This article was first published on September 21, 2022.
Daridorexant (brand name Quviviq) is an orexin receptor antagonist approved by the FDA in 2022 for the treatment of insomnia.
On this page, we will provide basic information about this medication. Links to other articles on this website with more advanced information and tips related to this medication and related topics are provided below—under Related Pages below.
Daridorexant is indicated for the treatment of insomnia in adult patients who are having difficulties with sleep onset and/or maintenance.
Mechanism of action/ Pharmacodynamics
Orexin neuropeptide signaling pathway promotes wakefulness. Daridorexant acts as an antagonist on orexin receptors and suppresses wake drive by blocking the binding of wake-promoting neuropeptides orexin A and orexin B to receptors OX1R and OX2R.
The commonest side effects of daridorexant (occurring in 5% or more of patients and greater than the rate of placebo) were headache and somnolence or fatigue.
Daridorexant is contraindicated in patients with narcolepsy.
Warnings and Precautions
a. Daridorexant may depress central nervous system (CNS) and cause daytime impairment especially when used with other CNS depressant medications. Patients should be cautioned against next-day driving and other activities requiring mental alertness.
b. May worsen depression or suicidal ideation in some patients.
c. Patients may experience hypnagogic/hypnopompic hallucinations and cataplexy-like symptoms with daridorexant. Prescribers should explain and warn about these symptoms to the patients.
d. Complex sleep behaviors, including sleepwalking, sleep-driving, and engaging in other activities while not fully awake (e.g., preparing and eating food, making phone calls, having sex) may occur and patients usually do not remember these events. If complex sleep behaviors occur, daridorexant should be discontinued immediately.
e. While prescribing to patients with respiratory problems, its effect on respiratory function should be considered.
f. If insomnia persists after 7 to 10 days, other comorbid medical/psychiatric diagnoses should be considered.
Dosage and Administration
Recommended dosage is 25 mg to 50 mg once at night within 30 minutes of going to bed and at least 7 hours before waking up.
Do not take with or right after meal as the effect may be delayed.
Dosage forms and strengths
Tablets: 25 mg and 50 mg
Important! This page does not provide all the information needed to prescribe this medication. Please refer to the full Prescribing Information (see link below) before prescribing this medication.
Insomnia disorder—Sleep hygiene and Cognitive-behavior therapy
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