DAYVIGO (Lemborexant) for Insomnia

DAYVIGO (lemborexant) is indicated for the treatment of insomnia, characterized by difficulties with sleep onset and/or sleep maintenance.

Lemborexant is a competitive antagonist of both orexin receptors, OX1R and OX2R, with a higher affinity for OX2R. It belongs to the pharmacologic class of orexin receptor antagonists. The orexin neuropeptide signaling system is a central promoter of wakefulness. Blocking the binding of wake-promoting neuropeptides orexin A and orexin B to receptors OX1R and OX2R is thought to suppress wake drive.

Contraindications

Patients who are hypersensitive to this drug or to any ingredient in the formulation.
Patients with narcolepsy.

Recommended Dose and Dosage Adjustment

Use the lowest effective dose for the patient.
The recommended dose of DAYVIGO is 5 mg, taken no more than once per night and within a few minutes before going to bed, with at least 7 hours remaining before the planned time of awakening. The dose may be increased to the maximum recommended dose of 10 mg based on clinical response and tolerability.
Time to sleep onset may be delayed if taken with or soon after a meal.
Patients should be advised not to consume alcohol in combination with DAYVIGO.
No dosage adjustment is required in renal impairment.

Adverse reactions

Common: Somnolence, nausea, headache and nightmares.
Others may include: sleep paralysis, complex sleep behavioirs, hallucinations and suicidal ideation.

NOTES:

No adequate studies are available to support its safe use during pregnancy and breast feeding.
Lemborexant is metabolized mainly by CYP3A4; therefore, drug inducers or inhibitors of this pathway may either reduce or increase its levels in the body.

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Resource Person: Lobna Adi