Solriamfetol - Indications, Dosage, Side Effects and Precautions

Solriamfetol is indicated to improve wakefulness in adult patients with excessive daytime sleepiness that is associated with narcolepsy or obstructive sleep apnea.

Solriamfetol is indicated to improve wakefulness in adult patients with excessive daytime sleepiness that is associated with narcolepsy or obstructive sleep apnea (OSA).
Narcolepsy is a chronic sleep disorder that causes excessive daytime sleepiness.
Obstructive sleep apnea (OSA) is a potentially serious sleep disorder in which the airway is narrowed or closed, and breathing is momentarily stopped.  

In patients suffering from narcolepsy, initial dose is 75 mg once daily.
In patients suffering from obstructive sleep apnea (OSA) initial dose is 37.5 mg once daily.
Dose of Solriamfetol can be increased at intervals of at least 3 days.
Maximum dose of Solriamfetol is 150 mg once daily.
In patients with kidney impairment- Moderate impairment, initial dose is 37.5 mg once daily and it can be increased to 75 mg once daily after at least 7 days. Severe impairment, initial and maximum dose is 37.5 mg once daily. Do not give Solriamfetol in patients with end stage kidney disease. Available tablet strengths of Solriamfetol- 75 mg and 150 mg.

Solriamfetol should be administered in the morning after waking up with or without food.
Do not administer Solriamfetol 9 hours before bedtime as it can interfere with sleep. Solriamfetol 75 mg tablets are functionally scored tablets (have a dividing line in the center of the tablet) and hence can be split in half (37.5 mg dose).
Duration for which Solriamfetol will be taken is decided by the healthcare provider according to the disease condition.

In case a dose of Solriamfetol is missed, then take it within 9 hours of planned bedtime as it can interfere with sleep if taken too late in the day. Do not double the dose.

Side effects include-
Headache
Nausea
Trouble sleeping
Anxiety
Deceased appetite
High blood pressure

Solriamfetol can increase blood pressure and heart rate. Before initiating Solriamfetol, the healthcare provider should check the blood pressure and treat hypertension. Monitor blood pressure during treatment and treat new onset hypertension immediately.
Do not use Solriamfetol in patients with unstable heart disease, serious heart arrhythmias, or other serious heart problems.
Solriamfetol should be used cautiously in patients with a history of psychosis or bipolar disorders. If psychiatric symptoms develop during treatment with Solriamfetol, then the dose should be reduced or the drug should be discontinued depending on the severity.
Before taking Solriamfetol, inform your healthcare provider if you have had a stroke, high cholesterol, kidney problems or diabetes, history of mental health including psychosis and bipolar disorders, history of drug or alcohol abuse or addiction, are pregnant or planning to become pregnant, are breastfeeding.
The patient should inform the healthcare provider about all the medicines they take including, OTCs, vitamins, herbal supplements and prescription medicines.
Inform your healthcare provider if you have taken a medication called monoamine oxidase inhibitors like isocarboxazid, phenelzine, selegiline, tranylcypromine to treat depression.

Do not administer Solriamfetol with Monoamine oxidase inhibitors like isocarboxazid, phenelzine, selegiline, tranylcypromine, etc as it can increase the risk of hypertensive reaction.
Solriamfetol should be used cautiously with drugs that can increase blood pressure and/or heart rate like albuterol, amatidine, caffeine, terbutaline, etc.
Solriamfetol should be used cautiously with dopaminergic drugs like dopamine, pramipexole, rotigotine, ropinrole, etc.

Store Solriamfetol at room temperature between 68°F to 77°F (20°C to 25°C) in a safe place.