Generic Name and Formulations:
Suvorexant 5mg, 10mg, 15mg, 20mg; tabs.
Merck & Co., Inc.
Treatment of insomnia characterized by difficulties with sleep onset and/or sleep maintenance.
Use lowest effective dose. Take within 30 mins of bedtime if able to get full night’s sleep (≥7hrs) before awakening. 10mg once per night; may increase if ineffective; max 20mg once daily. Concomitant moderate CYP3A inhibitors: 5mg once daily; max 10mg once daily. Effect may be delayed if taken with or soon after a meal.
Monitor for somnolence and CNS depression; discontinue or reduce dose if daytime somnolence develops. Risk of next-day impairment (including impaired driving). Monitor for worsening insomnia or abnormal thinking and behavioral changes. Consider discontinuing if any complex sleep behaviors develop. Depression. Monitor for suicidal ideation. Compromised respiratory function (eg, COPD, obstructive sleep apnea). Increased risk of exposure-related effects in obese women. Reevaluate if unresponsive after 7–10 days of treatment. Severe hepatic impairment: not recommended. Drug or alcohol abusers. Pregnancy (Cat.C). Nursing mothers.
Avoid alcohol. Potentiates CNS depression with other CNS depressants (eg, benzodiazepines, opioids, tricyclic antidepressants, alcohol); may need to adjust doses. Concomitant strong CYP3A inhibitors (eg, ketoconazole, itraconazole, posaconazole, clarithromycin, nefazodone, ritonavir, saquinavir, nelfinavir, indinavir, boceprevir, telaprevir, telithromycin, conivaptan): not recommended. Concomitant moderate CYP3A inhibitors (eg, amprenavir, aprepitant, atazanavir, ciprofloxacin, diltiazem, erythromycin, fluconazole, fosamprenavir, grapefruit juice, imatinib, verapamil); use reduced dose (see Adults). May be antagonized by strong CYP3A inducers (eg, rifampin, carbamazepine, phenytoin). Monitor digoxin.
Orexin receptor antagonist.
Somnolence, headache, dizziness; CNS depression, daytime impairment, complex sleep-related behaviors (eg, sleep-driving), sleep paralysis, hallucinations, cataplexy-like symptoms.
Join MIMS Learning now to manage all your CPD and notes in one place!
Already a MIMS Learning member?Sign In Now »
Fever in adults can have potentially serious causes, ranging from sepsis to malignancy. Dr Pipin Singh...
In this article Dr Pipin Singh advises on how to identify red flags in patients presenting with bone...
Dr Matthew West covers the red flags to look out for in pregnancy, including back pain, bleeding, headaches...
This article, updated in 2016 by Dr Anthony De Soyza, advises on causes, investigations and managing...
Dr Keith Barnard discusses the aetiology and symptoms of Brugada syndrome. Key learning points for GPs...
Dr Kirsty Le Doare and Dr Nuria Martinez-Alier describe the signs and symptoms of measles and outline...