Generic
Suvorexant
4 brands available in the market
At a glance
Suvorexant is an orexin receptor antagonist used for the treatment of insomnia, particularly difficulty with sleep onset and/or sleep maintenance. It works by blocking the action of wake-promoting neuropeptides orexin.
Description
Suvorexant is a highly selective antagonist for orexin receptors OX1R and OX2R. The orexin neuropeptide signaling system is a central promoter of wakefulness. Blocking the binding of wake-promoting neuropeptides orexin A and B to OX1R and OX2R suppresses wake drive, promoting sleep onset and maintenance.
Indications
- Insomnia (difficulty with sleep onset and/or sleep maintenance)
Therapeutic class
Miscellaneous Sedatives & Hypnotics
Pharmacological class
Orexin Receptor Antagonist
Pharmacology
Suvorexant selectively antagonizes orexin receptors OX1R and OX2R. The orexin neuropeptide signaling system is a central promoter of wakefulness. Receptor blockade suppresses wake drive, making it easier to initiate and maintain sleep.
Mechanism of action
Suppresses wake drive by blocking orexin receptors to promote sleep.
Dosage
Adult Dose (Oral):
- Recommended: 10 mg once nightly (30 minutes before bedtime)
- At least 7 hours remaining before planned awakening
- If tolerated but not effective, dose may be increased to 20 mg
- Use the lowest effective dose
Administration
- Take 30 minutes before bedtime
- Time to effect may be delayed if taken with or soon after a meal
- Do not take more than once daily
Missed dose
If you miss a dose, take it the next night; do not double the dose.
Side effects
Common Side Effects:
- Daytime sleepiness
- Not thinking clearly
- Strange behavior, confusion, or upset
- Sleep-walking or complex behaviors
Precautions & warnings
- Risk of daytime somnolence (especially at 20 mg dose); avoid driving
- Re-evaluate if insomnia persists after 7-10 days of treatment
- Depression or suicidal thinking may worsen
- Risk increases with alcohol and CNS depressants
Contraindications
- Narcolepsy
Drug interactions
- Strong CYP3A inhibitors (ketoconazole, itraconazole): Significantly increase suvorexant exposure
- Moderate CYP3A inhibitors (diltiazem): Increase exposure
- Strong CYP3A inducers (rifampin): Substantially decrease exposure
- Alcohol: Additive effect on psychomotor performance
Food interactions
Caution is advised when consuming alcohol with Suvorexant (excessive drowsiness and psychomotor effects); consult your doctor.
Use in pregnancy
Use in Pregnancy: No adequate controlled studies; use only if clearly needed; consult your doctor.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Use in lactation
Use in Lactation: Unknown if excreted in human milk; caution required; consult your doctor.
Pediatric use
Safety and efficacy not established in pediatric patients
Geriatric use
Caution required in elderly patients
Renal / hepatic impairment
Renal Impairment: Caution needed; dose adjustment may be needed; consult your doctor.
Hepatic Impairment: Caution needed; dose adjustment may be needed; consult your doctor.
Overdose effects
No specific overdose information; provide symptomatic and supportive treatment.
Storage conditions
Store in a cool and dry place, protected from light; keep out of reach of children.
Chemical structure
Suvorexant