Belsomra (suvorexant): Sleep Aid Warnings, Side Effects & Dosage

What is suvorexant (Belsomra)? What is suvorexant used for?

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?

Do I need a prescription for suvorexant belsomra?

Yes

What are the uses for suvorexant?

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

What are the side effects of suvorexant?

: 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:

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

What is the dosage for suvorexant?

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.

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Which drugs or supplements interact with suvorexant?

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.

Is suvorexant safe to take if I’m pregnant or breastfeeding?

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 else should I know about suvorexant?

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.