XYWAV (calcium oxybate)
XYWAV is indicated for the treatment of Cataplexy; Excessive Daytime Sleepiness; Narcolepsy; Idiopathic Hypersomnia.
How XYWAV Works
XYWAV is a mixture of calcium, magnesium, potassium, and sodium oxybates (gamma-hydroxybutyrate). While the exact mechanism of action is unknown, gamma-hydroxybutyrate (GHB) is an endogenous metabolite of the neurotransmitter GABA. It is hypothesized that the therapeutic effects of XYWAV are mediated through GABA$_B$ actions during sleep at noradrenergic, dopaminergic, and thalamocortical neurons.
Details
- Status
- Prescription
- First Approved
- 2020-07-21
- Patent Cliff
- 2041
- Revenue
- $465M (Q4-2025)
- Routes
- ORAL
- Dosage Forms
- SOLUTION
Companies
XYWAV Approval History
What XYWAV Treats
4 indicationsXYWAV is approved for 4 conditions since its original approval in 2020. These indications span multiple therapeutic areas including oncology, immunology, and more.
- Cataplexy
- Excessive Daytime Sleepiness
- Narcolepsy
- Idiopathic Hypersomnia
XYWAV Boxed Warning
CENTRAL NERVOUS SYSTEM DEPRESSION and ABUSE AND MISUSE. • Central Nervous System Depression XYWAV is a CNS depressant. Clinically significant respiratory depression and obtundation may occur in patients treated with XYWAV at recommended doses [see Warnings and Precautions ( 5.1 , 5.4 )]. Many patients who received XYWAV during clinical trials in narcolepsy and idiopathic hypersomnia were receiving central nervous system stimulants [see Clinical Studies ( 14.1 , 14.2 , 14.3 )]. • Abuse and Misuse...
WARNING: CENTRAL NERVOUS SYSTEM DEPRESSION and ABUSE AND MISUSE. • Central Nervous System Depression XYWAV is a CNS depressant. Clinically significant respiratory depression and obtundation may occur in patients treated with XYWAV at recommended doses [see Warnings and Precautions ( 5.1 , 5.4 )]. Many patients who received XYWAV during clinical trials in narcolepsy and idiopathic hypersomnia were receiving central nervous system stimulants [see Clinical Studies ( 14.1 , 14.2 , 14.3 )]. • Abuse and Misuse The active moiety of XYWAV is oxybate or gamma-hydroxybutyrate (GHB). Abuse or misuse of illicit GHB, either alone or in combination with other CNS depressants, is associated with CNS adverse reactions, including seizure, respiratory depression, decreases in the level of consciousness, coma, and death [see Warnings and Precautions ( 5.2 )]. Because of the risks of CNS depression and abuse and misuse, XYWAV is available only through a restricted program under a Risk Evaluation and Mitigation Strategy (REMS) called the XYWAV and XYREM REMS [see Warnings and Precautions ( 5.3 )]. WARNING: CENTRAL NERVOUS SYSTEM (CNS) DEPRESSION and ABUSE AND MISUSE. See full prescribing information for complete boxed warning. Central Nervous System Depression • XYWAV is a CNS depressant, and respiratory depression can occur with XYWAV use ( 5.1 , 5.4 ) Abuse and Misuse • The active moiety of XYWAV is oxybate or gamma-hydroxybutyrate (GHB). Abuse or misuse of illicit GHB is associated with CNS adverse reactions, including seizure, respiratory depression, decreased consciousness, coma, and death ( 5.2 , 9.2 ) XYWAV is available only through a restricted program called the XYWAV and XYREM REMS ( 5.3 )
XYWAV Competitive Set
ProThree rings of competition based on shared molecular targets and treated indications.
Direct competitors
Same target(s) AND same indication — head-to-head.
MoA expansion candidates
Same target(s), different indications — where else is this mechanism being explored?
Indication competitors
Same indication, different mechanism — what else might this patient receive?
Filters applied: drops same-active-ingredient (505(b)(2) reformulations), route-mismatch (topical vs systemic), and cross-therapeutic-area matches in same-indication rings.
Drugs Similar to XYWAV
3 of 20FDA-approved drugs for similar conditions. Compare mechanisms and indications to understand treatment alternatives.
Clinical Trial Registry
1 trials| Trial | Sponsor ID | Phase | Status | Title |
|---|---|---|---|---|
| NCT06421532 Clear-Brain | P23.100 | Ph 2 | enrolling by invitation | Stimulating Amyloid Clearance in Cerebral Amyloid Angiopathy |
Active Pipeline
Ongoing clinical trials by development phase
Key Completed Trials
Completed studies with published results, ranked by significance
Trial Timeline
Full development history with FDA approval milestones
Understanding FDA Approval Types
| Count | Type | What it means |
|---|---|---|
| - | ORIG | Original approval - drug first enters market |
| - | SUPPL - Efficacy | New indication (new disease/condition approved) |
| - | SUPPL - Labeling | Label text changes (warnings, dosing updates) |
| - | SUPPL - Manufacturing | Production changes (new facility) |
| - | SUPPL - Chemistry | Formulation changes (new dosage strength) |
Green lines in the timeline show ORIG and Efficacy approvals - the clinically meaningful milestones.
XYWAV FDA Label Details
Indications & Usage
FDA Label (PDF)XYWAV is indicated for the treatment of Cataplexy; Excessive Daytime Sleepiness; Narcolepsy; Idiopathic Hypersomnia.
WARNING: CENTRAL NERVOUS SYSTEM DEPRESSION and ABUSE AND MISUSE. • Central Nervous System Depression XYWAV is a CNS depressant. Clinically significant respiratory depression and obtundation may occur in patients treated with XYWAV at recommended doses [see Warnings and Precautions ( 5.1 , 5.4 )]. Ma...
XYWAV Patents & Exclusivity
Patents (22 active)
Exclusivity
Pro Intelligence Preview
Deep insights for XYWAV
Revenue Insights
- • Q4-2025: $465M
- • Historical trend analysis
Patent Timeline
- • Cliff: 2041
- • 25 active patents
Trial Analysis
- • Clinical trial tracking
- • Development stage analysis
Competitive Landscape
- • 20 similar drugs
- • Same target/indication analysis
Full approval history • All patents • Revenue trends • Competitor analysis
Data Sources
Data sourced from official FDA and NIH databases. Click links to verify on original sources.