Identification

Name
Gamma Hydroxybutyric Acid
Accession Number
DB01440
Type
Small Molecule
Groups
Approved, Illicit, Investigational
Description

Gamma Hydroxybutyric Acid, commonly abbreviated GHB, is a therapeutic drug which is illegal in multiple countries. It is currently regulated in the US and sold by Jazz Pharmaceuticals under the name Xyrem. However, it is important to note that GHB is a designated Orphan drug (in 1985). Today Xyrem is a Schedule III drug; however GHB remains a Schedule I drug and the illicit use of Xyrem falls under penalties of Schedule I. GHB is a naturally occurring substance found in the central nervous system, wine, beef, small citrus fruits and almost all other living creatures in small amounts. It is used illegally under the street names Juice, Liquid Ecstasy or simply G, either as an intoxicant, or as a date rape drug. Xyrem is a central nervous system depressant that reduces excessive daytime sleepiness and cataplexy in patients with narcolepsy.

Structure
Thumb
Synonyms
  • 3-carboxypropoxy acid
  • 4-hydroxy-butyric acid
  • 4-hydroxybutanoate
  • 4-hydroxybutanoic acid
  • 4-Hydroxybutyric acid
  • gamma-Hydroxybutyrate
  • gamma-Hydroxybutyric acid
  • GHB
  • oxy-n-butyric acid
  • γ-Hydroxybutyric acid
Categories
UNII
30IW36W5B2
CAS number
591-81-1
Weight
Average: 103.0966
Monoisotopic: 103.03951909
Chemical Formula
C4H7O3
InChI Key
SJZRECIVHVDYJC-UHFFFAOYSA-M
InChI
InChI=1S/C4H8O3/c5-3-1-2-4(6)7/h5H,1-3H2,(H,6,7)/p-1
IUPAC Name
4-hydroxybutanoate
SMILES
OCCCC([O-])=O

Pharmacology

Indication

Used as a general anesthetic, to treat conditions such as insomnia, clinical depression, narcolepsy, and alcoholism, and to improve athletic performance.

Structured Indications
Not Available
Pharmacodynamics

GHB has at least two distinct binding sites in the central nervous system. GHB is an agonist at the newly-characterized GHB receptor, which is excitatory, and it is a weak agonist at the GABAB receptor, which is inhibitory. GHB is a naturally-occurring substance that acts in a similar fashion to some neurotransmitters in the mammalian brain. GHB is probably synthesized from GABA in GABAergic neurons, and released when the neurons fire.

Mechanism of action

GHB reaches much higher concentrations in the brain and activates GABAB receptors, which are primarily responsible for its sedative effects. GHB receptors are densely expressed in many areas of the brain, including the cortex and hippocampus, and these are the receptors that GHB displays the highest affinity for. There has been somewhat limited research into the GHB receptor; however, there is evidence that activation of the GHB receptor in some brain areas results in the release of glutamate, the principal excitatory neurotransmitter. Activation of both the GHB receptor and GABA(B) is responsible for the addictive profile of GHB. GHB's effect on dopamine release is biphasic,[19] low concentrations stimulate dopamine release via the GHB receptor.[20] Higher concentrations inhibit dopamine release via GABA(B) receptors as do other GABA(B) agonists such as baclofen and phenibut.[21] After an initial phase of inhibition, dopamine release is then increased via the GHB receptor. This explains the paradoxical mix of sedative and stimulatory properties of GHB, as well as the so-called "rebound" effect, experienced by individuals using GHB as a sleeping agent, wherein they awake suddenly after several hours of GHB-induced deep sleep. That is to say that, over time, the concentration of GHB in the system decreases below the threshold for significant GABAB receptor activation and activates predominantly the GHB receptor, leading to wakefulness.

TargetActionsOrganism
AGamma-hydroxybutyrate (GHB) receptor
agonist
Human
AGamma-aminobutyric acid receptor subunit beta-1
agonist
Human
Absorption
Not Available
Volume of distribution
  • 190 to 384 mL/kg
Protein binding
Not Available
Metabolism
Not Available
Route of elimination

Animal studies indicate that metabolism is the major elimination pathway for sodium oxybate, producing carbon dioxide and water via the tricarboxylic acid (Krebs) cycle and secondarily by beta-oxidation. Succinic acid enters the Krebs cycle where it is metabolized to carbon dioxide and water. Fecal and renal excretion is negligible. 5% renal elimination.

Half life

30 to 60 minutes

Clearance
  • apparent oral cl=9.1 mL/min/kg [healthy adults receiving a single oral dose of 25 mg/kg]
  • 4.5 mL/min/kg [cirrhotic patients without ascites receiving a single oral dose of 25 mg/kg]
  • 4.1 mL/min/kg [cirrhotic patients with ascites receiving a single oral dose of 25 mg/kg]
Toxicity

At higher doses, GHB may induce nausea, dizziness, drowsiness, agitation, visual disturbances, depressed breathing, amnesia, unconsciousness, and death.

Affected organisms
  • Humans and other mammals
Pathways
Not Available
Pharmacogenomic Effects/ADRs
Not Available

Interactions

Drug Interactions
DrugInteractionDrug group
7-NitroindazoleThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with 7-Nitroindazole.Experimental
AcepromazineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Acepromazine.Approved, Vet Approved
AceprometazineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Aceprometazine.Approved
AdipiplonThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Adipiplon.Investigational
AgomelatineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Agomelatine.Approved, Investigational
AlaproclateThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Alaproclate.Experimental
AlfaxaloneThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Alfaxalone.Vet Approved
AlfentanilThe risk or severity of adverse effects can be increased when Alfentanil is combined with Gamma Hydroxybutyric Acid.Approved, Illicit
AllopregnanoloneThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Allopregnanolone.Investigational
AlphacetylmethadolThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Alphacetylmethadol.Experimental, Illicit
AlphaprodineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Alphaprodine.Illicit
AlprazolamThe risk or severity of adverse effects can be increased when Alprazolam is combined with Gamma Hydroxybutyric Acid.Approved, Illicit, Investigational
AmisulprideThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Amisulpride.Approved, Investigational
AmitriptylineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Amitriptyline.Approved
AmobarbitalThe risk or severity of adverse effects can be increased when Amobarbital is combined with Gamma Hydroxybutyric Acid.Approved, Illicit
AmoxapineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Amoxapine.Approved
AmperozideThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Amperozide.Experimental
AripiprazoleThe risk or severity of adverse effects can be increased when Aripiprazole is combined with Gamma Hydroxybutyric Acid.Approved, Investigational
ArticaineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Articaine.Approved
AsenapineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Asenapine.Approved
AzaperoneThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Azaperone.Investigational, Vet Approved
AzelastineGamma Hydroxybutyric Acid may increase the central nervous system depressant (CNS depressant) activities of Azelastine.Approved
BaclofenThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Baclofen.Approved
BarbitalThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Barbital.Illicit
BenperidolThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Benperidol.Investigational
BenzocaineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Benzocaine.Approved
Benzyl alcoholThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Benzyl alcohol.Approved
BrexpiprazoleThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Brexpiprazole.Approved
BrimonidineBrimonidine may increase the central nervous system depressant (CNS depressant) activities of Gamma Hydroxybutyric Acid.Approved
BromazepamThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Bromazepam.Approved, Illicit
BromisovalThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Bromisoval.Experimental
BromperidolThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Bromperidol.Investigational
BrompheniramineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Brompheniramine.Approved
BrotizolamThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Brotizolam.Approved, Investigational, Withdrawn
BupivacaineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Bupivacaine.Approved, Investigational
BuprenorphineGamma Hydroxybutyric Acid may increase the central nervous system depressant (CNS depressant) activities of Buprenorphine.Approved, Illicit, Investigational, Vet Approved
BuspironeThe risk or severity of adverse effects can be increased when Buspirone is combined with Gamma Hydroxybutyric Acid.Approved, Investigational
ButabarbitalThe risk or severity of adverse effects can be increased when Butabarbital is combined with Gamma Hydroxybutyric Acid.Approved, Illicit
ButacaineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Butacaine.Vet Approved
ButalbitalThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Butalbital.Approved, Illicit
ButambenThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Butamben.Approved
ButethalThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Butethal.Approved, Illicit
ButorphanolThe risk or severity of adverse effects can be increased when Butorphanol is combined with Gamma Hydroxybutyric Acid.Approved, Illicit, Vet Approved
CanertinibThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Canertinib.Investigational
CarbamazepineThe risk or severity of adverse effects can be increased when Carbamazepine is combined with Gamma Hydroxybutyric Acid.Approved, Investigational
CarbinoxamineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Carbinoxamine.Approved
CarfentanilThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Carfentanil.Illicit, Investigational, Vet Approved
CarisoprodolThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Carisoprodol.Approved
CetirizineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Cetirizine.Approved
Chloral hydrateThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Chloral hydrate.Approved, Illicit, Vet Approved
ChlordiazepoxideThe risk or severity of adverse effects can be increased when Chlordiazepoxide is combined with Gamma Hydroxybutyric Acid.Approved, Illicit
ChlormezanoneThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Chlormezanone.Approved, Investigational, Withdrawn
ChloroprocaineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Chloroprocaine.Approved
ChlorphenamineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Chlorphenamine.Approved
ChlorpromazineThe risk or severity of adverse effects can be increased when Chlorpromazine is combined with Gamma Hydroxybutyric Acid.Approved, Vet Approved
ChlorprothixeneThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Chlorprothixene.Approved, Investigational, Withdrawn
ChlorzoxazoneThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Chlorzoxazone.Approved
CinchocaineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Cinchocaine.Approved, Vet Approved
CitalopramThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Citalopram.Approved
ClemastineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Clemastine.Approved
ClidiniumThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Clidinium.Approved
ClobazamThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Clobazam.Approved, Illicit
clomethiazoleThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with clomethiazole.Investigational
ClomipramineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Clomipramine.Approved, Vet Approved
ClonazepamThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Clonazepam.Approved, Illicit
ClonidineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Clonidine.Approved
ClopenthixolThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Clopenthixol.Experimental
ClorazepateThe risk or severity of adverse effects can be increased when Clorazepate is combined with Gamma Hydroxybutyric Acid.Approved, Illicit
ClothiapineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Clothiapine.Experimental
ClozapineThe risk or severity of adverse effects can be increased when Clozapine is combined with Gamma Hydroxybutyric Acid.Approved
CocaineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Cocaine.Approved, Illicit
CodeineThe risk or severity of adverse effects can be increased when Codeine is combined with Gamma Hydroxybutyric Acid.Approved, Illicit
CyclizineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Cyclizine.Approved
CyclobenzaprineThe risk or severity of adverse effects can be increased when Cyclobenzaprine is combined with Gamma Hydroxybutyric Acid.Approved
CyproheptadineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Cyproheptadine.Approved
DantroleneThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Dantrolene.Approved
DapiprazoleThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Dapiprazole.Approved
DapoxetineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Dapoxetine.Investigational
DeramciclaneThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Deramciclane.Investigational
DesfluraneThe risk or severity of adverse effects can be increased when Desflurane is combined with Gamma Hydroxybutyric Acid.Approved
DesipramineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Desipramine.Approved
DesloratadineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Desloratadine.Approved, Investigational
DesvenlafaxineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Desvenlafaxine.Approved
DetomidineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Detomidine.Vet Approved
DexbrompheniramineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Dexbrompheniramine.Approved
DexmedetomidineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Dexmedetomidine.Approved, Vet Approved
DextromoramideThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Dextromoramide.Experimental, Illicit
DextropropoxypheneThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Dextropropoxyphene.Approved, Illicit, Investigational, Withdrawn
DezocineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Dezocine.Approved, Investigational
DiazepamThe risk or severity of adverse effects can be increased when Diazepam is combined with Gamma Hydroxybutyric Acid.Approved, Illicit, Vet Approved
Diethyl etherThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Diethyl ether.Experimental
DifenoxinThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Difenoxin.Approved, Illicit
DihydrocodeineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Dihydrocodeine.Approved, Illicit
DihydroetorphineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Dihydroetorphine.Experimental, Illicit
DihydromorphineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Dihydromorphine.Experimental, Illicit
DimenhydrinateThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Dimenhydrinate.Approved
DiphenhydramineThe risk or severity of adverse effects can be increased when Diphenhydramine is combined with Gamma Hydroxybutyric Acid.Approved
DiphenoxylateThe risk or severity of adverse effects can be increased when Diphenoxylate is combined with Gamma Hydroxybutyric Acid.Approved, Illicit
DixyrazineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Dixyrazine.Experimental
DoramectinThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Doramectin.Vet Approved
DoxepinThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Doxepin.Approved
DoxylamineDoxylamine may increase the central nervous system depressant (CNS depressant) activities of Gamma Hydroxybutyric Acid.Approved, Vet Approved
DPDPEThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with DPDPE.Investigational
DronabinolDronabinol may increase the central nervous system depressant (CNS depressant) activities of Gamma Hydroxybutyric Acid.Approved, Illicit
DroperidolDroperidol may increase the central nervous system depressant (CNS depressant) activities of Gamma Hydroxybutyric Acid.Approved, Vet Approved
DrotebanolThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Drotebanol.Experimental, Illicit
DuloxetineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Duloxetine.Approved
DyclonineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Dyclonine.Approved
EcgonineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Ecgonine.Experimental, Illicit
EcopipamThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Ecopipam.Investigational
EfavirenzThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Efavirenz.Approved, Investigational
EltanoloneThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Eltanolone.Investigational
EnfluraneThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Enflurane.Approved, Investigational, Vet Approved
EntacaponeThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Entacapone.Approved, Investigational
EscitalopramThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Escitalopram.Approved, Investigational
EstazolamThe risk or severity of adverse effects can be increased when Estazolam is combined with Gamma Hydroxybutyric Acid.Approved, Illicit
EszopicloneThe risk or severity of adverse effects can be increased when Eszopiclone is combined with Gamma Hydroxybutyric Acid.Approved
EthanolGamma Hydroxybutyric Acid may increase the central nervous system depressant (CNS depressant) activities of Ethanol.Approved
EthchlorvynolThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Ethchlorvynol.Approved, Illicit, Withdrawn
EthosuximideThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Ethosuximide.Approved
EthotoinThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Ethotoin.Approved
Ethyl carbamateThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Ethyl carbamate.Withdrawn
Ethyl chlorideThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Ethyl chloride.Experimental, Investigational
Ethyl loflazepateThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Ethyl loflazepate.Approved, Illicit
EthylmorphineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Ethylmorphine.Approved, Illicit
EtidocaineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Etidocaine.Approved
EtifoxineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Etifoxine.Investigational, Withdrawn
EtizolamThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Etizolam.Approved
EtomidateThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Etomidate.Approved
EtoperidoneThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Etoperidone.Withdrawn
EtorphineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Etorphine.Illicit, Vet Approved
EzogabineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Ezogabine.Approved
FelbamateThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Felbamate.Approved
FencamfamineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Fencamfamine.Approved, Illicit, Withdrawn
FentanylThe risk or severity of adverse effects can be increased when Fentanyl is combined with Gamma Hydroxybutyric Acid.Approved, Illicit, Investigational, Vet Approved
FexofenadineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Fexofenadine.Approved
FlibanserinThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Flibanserin.Approved
FluanisoneThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Fluanisone.Experimental
FludiazepamThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Fludiazepam.Approved, Illicit
FlunarizineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Flunarizine.Approved
FlunitrazepamThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Flunitrazepam.Approved, Illicit
FluoxetineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Fluoxetine.Approved, Vet Approved
FlupentixolThe risk or severity of adverse effects can be increased when Flupentixol is combined with Gamma Hydroxybutyric Acid.Approved, Withdrawn
FluphenazineThe risk or severity of adverse effects can be increased when Fluphenazine is combined with Gamma Hydroxybutyric Acid.Approved
FlurazepamThe risk or severity of adverse effects can be increased when Flurazepam is combined with Gamma Hydroxybutyric Acid.Approved, Illicit
FluspirileneThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Fluspirilene.Approved, Investigational
Fluticasone propionateThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Fluticasone propionate.Approved
FluvoxamineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Fluvoxamine.Approved, Investigational
FosphenytoinThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Fosphenytoin.Approved
FospropofolThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Fospropofol.Approved, Illicit, Investigational
GabapentinThe risk or severity of adverse effects can be increased when Gabapentin is combined with Gamma Hydroxybutyric Acid.Approved, Investigational
Gabapentin EnacarbilThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Gabapentin Enacarbil.Approved
GepironeThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Gepirone.Investigational
GlutethimideThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Glutethimide.Approved, Illicit
GuanfacineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Guanfacine.Approved, Investigational
HalazepamThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Halazepam.Approved, Illicit, Withdrawn
HaloperidolThe risk or severity of adverse effects can be increased when Haloperidol is combined with Gamma Hydroxybutyric Acid.Approved
HalothaneThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Halothane.Approved, Vet Approved
HeroinThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Heroin.Approved, Illicit, Investigational
HexobarbitalThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Hexobarbital.Approved
HydrocodoneGamma Hydroxybutyric Acid may increase the central nervous system depressant (CNS depressant) activities of Hydrocodone.Approved, Illicit
HydromorphoneThe risk or severity of adverse effects can be increased when Hydromorphone is combined with Gamma Hydroxybutyric Acid.Approved, Illicit
HydroxyzineHydroxyzine may increase the central nervous system depressant (CNS depressant) activities of Gamma Hydroxybutyric Acid.Approved
IloperidoneThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Iloperidone.Approved
ImipramineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Imipramine.Approved
IndalpineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Indalpine.Investigational, Withdrawn
IndiplonThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Indiplon.Investigational
IsofluraneThe risk or severity of adverse effects can be increased when Isoflurane is combined with Gamma Hydroxybutyric Acid.Approved, Vet Approved
KetamineThe risk or severity of adverse effects can be increased when Ketamine is combined with Gamma Hydroxybutyric Acid.Approved, Vet Approved
KetazolamThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Ketazolam.Approved
KetobemidoneThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Ketobemidone.Approved, Investigational
LamotrigineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Lamotrigine.Approved, Investigational
LevetiracetamThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Levetiracetam.Approved, Investigational
LevobupivacaineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Levobupivacaine.Approved, Investigational
LevocabastineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Levocabastine.Approved
LevocetirizineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Levocetirizine.Approved
LevodopaThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Levodopa.Approved
Levomethadyl AcetateThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Levomethadyl Acetate.Approved, Investigational
LevomilnacipranThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Levomilnacipran.Approved
LevorphanolThe risk or severity of adverse effects can be increased when Levorphanol is combined with Gamma Hydroxybutyric Acid.Approved
LidocaineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Lidocaine.Approved, Vet Approved
LithiumThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Lithium.Approved
LofentanilThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Lofentanil.Illicit
LoprazolamThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Loprazolam.Experimental
LoratadineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Loratadine.Approved
LorazepamThe risk or severity of adverse effects can be increased when Lorazepam is combined with Gamma Hydroxybutyric Acid.Approved
LormetazepamThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Lormetazepam.Approved
LoxapineThe risk or severity of adverse effects can be increased when Loxapine is combined with Gamma Hydroxybutyric Acid.Approved
LurasidoneThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Lurasidone.Approved
Magnesium SulfateMagnesium Sulfate may increase the central nervous system depressant (CNS depressant) activities of Gamma Hydroxybutyric Acid.Approved, Vet Approved
MaprotilineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Maprotiline.Approved
MebicarThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Mebicar.Experimental
MeclizineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Meclizine.Approved
MedazepamThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Medazepam.Experimental
MedetomidineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Medetomidine.Vet Approved
MelatoninThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Melatonin.Approved, Nutraceutical, Vet Approved
MelperoneThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Melperone.Approved, Investigational
MepivacaineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Mepivacaine.Approved, Vet Approved
MeprobamateThe risk or severity of adverse effects can be increased when Meprobamate is combined with Gamma Hydroxybutyric Acid.Approved, Illicit
MeptazinolThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Meptazinol.Experimental
MesoridazineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Mesoridazine.Approved, Investigational
MetaxaloneThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Metaxalone.Approved
MethadoneThe risk or severity of adverse effects can be increased when Methadone is combined with Gamma Hydroxybutyric Acid.Approved
Methadyl AcetateThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Methadyl Acetate.Approved, Illicit
MethapyrileneThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Methapyrilene.Withdrawn
MethaqualoneThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Methaqualone.Illicit, Withdrawn
MethocarbamolThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Methocarbamol.Approved, Vet Approved
MethohexitalThe risk or severity of adverse effects can be increased when Methohexital is combined with Gamma Hydroxybutyric Acid.Approved
MethotrimeprazineGamma Hydroxybutyric Acid may increase the central nervous system depressant (CNS depressant) activities of Methotrimeprazine.Approved
MethoxyfluraneThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Methoxyflurane.Approved, Investigational, Vet Approved
MethsuximideThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Methsuximide.Approved
MethylecgonineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Methylecgonine.Experimental
MethylphenobarbitalThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Methylphenobarbital.Approved
MetyrosineGamma Hydroxybutyric Acid may increase the sedative activities of Metyrosine.Approved
MidazolamThe risk or severity of adverse effects can be increased when Midazolam is combined with Gamma Hydroxybutyric Acid.Approved, Illicit
MilnacipranThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Milnacipran.Approved
MinocyclineMinocycline may increase the central nervous system depressant (CNS depressant) activities of Gamma Hydroxybutyric Acid.Approved, Investigational
MirtazapineGamma Hydroxybutyric Acid may increase the central nervous system depressant (CNS depressant) activities of Mirtazapine.Approved
MolindoneThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Molindone.Approved
MorphineThe risk or severity of adverse effects can be increased when Morphine is combined with Gamma Hydroxybutyric Acid.Approved, Investigational
NabiloneNabilone may increase the central nervous system depressant (CNS depressant) activities of Gamma Hydroxybutyric Acid.Approved, Investigational
NalbuphineThe risk or severity of adverse effects can be increased when Nalbuphine is combined with Gamma Hydroxybutyric Acid.Approved
NefazodoneThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Nefazodone.Approved, Withdrawn
NitrazepamThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Nitrazepam.Approved
Nitrous oxideThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Nitrous oxide.Approved, Vet Approved
NorfluraneThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Norflurane.Investigational
NormethadoneThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Normethadone.Approved, Illicit
NortriptylineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Nortriptyline.Approved
OlanzapineThe risk or severity of adverse effects can be increased when Olanzapine is combined with Gamma Hydroxybutyric Acid.Approved, Investigational
OlopatadineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Olopatadine.Approved
OndansetronThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Ondansetron.Approved
OpiumThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Opium.Approved, Illicit
OrphenadrineGamma Hydroxybutyric Acid may increase the central nervous system depressant (CNS depressant) activities of Orphenadrine.Approved
OsanetantThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Osanetant.Investigational
OxazepamThe risk or severity of adverse effects can be increased when Oxazepam is combined with Gamma Hydroxybutyric Acid.Approved
OxethazaineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Oxethazaine.Approved, Investigational
OxprenololThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Oxprenolol.Approved
OxybuprocaineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Oxybuprocaine.Approved
OxycodoneThe risk or severity of adverse effects can be increased when Oxycodone is combined with Gamma Hydroxybutyric Acid.Approved, Illicit, Investigational
OxymorphoneThe risk or severity of adverse effects can be increased when Oxymorphone is combined with Gamma Hydroxybutyric Acid.Approved, Investigational, Vet Approved
PaliperidoneThe risk or severity of adverse effects can be increased when Paliperidone is combined with Gamma Hydroxybutyric Acid.Approved
ParaldehydeGamma Hydroxybutyric Acid may increase the central nervous system depressant (CNS depressant) activities of Paraldehyde.Approved, Investigational
ParoxetineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Paroxetine.Approved, Investigational
PenfluridolThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Penfluridol.Experimental
PentazocineThe risk or severity of adverse effects can be increased when Pentazocine is combined with Gamma Hydroxybutyric Acid.Approved, Vet Approved
PentobarbitalThe risk or severity of adverse effects can be increased when Pentobarbital is combined with Gamma Hydroxybutyric Acid.Approved, Vet Approved
PerampanelPerampanel may increase the central nervous system depressant (CNS depressant) activities of Gamma Hydroxybutyric Acid.Approved
PerazineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Perazine.Investigational
PerospironeThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Perospirone.Approved
PerphenazineThe risk or severity of adverse effects can be increased when Perphenazine is combined with Gamma Hydroxybutyric Acid.Approved
PethidineThe risk or severity of adverse effects can be increased when Pethidine is combined with Gamma Hydroxybutyric Acid.Approved
PhenazocineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Phenazocine.Experimental
PhenibutThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Phenibut.Experimental
PhenobarbitalThe risk or severity of adverse effects can be increased when Phenobarbital is combined with Gamma Hydroxybutyric Acid.Approved
PhenoperidineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Phenoperidine.Experimental
PhenoxyethanolThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Phenoxyethanol.Approved
PhenytoinThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Phenytoin.Approved, Vet Approved
PimozideThe risk or severity of adverse effects can be increased when Pimozide is combined with Gamma Hydroxybutyric Acid.Approved
PipamperoneThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Pipamperone.Approved, Investigational
PipotiazineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Pipotiazine.Approved, Investigational
PiritramideThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Piritramide.Investigational
PizotifenThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Pizotifen.Approved
PomalidomideThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Pomalidomide.Approved
PramipexoleGamma Hydroxybutyric Acid may increase the sedative activities of Pramipexole.Approved, Investigational
PramocaineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Pramocaine.Approved
PrazepamThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Prazepam.Approved, Illicit
PregabalinThe risk or severity of adverse effects can be increased when Pregabalin is combined with Gamma Hydroxybutyric Acid.Approved, Illicit, Investigational
PrilocaineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Prilocaine.Approved
PrimidoneThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Primidone.Approved, Vet Approved
ProcaineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Procaine.Approved, Investigational, Vet Approved
ProchlorperazineThe risk or severity of adverse effects can be increased when Prochlorperazine is combined with Gamma Hydroxybutyric Acid.Approved, Vet Approved
PromazineThe risk or severity of adverse effects can be increased when Promazine is combined with Gamma Hydroxybutyric Acid.Approved, Vet Approved
PromethazineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Promethazine.Approved
PropanididThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Propanidid.Experimental
ProparacaineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Proparacaine.Approved, Vet Approved
PropofolThe risk or severity of adverse effects can be increased when Propofol is combined with Gamma Hydroxybutyric Acid.Approved, Investigational, Vet Approved
PropoxycaineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Propoxycaine.Approved
ProtriptylineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Protriptyline.Approved
ProxibarbalThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Proxibarbal.Experimental
PSD502The risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with PSD502.Investigational
QuazepamThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Quazepam.Approved, Illicit
QuetiapineThe risk or severity of adverse effects can be increased when Quetiapine is combined with Gamma Hydroxybutyric Acid.Approved
QuinisocaineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Quinisocaine.Experimental
RacloprideThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Raclopride.Investigational
RamelteonThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Ramelteon.Approved, Investigational
RemifentanilThe risk or severity of adverse effects can be increased when Remifentanil is combined with Gamma Hydroxybutyric Acid.Approved
RemoxiprideThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Remoxipride.Approved, Withdrawn
ReserpineThe risk or severity of adverse effects can be increased when Reserpine is combined with Gamma Hydroxybutyric Acid.Approved, Investigational
RisperidoneThe risk or severity of adverse effects can be increased when Risperidone is combined with Gamma Hydroxybutyric Acid.Approved, Investigational
RitanserinThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Ritanserin.Investigational
RomifidineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Romifidine.Vet Approved
RopiniroleGamma Hydroxybutyric Acid may increase the sedative activities of Ropinirole.Approved, Investigational
RopivacaineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Ropivacaine.Approved
RotigotineGamma Hydroxybutyric Acid may increase the sedative activities of Rotigotine.Approved
RufinamideThe risk or severity of adverse effects can be increased when Rufinamide is combined with Gamma Hydroxybutyric Acid.Approved
ScopolamineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Scopolamine.Approved
SecobarbitalThe risk or severity of adverse effects can be increased when Secobarbital is combined with Gamma Hydroxybutyric Acid.Approved, Vet Approved
SepranoloneThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Sepranolone.Investigational
SertindoleThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Sertindole.Approved, Investigational, Withdrawn
SertralineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Sertraline.Approved
SevofluraneThe risk or severity of adverse effects can be increased when Sevoflurane is combined with Gamma Hydroxybutyric Acid.Approved, Vet Approved
Sodium oxybateSodium oxybate may increase the central nervous system depressant (CNS depressant) activities of Gamma Hydroxybutyric Acid.Approved
StiripentolThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Stiripentol.Approved
SufentanilThe risk or severity of adverse effects can be increased when Sufentanil is combined with Gamma Hydroxybutyric Acid.Approved, Investigational
SulpirideThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Sulpiride.Approved, Investigational
SultoprideThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Sultopride.Experimental
SuvorexantGamma Hydroxybutyric Acid may increase the central nervous system depressant (CNS depressant) activities of Suvorexant.Approved
TandospironeThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Tandospirone.Investigational
TapentadolTapentadol may increase the central nervous system depressant (CNS depressant) activities of Gamma Hydroxybutyric Acid.Approved
TasimelteonThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Tasimelteon.Approved
TemazepamThe risk or severity of adverse effects can be increased when Temazepam is combined with Gamma Hydroxybutyric Acid.Approved
TetrabenazineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Tetrabenazine.Approved
TetracaineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Tetracaine.Approved, Vet Approved
TetrahydropalmatineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Tetrahydropalmatine.Investigational
TetrodotoxinThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Tetrodotoxin.Investigational
ThalidomideGamma Hydroxybutyric Acid may increase the central nervous system depressant (CNS depressant) activities of Thalidomide.Approved, Investigational, Withdrawn
ThiamylalThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Thiamylal.Approved, Vet Approved
ThiopentalThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Thiopental.Approved, Vet Approved
ThioridazineThe risk or severity of adverse effects can be increased when Thioridazine is combined with Gamma Hydroxybutyric Acid.Approved, Withdrawn
ThiothixeneThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Thiothixene.Approved
TiagabineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Tiagabine.Approved
TiaprideThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Tiapride.Approved, Investigational
TiletamineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Tiletamine.Vet Approved
TilidineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Tilidine.Experimental
TizanidineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Tizanidine.Approved
TolcaponeThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Tolcapone.Approved, Withdrawn
TopiramateThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Topiramate.Approved
TramadolThe risk or severity of adverse effects can be increased when Tramadol is combined with Gamma Hydroxybutyric Acid.Approved, Investigational
Trans-2-PhenylcyclopropylamineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Trans-2-Phenylcyclopropylamine.Experimental
TranylcypromineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Tranylcypromine.Approved
TrazodoneThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Trazodone.Approved, Investigational
TriazolamThe risk or severity of adverse effects can be increased when Triazolam is combined with Gamma Hydroxybutyric Acid.Approved
Tricaine methanesulfonateThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Tricaine methanesulfonate.Vet Approved
TrichloroethyleneThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Trichloroethylene.Experimental
TrifluoperazineThe risk or severity of adverse effects can be increased when Trifluoperazine is combined with Gamma Hydroxybutyric Acid.Approved
TrifluperidolThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Trifluperidol.Experimental
TriflupromazineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Triflupromazine.Approved, Vet Approved
TrimipramineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Trimipramine.Approved
TriprolidineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Triprolidine.Approved
Valproic AcidThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Valproic Acid.Approved, Investigational
VenlafaxineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Venlafaxine.Approved
VeraliprideThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Veralipride.Experimental
VigabatrinThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Vigabatrin.Approved
Vinyl etherThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Vinyl ether.Experimental
VortioxetineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Vortioxetine.Approved
XenonThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Xenon.Experimental
XylazineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Xylazine.Vet Approved
ZaleplonThe risk or severity of adverse effects can be increased when Zaleplon is combined with Gamma Hydroxybutyric Acid.Approved, Illicit, Investigational
ZiconotideThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Ziconotide.Approved
ZimelidineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Zimelidine.Withdrawn
ZiprasidoneThe risk or severity of adverse effects can be increased when Ziprasidone is combined with Gamma Hydroxybutyric Acid.Approved
ZolazepamThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Zolazepam.Vet Approved
ZolpidemGamma Hydroxybutyric Acid may increase the central nervous system depressant (CNS depressant) activities of Zolpidem.Approved
ZonisamideThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Zonisamide.Approved, Investigational
ZopicloneThe risk or severity of adverse effects can be increased when Zopiclone is combined with Gamma Hydroxybutyric Acid.Approved
ZotepineThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Zotepine.Approved, Investigational
ZuclopenthixolThe risk or severity of adverse effects can be increased when Gamma Hydroxybutyric Acid is combined with Zuclopenthixol.Approved, Investigational
Food Interactions
Not Available

References

Synthesis Reference

Joseph Klosa, "Production of nonhygroscopic salts of 4-hydroxybutyric acid." U.S. Patent US4393236, issued March, 1963.

US4393236
General References
Not Available
External Links
Human Metabolome Database
HMDB15507
KEGG Compound
C00989
PubChem Compound
3037032
PubChem Substance
46507548
ChemSpider
2300886
ChEBI
16724
Therapeutic Targets Database
DAP001522
PharmGKB
PA10819
Wikipedia
Gamma-Hydroxybutyric_acid

Clinical Trials

Clinical Trials
PhaseStatusPurposeConditionsCount
4CompletedTreatmentAlcohol Dependence / Alcohol Withdrawal Syndrome(AWS)1
4RecruitingBasic ScienceNarcolepsy With Cataplexy1

Pharmacoeconomics

Manufacturers
Not Available
Packagers
Dosage forms
Not Available
Prices
Unit descriptionCostUnit
Xyrem 500 mg/ml oral solution5.33USD ml
DrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only.
Patents
Patent NumberPediatric ExtensionApprovedExpires (estimated)
US7765106No2004-06-162024-06-16Us
US6780889No2000-07-042020-07-04Us
CA2355293No2005-08-162019-12-22Canada

Properties

State
Solid
Experimental Properties
Not Available
Predicted Properties
PropertyValueSource
Water Solubility711.0 mg/mLALOGPS
logP-0.6ALOGPS
logP-0.51ChemAxon
logS0.77ALOGPS
pKa (Strongest Acidic)4.44ChemAxon
pKa (Strongest Basic)-2.4ChemAxon
Physiological Charge-1ChemAxon
Hydrogen Acceptor Count3ChemAxon
Hydrogen Donor Count1ChemAxon
Polar Surface Area60.36 Å2ChemAxon
Rotatable Bond Count3ChemAxon
Refractivity34.64 m3·mol-1ChemAxon
Polarizability9.73 Å3ChemAxon
Number of Rings0ChemAxon
Bioavailability1ChemAxon
Rule of FiveYesChemAxon
Ghose FilterNoChemAxon
Veber's RuleNoChemAxon
MDDR-like RuleNoChemAxon
Predicted ADMET features
PropertyValueProbability
Human Intestinal Absorption+0.7851
Blood Brain Barrier+0.9171
Caco-2 permeable+0.5539
P-glycoprotein substrateNon-substrate0.8415
P-glycoprotein inhibitor INon-inhibitor0.981
P-glycoprotein inhibitor IINon-inhibitor0.9783
Renal organic cation transporterNon-inhibitor0.9223
CYP450 2C9 substrateNon-substrate0.8341
CYP450 2D6 substrateNon-substrate0.9043
CYP450 3A4 substrateNon-substrate0.7878
CYP450 1A2 substrateNon-inhibitor0.8141
CYP450 2C9 inhibitorNon-inhibitor0.9518
CYP450 2D6 inhibitorNon-inhibitor0.9541
CYP450 2C19 inhibitorNon-inhibitor0.9642
CYP450 3A4 inhibitorNon-inhibitor0.9721
CYP450 inhibitory promiscuityLow CYP Inhibitory Promiscuity0.9884
Ames testNon AMES toxic0.9331
CarcinogenicityNon-carcinogens0.7478
BiodegradationReady biodegradable0.9967
Rat acute toxicity1.7448 LD50, mol/kg Not applicable
hERG inhibition (predictor I)Weak inhibitor0.9579
hERG inhibition (predictor II)Non-inhibitor0.97
ADMET data is predicted using admetSAR, a free tool for evaluating chemical ADMET properties. (23092397)

Spectra

Mass Spec (NIST)
Download (8.17 KB)
Spectra
SpectrumSpectrum TypeSplash Key
Predicted MS/MS Spectrum - 10V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 20V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 40V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 10V, Negative (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 20V, Negative (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 40V, Negative (Annotated)Predicted LC-MS/MSNot Available

Taxonomy

Description
This compound belongs to the class of organic compounds known as hydroxy fatty acids. These are fatty acids in which the chain bears a hydroxyl group.
Kingdom
Organic compounds
Super Class
Lipids and lipid-like molecules
Class
Fatty Acyls
Sub Class
Fatty acids and conjugates
Direct Parent
Hydroxy fatty acids
Alternative Parents
Short-chain hydroxy acids and derivatives / Straight chain fatty acids / Monocarboxylic acids and derivatives / Carboxylic acids / Primary alcohols / Organic oxides / Hydrocarbon derivatives / Carbonyl compounds / Organic anions
Substituents
Short-chain hydroxy acid / Hydroxy fatty acid / Straight chain fatty acid / Monocarboxylic acid or derivatives / Carboxylic acid / Carboxylic acid derivative / Organic oxygen compound / Organic oxide / Hydrocarbon derivative / Primary alcohol
Molecular Framework
Aliphatic acyclic compounds
External Descriptors
hydroxy monocarboxylic acid anion (CHEBI:16724) / a small molecule (4-HYDROXY-BUTYRATE)

Targets

Kind
Protein
Organism
Human
Pharmacological action
Yes
Actions
Agonist
General Function
Virus receptor activity
Specific Function
Riboflavin transporter. Riboflavin transport is Na(+)-independent but moderately pH-sensitive. Activity is strongly inhibited by riboflavin analogs, such as lumiflavin. Weakly inhibited by flavin a...
Gene Name
SLC52A2
Uniprot ID
Q9HAB3
Uniprot Name
Solute carrier family 52, riboflavin transporter, member 2
Molecular Weight
45776.61 Da
References
  1. Castelli MP, Mocci I, Pistis M, Peis M, Berta D, Gelain A, Gessa GL, Cignarella G: Stereoselectivity of NCS-382 binding to gamma-hydroxybutyrate receptor in the rat brain. Eur J Pharmacol. 2002 Jun 20;446(1-3):1-5. [PubMed:12098579]
  2. Castelli MP, Ferraro L, Mocci I, Carta F, Carai MA, Antonelli T, Tanganelli S, Cignarella G, Gessa GL: Selective gamma-hydroxybutyric acid receptor ligands increase extracellular glutamate in the hippocampus, but fail to activate G protein and to produce the sedative/hypnotic effect of gamma-hydroxybutyric acid. J Neurochem. 2003 Nov;87(3):722-32. [PubMed:14535954]
Kind
Protein
Organism
Human
Pharmacological action
Yes
Actions
Agonist
General Function
Ligand-gated ion channel activity
Specific Function
Component of the heteropentameric receptor for GABA, the major inhibitory neurotransmitter in the vertebrate brain. Functions also as histamine receptor and mediates cellular responses to histamine...
Gene Name
GABRB1
Uniprot ID
P18505
Uniprot Name
Gamma-aminobutyric acid receptor subunit beta-1
Molecular Weight
54234.085 Da
References
  1. Maitre M, Humbert JP, Kemmel V, Aunis D, Andriamampandry C: [A mechanism for gamma-hydroxybutyrate (GHB) as a drug and a substance of abuse]. Med Sci (Paris). 2005 Mar;21(3):284-9. [PubMed:15745703]

Transporters

Kind
Protein
Organism
Human
Pharmacological action
Unknown
Actions
Inhibitor
General Function
Symporter activity
Specific Function
Proton-coupled monocarboxylate transporter. Catalyzes the rapid transport across the plasma membrane of many monocarboxylates such as lactate, pyruvate, branched-chain oxo acids derived from leucin...
Gene Name
SLC16A7
Uniprot ID
O60669
Uniprot Name
Monocarboxylate transporter 2
Molecular Weight
52199.745 Da
References
  1. Lin RY, Vera JC, Chaganti RS, Golde DW: Human monocarboxylate transporter 2 (MCT2) is a high affinity pyruvate transporter. J Biol Chem. 1998 Oct 30;273(44):28959-65. [PubMed:9786900]
Kind
Protein
Organism
Human
Pharmacological action
Unknown
Actions
Inhibitor
General Function
Symporter activity
Specific Function
Proton-coupled monocarboxylate transporter. Catalyzes the rapid transport across the plasma membrane of many monocarboxylates such as lactate, pyruvate, branched-chain oxo acids derived from leucin...
Gene Name
SLC16A1
Uniprot ID
P53985
Uniprot Name
Monocarboxylate transporter 1
Molecular Weight
53943.685 Da
References
  1. Lin RY, Vera JC, Chaganti RS, Golde DW: Human monocarboxylate transporter 2 (MCT2) is a high affinity pyruvate transporter. J Biol Chem. 1998 Oct 30;273(44):28959-65. [PubMed:9786900]
Kind
Protein
Organism
Human
Pharmacological action
Unknown
Actions
Substrate
General Function
Symporter activity
Specific Function
Proton-linked monocarboxylate transporter. Catalyzes the rapid transport across the plasma membrane of many monocarboxylates such as lactate, pyruvate, branched-chain oxo acids derived from leucine...
Gene Name
SLC16A3
Uniprot ID
O15427
Uniprot Name
Monocarboxylate transporter 4
Molecular Weight
49468.9 Da
References
  1. Manning Fox JE, Meredith D, Halestrap AP: Characterisation of human monocarboxylate transporter 4 substantiates its role in lactic acid efflux from skeletal muscle. J Physiol. 2000 Dec 1;529 Pt 2:285-93. [PubMed:11101640]

Drug created on July 31, 2007 07:09 / Updated on November 09, 2017 03:00