XYLO JZP258-406 -  NCT05869773 -  A Blood Pressure Study For People With Narcolepsy ELIGIBILITY PRE-SCREEN QUESTIONNAIRE

This checklist should be used only as a guide. For the complete list of inclusion and exclusion criteria, please refer to the ClinicalTrials.gov. Any questions, please call us at 726-444-5230.

Email *
LAST NAME *
FIRST NAME
DATE OF BIRTH
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YYYY
Are you between the ages of 18-70 years of age, inclusive? *

Have you been diagnosed with narcolepsy?

*

If you have been diagnosed with narcolepsy, are you currently taking 6-9 g of a high-sodium oxybate (like XYREM) nightly. 

*

If you are on a stable dose of high-sodium oxybate (like XYREM) for at least 6 consecutive weeks. 

*

On average what is your systolic blood pressure number (i.e. if your blood pressure is 120 over 80, the systolic number is 120 mm Hg)

*

On average what is your diastolic number (i.e. if your blood pressure is 120 over 80, the diastolic number is 80 mm Hg). 

*

lf you are taking antihypertensive (blood pressure) medication, have you been on a stable dose over the past month?

*

lf you are taking stimulants or other medications that affect blood pressure, have you been taking a stable dose for at least 2 months prior to study.

*

Do you have a history of or are currently experiencing an acutely unstable medical condition, behavioral or psychiatric disorder, or surgical history?

*

Have you had or do you have any significant cardiovascular disease including but not limited to:
Atrial fibrillation
Unstable angina pectoris
Congestive heart failure
Arrhythmias requiring automatic implantable cardioverter defibrillator or anti-arrhythmic therapy
Or within the past year have a:
Myocardial infarction
Revascularization procedure

*

Have you had a substance use disorder (Excluding caffeine. Nicotine use disorder only if it disrupts sleep)

*

Do you have a known diagnosis of:
Phenylketonuria, Hypersensitivity to phenylalanine-derived products, or Succinic semi-aldehyde dehydrogenase deficiency

*

Are you employed in an occupation that requires nighttime (starting work at night and working into morning) or variable shift work.

*
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