Suvorexant is an orexin antagonist used for the treatment of insomnia (lack of sleep). Insomnia is when there is difficulty with the onset and sometimes also with the maintenance of sleep or when both occur.
Suvorexant tablets are used in treating insomnia patients who are having difficulty with sleep onset and/or sleep maintenance
Suvorexant should not be used in patients:
• with an allergy to suvorexant
• with narcolepsy
• who are pregnant and breastfeeding women
Suvorexant tablets are available in the doses of 5 mg, 10 mg, 15 mg, 20 mg to be taken by mouth at night time for treating Insomnia or sleeplessness.
The initial recommended dose is 10 mg taken once every night within 30 minutes of going to bed, with at least 7 hours remaining before the intended time of waking up.
If the 10 mg dose is tolerated well, but not effective, the dose can be raised, but it should not exceed 20 mg once daily.
The effect may be delayed if taken with or soon after food.
• Suvorexant may cause daytime somnolence (excess sleepiness).
• Risk of impaired alertness, motor coordination, impaired driving may be seen which increases with increase in the dose. So, patients are advised to take a low dose in case of next-day driving and other activities requiring full mental alertness.
• Nighttime sleep-driving and other abnormal behaviors, sleep paralysis, hallucinations may be seen with excess dose and with use of CNS depressants, alcohol along with suvorexant. Family members should monitor these effects and should inform the health care provider during their next visit.
• Worsening of depression or suicidal thoughts may occur. Evaluate the patient for any new behavioral changes and take to a nearby hospital immediately.
• Patients are reevaluated if insomnia persists after 7 to 10 days of treatment.
The most common side effect is somnolence (sleepiness)
Suvorexant is not recommended in patients with severe liver damage.
The patient should read the medication guide before taking this medicine.
Patients who are more sensitive to suvorexant taking lower doses should also be advised about the potential for driving impairment.
Patients are advised not to use suvorexant if they drank alcohol that evening or before bed.
Patients should not increase the dose of suvorexant on their own if they think that the medicine does not work.
Patients are advised to inform all of their prescription and nonprescription medicines, vitamins and herbal products to their doctor.
Suvorexant dose should be reduced to 5 mg when used along with anti-viral medicines like amprenavir, atazanavir, antibiotics like ciprofloxacin, erythromycin, antifungal medicines like fluconazole, and others like imatinib, verapamil.
The dose should be reduced if the patient is consuming grapefruit juice regularly.
The dose can be increased to 10mg if 5mg is not producing sufficient effect.
Suvorexant is not recommended if patients are taking antifungal medicines like ketoconazole, itraconazole, antibiotics like clarithromycin, antiviral drugs like ritonavir, saquinavir, nelfinavir, telaprevir.
Digoxin blood levels should be monitored when prescribed along with digoxin.
Suvorexant effect may be decreased when used along with rifampin, carbamazepine, and phenytoin.
Suvorexant tablets are stored at 20°C to 25°C
Tablets must be protected from light and moisture.
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