Suvorexant

DEA Class;  Rx

Common Brand Names; Belsomra

• Somnolence, females (8%)
• Somnolence (7%)
• Headache (7%)
• Somnolence, males (3%)
• Dizziness (3%)
• Abnormal dreams (2%)
• Cough (2%)
• Diarrhea (2%)
• Dry mouth (2%)
• Upper respiratory tract infection (2%)

Can impair daytime wakefulness; CNS depressant effects can last for up to several days after discontinuation

Can impair driving skills and may increase the risk of falling asleep while driving

Patients should not use suvorexant if they drank alcohol that evening or before bed; coadministration with other CNS depressants (eg, benzodiazepines, opioids, tricyclic antidepressants, alcohol) increases the risk of CNS depression

Dosage adjustments of suvorexant and concomitant CNS depressants may be necessary when administered together because of potentially additive effects

Use with other drugs to treat insomnia is not recommended

Risk of next-day impairment, including impaired driving, is increased if taken with less than a full night of sleep remaining, if a higher than the recommended dose is taken, if coadministered with other CNS depressants, or if coadministered with other drugs that increase suvorexant blood levels

Caution patients taking 20 mg to refrain from next-day driving and other activities requiring full mental alertness

Reevaluate patients for comorbid conditions if insomnia persists after 7-10 days of treatment

Available data from postmarketing reports in pregnant women are insufficient to establish a drug-associated risk of major birth defects, miscarriage or adverse maternal or fetal outcomes

There are no data on presence of drug in human milk, effects on breastfed infant or on milk production; drug and metabolite are present in rat milk; when drug is present in animal milk, it is likely that the drug will be present in human milk