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<p class="elementToProof" style="margin-top: 0px; margin-bottom: 0px;"><span style="font-family: Arial; font-size: 12pt; color: rgb(0, 0, 0);">Also, this is what I was referring to with the GHB dosing timing. The case I had was a person who accidentally took
the second dose very shortly after the first (she had messed up her alarm). The dosing is interesting - see package insert for more info. </span></p>
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<p class="elementToProof" style="margin-top: 0px; margin-bottom: 0px;"><span style="font-family: Arial; font-size: 12pt; color: rgb(0, 0, 0); font-weight: 700;">2.3 Important Administration Instructions for All Patients</span></p>
<p style="text-align: left; text-indent: 0px;"><span style="font-family: TimesNewRomanPSMT; font-size: 12pt; color: rgb(0, 0, 0);">The total nightly dosage of Xyrem is divided into two doses. Prepare both doses of Xyrem prior to bedtime. Prior to ingestion,
each dose of Xyrem should be diluted with approximately 1⁄4 cup (approximately 60 mL) of water in the empty pharmacy containers provided.</span></p>
<p style="text-align: left; text-indent: 0px;"><span style="font-family: TimesNewRomanPSMT; font-size: 12pt; color: rgb(0, 0, 0);">Take the first nightly dose of Xyrem at least 2 hours after eating
</span><span style="font-family: TimesNewRomanPS; font-size: 12pt; color: rgb(0, 0, 0);"><i>[see Clinical Pharmacology (12.3)].
</i></span><span style="font-family: TimesNewRomanPSMT; font-size: 12pt; color: rgb(0, 0, 0); background-color: rgb(255, 255, 0);">Take the second nightly dose 2.5 to 4 hours after the first dose.</span></p>
<p style="text-align: left; text-indent: 0px;"><span style="font-family: TimesNewRomanPSMT; font-size: 12pt; color: rgb(0, 0, 0); background-color: rgb(255, 255, 0);">Patients should take both doses of Xyrem while in bed and lie down immediately after dosing,
and remain in bed following ingestion of each dose. Xyrem may cause patients to fall asleep abruptly without first feeling drowsy
</span><span style="font-family: TimesNewRomanPS; font-size: 12pt; color: rgb(0, 0, 0); background-color: rgb(255, 255, 0);"><i>[see Adverse Reactions (6.2)]</i></span><span style="font-family: TimesNewRomanPSMT; font-size: 12pt; color: rgb(0, 0, 0); background-color: rgb(255, 255, 0);">.
Patients will often fall asleep within 5 minutes of taking Xyrem,</span><span style="font-family: TimesNewRomanPSMT; font-size: 12pt; color: rgb(0, 0, 0);"> and will usually fall asleep within 15 minutes, though the time it takes any individual patient to
fall asleep may vary from night to night. Patients may need to set an alarm to awaken for the second dose. Rarely, patients may take up to 2 hours to fall asleep.</span></p>
<p class="elementToProof" style="text-align: left; text-indent: 0px;"><span style="font-family: TimesNewRomanPSMT; font-size: 12pt; color: rgb(0, 0, 0);">If the second dose is missed, that dose should be skipped and Xyrem should not be taken again until the
next night. </span><span style="font-family: TimesNewRomanPSMT; font-size: 12pt; color: rgb(0, 0, 0); background-color: rgb(255, 255, 0);">Both Xyrem doses should never be taken at one time.</span></p>
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<p class="elementToProof" style="text-align: left; text-indent: 0px;"><span style="font-family: TimesNewRomanPS; font-size: 12pt; color: rgb(0, 0, 0); font-weight: 700;">WARNING: CENTRAL NERVOUS SYSTEM DEPRESSION and ABUSE AND MISUSE.</span></p>
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<p style="text-align: left; text-indent: 0px;"><span style="font-family: TimesNewRomanPS; font-size: 12pt; color: rgb(0, 0, 0); font-weight: 700;">Central Nervous System Depression<br>
</span><span style="font-family: TimesNewRomanPS; font-size: 12pt; color: rgb(0, 0, 0); background-color: rgb(255, 255, 0); font-weight: 700;">Xyrem (sodium oxybate) is a CNS depressant. In clinical trials at recommended doses, obtundation and clinically significant
respiratory depression occurred in adult patients treated with Xyrem </span><span style="font-family: TimesNewRomanPS; font-size: 12pt; color: rgb(0, 0, 0); font-weight: 700;"><i>[see Warnings and Precautions (5.1)]</i>. Many patients who received Xyrem during
clinical trials in narcolepsy were receiving central nervous system stimulants <i>
[see Clinical Trials (14)]</i>.</span></p>
</li></ul>
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