netFormulary

North East and North Cumbria
ICS Formulary

4 Central nervous system

04-01-01 Sodium oxybate

Sodium Oxybate 500mg/1ml oral solution Xyrem^®

Formulary

Approved for the treatment of narcolepsy with cataplexy in children age 7 years and above only in accordance with NHS England clinical commissioning policy.
The Northern (NHS) Treatment Advisory Group recommends the use of sodium oxybate in adult patients who have received and benefited from treatment with sodium oxybate as commissioned by NHS England. i.e. continuing treatment for those >19 years old.
The Northern (NHS) Treatment Advisory Group also recommends sodium oxybate for use in adults who have not received it as a child as per the RMOC criteria, noting that may sometimes be used in combination with other agents.
The following criteria for use in adults who have not received sodium oxybate as child apply:

Patients presenting with narcolepsy with cataplexy according to International Classification of sleep disorders 3 (ICSD) criteria for Narcolepsy Type 1 AND
Patients ≥ 19 years old AND
Where patients have co-morbidities, which are also affecting sleep, these should be managed and adequately treated (for example moderate to severe obstructive sleep apnoea or restless legs syndrome) AND
Failure to respond to non-pharmacological treatments consisting of behavioural and environmental adaptations, for example planned naps AND
Inadequate response (within 3 months) to, or intolerable adverse effects from, or contra-indicated use of, more than one stimulant for narcolepsy, and more than one anticataplectic agent AND
Assessed as being able to benefit from sodium oxybate via a specialist sleep centre.

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