Suvorexant: Uses,Dosage,Side Effects

Suvorexant

Rx

Generic NameSuvorexant

Therapeutic ClassDual Orexin Receptor Antagonist (DORA)

Common Strength5 mg, 10 mg, 15 mg, 20 mg tablet

Max / 24h20 mg once daily at bedtime

PregnancyUse only if benefit outweighs risk

Indications ▼

Insomnia: Treatment of insomnia characterized by difficulty with sleep onset and/or sleep maintenance.

Improves total sleep time and reduces nighttime awakenings.

May be considered in patients who do not tolerate benzodiazepines or non-benzodiazepine hypnotics.

Mechanism & Pharmacokinetics ▼

Mechanism: Selectively antagonizes orexin OX1R and OX2R receptors, suppressing wake-promoting neuropeptides and facilitating sleep initiation and maintenance.

Pharmacokinetics: Rapid oral absorption; peak plasma concentration in ~2 hours. Highly protein bound (>99%). Metabolized mainly via CYP3A4. Half-life approximately 12 hours. Eliminated primarily via feces.

Dosage & Administration ▼

Patient Group	Dose	Frequency
Adults (Initial)	10 mg	Once nightly within 30 minutes before bedtime
Adults (Maximum)	20 mg	Once nightly

Note: Ensure at least 7 hours remain before planned awakening. Start lower dose in elderly or hepatic impairment. Avoid with strong CYP3A inhibitors.

Side Effects ▼

Somnolence, next-day drowsiness

Dizziness, headache

Abnormal dreams

Sleep paralysis or hallucinations (rare)

Complex sleep behaviors (sleep-driving, sleep-eating)

Contraindications ▼

Narcolepsy

Hypersensitivity to suvorexant

Severe hepatic impairment

Drug Interaction ▼

Strong CYP3A inhibitors (e.g., ketoconazole, clarithromycin) increase levels

CYP3A inducers (e.g., rifampicin, carbamazepine) reduce efficacy

Alcohol and CNS depressants increase sedation risk

May increase digoxin levels; monitor

Pregnancy & Lactation ▼

Limited human data; use only if clearly needed

Unknown if excreted in breast milk; caution advised

Clinical / Research Summary ▼

Clinical Role: Novel non-GABAergic hypnotic for chronic insomnia.

Advantage: Lower dependence risk compared to benzodiazepines.

Limitation: Next-day impairment possible at higher doses.

Monitoring: Daytime alertness, behavioral changes, mood symptoms.

Patient Counseling Points ▼

Take only when ready for sleep

Avoid alcohol

Do not drive if drowsy next day

Report unusual sleep behaviors immediately

Storage & Handling ▼

Store below 30°C

Protect from moisture

Keep out of reach of children

Brand Names (Bangladesh & Global) ▼

Bangladesh:

Somarant® 10 mg Suvo® 10 mg Suvorest® 10 mg Suvotol® 10 mg

Global:

Belsomra®

Medical Disclaimer: For educational purposes only. Not a substitute for professional medical advice.

Reference Hubs:

• Drug Class: Orexin Receptor Antagonist • Condition: Insomnia