Belsomra (suvorexant)

• Belsomra belongs to a class of drugs called sedatives or hypnotics. It is used for treating insomnia. Belsomra has a unique mechanism of action different from other sleep medications, for example, from benzodiazepine type of sleep medicines like diazepam (Valium).
• Belsomra causes sleep by blocking receptors in the brain called orexin receptors. Orexin A and B are brain chemicals that cause people to stay awake by binding to orexin receptors. Belsomra prevents orexin A and orexin B from causing wakefulness by blocking their attachment to orexin receptors. Reduced wakefulness means more sleep or increased ability to fall asleep. Suvorexant is a Schedule IV controlled substance similar to benzodiazepines because it has a low potential for abuse.
• The FDA approved Belsomra in April 2014.

What brand names are available for suvorexant?

Belsomra

Is suvorexant available as a generic drug?

No

Do I need a prescription for suvorexant belsomra?

Yes

: Belsomra is used to treat insomnia that is caused by the delay in onset of sleep or maintaining sleep.

: Common side effects include:

• Somnolence
• Headache
• Dizziness

Other side effects include:

• Abnormal dreams
• Cough
• Diarrhea
• Dry mouth
• Upper respiratory tract infections

Other less common side effects include:

• Diarrhea
• Dry mouth
• Cough

Possible serious side effects include:

• Worsening of depression
• Suicidal thinking
• Abnormal thinking
• Behavioral changes
• Sleep paralysis
• Cataplexy (physical collapse while remaining conscious)
• Daytime impairment
• Sleep driving and other complex behaviors

:

The recommended dose is 10 mg within 30 minutes of going to bed, allow time for at least 7 hours of sleep, and it should only be taken once each night. The lowest effective dose should be used and the maximum dose is 20 mg once daily. The effect may be delayed if it is taken with or soon after a meal.

The recommended dose of suvorexant is 5 mg when it is combined with the following drugs because these drugs moderately block the breakdown of suvorexant in the liver:

• aprepitant (Emend),
• atazanavir (Reyataz),
• ciprofloxacin (Cipro),
• diltiazem (Cardizem),
• erythromycin,
• fluconazole (Diflucan),
• fosamprenavir (Lexiva),
• grapefruit juice,
• imatinib (Gleevec), and
• verapamil (Calan SR)

The dose of Belsomra may be increased to 10 mg if the 5 mg dose is not effective.

:

Combining Belsomra with alcohol increases the side effects of Belsomra.

The following drugs may increase blood levels of Belsomra significantly by blocking the breakdown of Belsomra in the liver:

• Ketoconazole,
• itraconazole (Sporanox),
• posaconazole (Noxafil),
• clarithromycin (Biaxin),
• nefazodone (Serzone),
• ritonavir (Norvir),
• saquinavir (Invirase),
• nelfinavir (Viracept),
• indinavir (crixivan),
• boceprevir (Victrelis),
• telithromycin (Ketek), and
• conivaptan (Vaprisol).

Belsomra should not be combined with these drugs and other drugs that significantly block its metabolism by liver enzymes.

The blood levels and effect of suvorexant may be reduced by rifampin, carbamazepine and phenytoin because these drugs increase the breakdown of suvorexant in the liver.

Belsomra may increase blood levels of digoxin (Lanoxin) by blocking the breakdown of digoxin.

:

• Belsomra has not been adequately studied in pregnant women. It should only be used by pregnant women if the potential benefit justifies the risk to the fetus.

What preparations of suvorexant are available?

PREPARATIONS: Tablets: 5, 10, 15, 20 mg

How should I keep suvorexant stored?

STORAGE:

• Belsomra should be stored at 15 C to 30 C (59 F to 86 F) and in the original package. It should be protected from light and moisture.