What is Suvorexant: Uses, Dosage, Side Effects and More

Suvorexant is a prescription sleep medication that helps people fall asleep and stay asleep by blocking certain brain chemicals that keep you awake. It belongs to a newer class of sleep aids called orexin receptor antagonists, which work differently than traditional sleeping pills by targeting the brain's natural wake-promoting system.

If you've been struggling with insomnia and your doctor has mentioned suvorexant, you might be wondering how it works and what to expect. This medication offers a unique approach to treating sleep problems, and understanding how it fits into your treatment plan can help you make informed decisions about your sleep health.

What is Suvorexant?

Suvorexant is a prescription medication specifically designed to treat insomnia in adults. It works by blocking orexin receptors in your brain, which are responsible for keeping you alert and awake during the day.

Think of orexin as your brain's natural "wake up" signal. When suvorexant blocks these signals, it allows your natural sleep processes to take over more easily. This makes it different from older sleep medications that work by enhancing sleepiness rather than reducing wakefulness.

The medication was approved by the FDA in 2014 and represents a newer approach to treating sleep disorders. It's classified as a controlled substance because it can cause dependence, but it's generally considered to have a lower risk of abuse compared to some other sleep medications.

What is Suvorexant Used For?

Suvorexant is primarily prescribed for adults who have trouble falling asleep or staying asleep throughout the night. Your doctor might recommend it if you experience difficulty with sleep onset, sleep maintenance, or both.

This medication is particularly helpful for people who lie awake at night with racing thoughts or feel wide awake when they should be winding down. It can also benefit those who fall asleep initially but wake up frequently during the night and struggle to get back to sleep.

Suvorexant is typically considered when other sleep hygiene measures haven't been effective, or when insomnia significantly impacts your daily functioning. Your doctor will evaluate whether this medication is appropriate based on your specific sleep patterns and overall health.

How Does Suvorexant Work?

Suvorexant works by blocking orexin receptors in your brain, which are part of your body's natural wake-promoting system. Orexin is a neurotransmitter that helps keep you alert and awake during the day.

When you take suvorexant, it essentially "turns down" these wake-promoting signals, allowing your brain's natural sleep mechanisms to function more effectively. This is different from medications that force drowsiness by enhancing sleep-promoting chemicals.

The medication is considered moderately strong among sleep aids. It's more targeted than older sleep medications but still requires careful monitoring and proper use. Most people find it effective for both falling asleep and staying asleep, though individual responses can vary.

How Should I Take Suvorexant?

Take suvorexant exactly as prescribed by your doctor, typically once per night within 30 minutes of bedtime. You should only take it when you can dedicate at least 7 hours to sleep, as the medication can cause drowsiness that lasts into the next day.

You can take suvorexant with or without food, but taking it with a large or high-fat meal may delay how quickly it works. If you choose to eat before taking it, opt for a light snack rather than a heavy meal.

Always take the medication with a full glass of water. Avoid alcohol completely when taking suvorexant, as the combination can be dangerous and increase the risk of serious side effects like difficulty breathing or extreme drowsiness.

Make sure your sleeping environment is ready before taking the medication. This means having your bedroom dark, quiet, and at a comfortable temperature, as suvorexant works best when combined with good sleep hygiene practices.

How Long Should I Take Suvorexant For?

Suvorexant is typically prescribed for short-term use, usually a few weeks to a few months. Your doctor will determine the appropriate duration based on your specific situation and response to treatment.

Most doctors prefer to start with the shortest effective treatment period and then reassess your sleep patterns. Some people may benefit from longer-term use, but this requires careful monitoring and regular check-ins with your healthcare provider.

It's important not to stop taking suvorexant suddenly without consulting your doctor, especially if you've been taking it for several weeks. Your doctor may recommend gradually reducing the dose to prevent potential withdrawal symptoms or rebound insomnia.

During your treatment, your doctor will likely schedule follow-up appointments to evaluate how well the medication is working and whether any adjustments are needed. Be prepared to discuss your sleep quality, any side effects, and how the medication affects your daily activities.

What Are the Side Effects of Suvorexant?

Like all medications, suvorexant can cause side effects, though not everyone experiences them. The most common side effects are generally mild and tend to improve as your body adjusts to the medication.

Here are the most frequently reported side effects that you might experience:

• Drowsiness or grogginess the next day
• Headache
• Dizziness
• Abnormal dreams or nightmares
• Dry mouth
• Cough
• Upper respiratory tract infection

These common side effects usually become less noticeable as your body adapts to the medication. If they persist or become bothersome, talk to your doctor about possible adjustments.

More serious side effects are less common but require immediate medical attention. These rare but important side effects include:

• Complex sleep behaviors (sleep-walking, sleep-driving, or sleep-eating)
• Temporary leg weakness or muscle paralysis
• Hallucinations or confusion
• Suicidal thoughts or mood changes
• Severe allergic reactions
• Difficulty breathing or swallowing

If you experience any of these serious side effects, stop taking suvorexant and contact your doctor immediately or seek emergency medical care. These reactions, while rare, can be dangerous and need prompt medical evaluation.

Who Should Not Take Suvorexant?

Suvorexant isn't suitable for everyone, and certain medical conditions or situations make it unsafe to use. Your doctor will carefully review your medical history before prescribing this medication.

You should not take suvorexant if you have narcolepsy, a condition that causes excessive daytime sleepiness and sudden sleep attacks. The medication can worsen symptoms of narcolepsy and potentially be dangerous for people with this condition.

People with severe liver disease should avoid suvorexant because their bodies cannot process the medication properly, leading to potentially dangerous levels in the bloodstream. Your doctor may need to check your liver function before prescribing this medication.

Additionally, certain groups need special consideration or may need to avoid suvorexant entirely:

• Pregnant or breastfeeding women
• People with a history of depression or suicidal thoughts
• Those with sleep apnea or other breathing disorders
• People taking certain medications that interact with suvorexant
• Adults over 65 (may need lower doses)
• People with a history of substance abuse

Your doctor will weigh the benefits and risks based on your individual situation. Be honest about your medical history and any other medications you're taking to ensure suvorexant is safe for you.

Suvorexant Brand Names

Suvorexant is available under the brand name Belsomra in the United States. This is the primary brand name you'll encounter when your doctor prescribes this medication.

Belsomra is manufactured by Merck and comes in tablet form with different strength options. Your pharmacist will typically dispense the brand name version unless you specifically request a generic, though generic versions may not be widely available yet.

When discussing this medication with your healthcare team, they might refer to it by either name - suvorexant or Belsomra - so it's helpful to know they're the same medication. Always verify with your pharmacist if you have questions about what you're receiving.

Suvorexant Alternatives

If suvorexant doesn't work well for you or causes troublesome side effects, several alternative sleep medications are available. Your doctor can help you explore these options based on your specific needs.

Other prescription sleep aids include zolpidem (Ambien), eszopiclone (Lunesta), and zaleplon (Sonata). These medications work differently than suvorexant and may be better suited to your individual situation.

Non-medication alternatives are also worth considering, especially for long-term sleep management. These include cognitive behavioral therapy for insomnia (CBT-I), sleep hygiene improvements, relaxation techniques, and addressing underlying conditions that might be affecting your sleep.

Your doctor might also suggest trying melatonin or other over-the-counter sleep aids, though these should still be used under medical guidance. The best alternative depends on your specific sleep problems, medical history, and how you respond to different treatments.

Is Suvorexant Better Than Zolpidem?

Suvorexant and zolpidem (Ambien) work differently and each has distinct advantages depending on your specific sleep issues. Neither is universally "better" - the choice depends on your individual needs and how you respond to each medication.

Suvorexant may be preferable if you have trouble staying asleep throughout the night, as it's specifically designed to maintain sleep for a full night. It also tends to have fewer complex sleep behaviors compared to zolpidem, though both can cause next-day drowsiness.

Zolpidem might work better if your main problem is falling asleep initially, as it typically works faster than suvorexant. It's also been available longer and is generally less expensive, with generic versions widely available.

Your doctor will consider factors like your specific sleep patterns, other medications you take, your age, and any underlying health conditions when choosing between these options. Some people may need to try both to determine which works better for their situation.