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.


  • 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.


  • 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

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