep-wake regulation. The product was developed by Jazz Pharmaceuticals as a lower-sodium oxybate formulation containing about 92% less sodium than sodium oxybate alone, and is approved for cataplexy or excessive daytime sleepiness in patients 7 years of age and older with narcolepsy and for idiopathic hypersomnia in adults. It is supplied as an oral solution and distributed in the United States through the Xywav and Xyrem REMS Program.
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