Lemborexant

Lemborexant Brand Name– DAYVIGO

What is Lemborexant

Lemborexant is an oral orexin receptor antagonist indicated for the treatment of insomnia characterized by difficulties with sleep onset and/or sleep maintenance in adults.

Lemborexant alters the signaling of neurotransmitters called orexins, which are responsible for regulating the sleep-wake cycle.

Similar to other hypnotics, lemborexant may cause worsening of depression or suicidality, primarily in patients with pre-existing depression. In addition, complex sleep-related behaviors such as sleep-walking, sleep talking, or engagement in other activities while not fully awake are also possible.

Patients should be informed of the potential for worsening depression, suicidality, or complex sleep-related behaviors prior to initiating treatment with lemborexant and be advised to seek medical attention immediately if any of these adverse effects occur during treatment with lemborexant.

Indications

  • insomnia

For the treatment of insomnia characterized by difficulties with sleep onset and/or sleep maintenance

Side Effects

  1. abnormal dreams
  2. complex sleep-related behaviors
  3. depression
  4. drowsiness
  5. fatigue
  6. hallucinations
  7. headache
  8. memory impairment
  9. nightmares
  10. psychological dependence
  11. sleep paralysis
  12. suicidal ideation
  13. weakness

Monitoring Parameters

  • laboratory monitoring not necessary

Contraindications

  • alcoholism
  • behavioral changes
  • breast-feeding
  • chronic obstructive pulmonary disease (COPD)
  • coadministration with other CNS depressants
  • complex sleep-related behaviors
  • depression
  • driving or operating machinery
  • ethanol ingestion
  • geriatric
  • hepatic disease
  • labor
  • narcolepsy
  • obstetric delivery
  • pregnancy
  • pulmonary disease
  • sleep apnea
  • sleep paralysis
  • substance abuse
  • suicidal ideation

Interactions

  • Acetaminophen; Butalbital
  • Acetaminophen; Butalbital; Caffeine
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
  • Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
  • Acetaminophen; Codeine
  • Acetaminophen; Dextromethorphan; Doxylamine
  • Acetaminophen; Diphenhydramine
  • Acetaminophen; Hydrocodone
  • Acetaminophen; Oxycodone
  • Acetaminophen; Pentazocine
  • Acetaminophen; Tramadol
  • Acrivastine; Pseudoephedrine
  • Alfentanil
  • Alprazolam
  • Amiodarone
  • Amitriptyline
  • Amitriptyline; Chlordiazepoxide
  • Amobarbital
  • Amoxapine
  • Amoxicillin; Clarithromycin; Lansoprazole
  • Amoxicillin; Clarithromycin; Omeprazole
  • Amprenavir
  • Anxiolytics; Sedatives; and Hypnotics
  • Apalutamide
  • Apomorphine
  • Aprepitant, Fosaprepitant
  • Aripiprazole
  • Asenapine
  • Aspirin, ASA; Butalbital; Caffeine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Caffeine; Orphenadrine
  • Aspirin, ASA; Carisoprodol
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Oxycodone
  • Atazanavir
  • Atazanavir; Cobicistat
  • Atropine
  • Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Atropine; Difenoxin
  • Atropine; Diphenoxylate
  • Atropine; Edrophonium
  • Atropine; Hyoscyamine; Phenobarbital; Scopolamine
  • atypical antipsychotic
  • Azelastine
  • Azelastine; Fluticasone
  • Baclofen
  • Belladonna Alkaloids; Ergotamine; Phenobarbital
  • Belladonna; Opium
  • Benzhydrocodone; Acetaminophen
  • Benzodiazepines
  • Bexarotene
  • Bicalutamide
  • Bosentan
  • Brexpiprazole
  • Brigatinib
  • Brompheniramine
  • Brompheniramine; Carbetapentane; Phenylephrine
  • Brompheniramine; Dextromethorphan; Guaifenesin
  • Brompheniramine; Dextromethorphan; Phenylephrine
  • Brompheniramine; Guaifenesin; Hydrocodone
  • Brompheniramine; Hydrocodone; Pseudoephedrine
  • Brompheniramine; Pseudoephedrine
  • Buprenorphine
  • Buprenorphine; Naloxone
  • Bupropion
  • Bupropion; Naltrexone
  • Butabarbital
  • Butorphanol
  • Cannabidiol
  • Capsaicin; Metaxalone
  • Carbamazepine
  • Carbetapentane; Chlorpheniramine
  • Carbetapentane; Chlorpheniramine; Phenylephrine
  • Carbetapentane; Diphenhydramine; Phenylephrine
  • Carbetapentane; Phenylephrine; Pyrilamine
  • Carbetapentane; Pyrilamine
  • Carbidopa; Levodopa
  • Carbidopa; Levodopa; Entacapone
  • Carbinoxamine
  • Carbinoxamine; Dextromethorphan; Pseudoephedrine
  • Carbinoxamine; Hydrocodone; Phenylephrine
  • Carbinoxamine; Hydrocodone; Pseudoephedrine
  • Carbinoxamine; Phenylephrine
  • Carbinoxamine; Pseudoephedrine
  • Cariprazine
  • Carisoprodol
  • Cenobamate
  • Ceritinib
  • Cetirizine
  • Cetirizine; Pseudoephedrine
  • Chlophedianol; Dexbrompheniramine
  • Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
  • Chloramphenicol
  • Chlorcyclizine
  • Chlordiazepoxide
  • Chlordiazepoxide; Clidinium
  • Chlorpheniramine
  • Chlorpheniramine; Codeine
  • Chlorpheniramine; Dextromethorphan
  • Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Phenylephrine
  • Chlorpheniramine; Pseudoephedrine
  • Chlorpromazine
  • Chlorthalidone; Clonidine
  • Chlorzoxazone
  • Cimetidine
  • Ciprofloxacin
  • Clarithromycin
  • Clemastine
  • Clobazam
  • Clofazimine
  • Clomipramine
  • Clonazepam
  • Clonidine
  • Clorazepate
  • Clozapine
  • Cobicistat
  • Cocaine
  • Codeine
  • Codeine; Guaifenesin
  • Codeine; Phenylephrine; Promethazine
  • Codeine; Promethazine
  • Conivaptan
  • Crizotinib
  • Cyclizine
  • Cyclobenzaprine
  • Cyclosporine
  • Cyproheptadine
  • Dabrafenib
  • Dalfopristin; Quinupristin
  • Danazol
  • Dantrolene
  • Darunavir
  • Darunavir; Cobicistat
  • Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
  • Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
  • Delavirdine
  • Desipramine
  • Deutetrabenazine
  • Dexamethasone
  • Dexchlorpheniramine
  • Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Dexmedetomidine
  • Dextromethorphan; Diphenhydramine; Phenylephrine
  • Dextromethorphan; Promethazine
  • Diazepam
  • Dihydrocodeine; Guaifenesin; Pseudoephedrine
  • Diltiazem
  • Dimenhydrinate
  • Diphenhydramine
  • Diphenhydramine; Hydrocodone; Phenylephrine
  • Diphenhydramine; Ibuprofen
  • Diphenhydramine; Naproxen
  • Diphenhydramine; Phenylephrine
  • Doxepin
  • Doxylamine
  • Doxylamine; Pyridoxine
  • Dronabinol
  • Dronedarone
  • Droperidol
  • Duvelisib
  • Efavirenz
  • Efavirenz; Emtricitabine; Tenofovir
  • Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
  • Elagolix
  • Elagolix; Estradiol; Norethindrone acetate
  • Elbasvir; Grazoprevir
  • Elexacaftor; tezacaftor; ivacaftor
  • Eluxadoline
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
  • Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
  • Enflurane
  • Entacapone
  • Enzalutamide
  • Erythromycin
  • Erythromycin; Sulfisoxazole
  • Eslicarbazepine
  • Estazolam
  • Ethanol
  • Etomidate
  • Etravirine
  • Everolimus
  • Fedratinib
  • Fenfluramine
  • Fentanyl
  • Flibanserin
  • Fluconazole
  • Fluoxetine
  • Fluoxetine; Olanzapine
  • Fluphenazine
  • Flurazepam
  • Fluvoxamine
  • Fosamprenavir
  • Fosphenytoin
  • Fospropofol
  • Fostamatinib
  • Gabapentin
  • General anesthetics
  • grapefruit juice
  • Guaifenesin; Hydrocodone
  • Guaifenesin; Hydrocodone; Pseudoephedrine
  • Guanfacine
  • Halothane
  • Homatropine; Hydrocodone
  • Hydrochlorothiazide, HCTZ; Methyldopa
  • Hydrocodone
  • Hydrocodone; Ibuprofen
  • Hydrocodone; Phenylephrine
  • Hydrocodone; Potassium Guaiacolsulfonate
  • Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
  • Hydrocodone; Pseudoephedrine
  • Hydromorphone
  • Hydroxyzine
  • Ibuprofen; Oxycodone
  • Idelalisib
  • Iloperidone
  • Imatinib
  • Imipramine
  • Indinavir
  • Isavuconazonium
  • Isocarboxazid
  • Isoflurane
  • Isoniazid, INH
  • Isoniazid, INH; Pyrazinamide, PZA; Rifampin
  • Isoniazid, INH; Rifampin
  • Istradefylline
  • Itraconazole
  • Ivacaftor
  • Ketamine
  • Ketoconazole
  • Lanreotide
  • Lapatinib
  • Larotrectinib
  • Lasmiditan
  • Lefamulin
  • Letermovir
  • Levocetirizine
  • Levodopa
  • Levorphanol
  • Lofexidine
  • Lopinavir; Ritonavir
  • Lorazepam
  • Lorlatinib
  • Lumacaftor; Ivacaftor
  • Lumacaftor; Ivacaftor
  • Lumateperone
  • Lurasidone
  • Maprotiline
  • Meclizine
  • Melatonin
  • Meperidine
  • Meperidine; Promethazine
  • Mesoridazine
  • Metaxalone
  • Methadone
  • Methocarbamol
  • Methohexital
  • Methyldopa
  • Metoclopramide
  • Midazolam
  • Mifepristone
  • Mirtazapine
  • Mitotane
  • Modafinil
  • Monoamine oxidase inhibitors
  • Morphine
  • Morphine; Naltrexone
  • Nabilone
  • Nafcillin
  • Nalbuphine
  • Nefazodone
  • Nelfinavir
  • Netupitant, Fosnetupitant; Palonosetron
  • Nevirapine
  • Nicardipine
  • Nilotinib
  • Nortriptyline
  • Octreotide
  • Olanzapine
  • Ombitasvir; Paritaprevir; Ritonavir
  • Omeprazole; Amoxicillin; Rifabutin
  • Opiate Agonists-Antagonists
  • Orphenadrine
  • Osilodrostat
  • Oxazepam
  • Oxycodone
  • Oxymorphone
  • Palbociclib
  • Paliperidone
  • Pazopanib
  • Pentazocine
  • Pentazocine; Naloxone
  • Pentobarbital
  • Perampanel
  • Perphenazine
  • Perphenazine; Amitriptyline
  • Phenelzine
  • Phenobarbital
  • Phenothiazines
  • Phenylephrine; Promethazine
  • Phenytoin
  • Posaconazole
  • Pramipexole
  • Pregabalin
  • Primidone
  • Prochlorperazine
  • Promethazine
  • Propofol
  • Protriptyline
  • Quazepam
  • Quetiapine
  • Quinine
  • Ramelteon
  • Ranitidine
  • Ranolazine
  • Rasagiline
  • Remifentanil
  • Ribociclib
  • Ribociclib; Letrozole
  • Rifabutin
  • Rifampin
  • Rifapentine
  • Rifaximin
  • Risperidone
  • Ritonavir
  • Ropinirole
  • Rotigotine
  • Rucaparib
  • Safinamide
  • Saquinavir
  • Scopolamine
  • Secobarbital
  • Sedating H1-blockers
  • Selegiline
  • Selpercatinib
  • Sevoflurane
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  • Sodium Oxybate
  • St. John’s Wort, Hypericum perforatum
  • Streptogramins
  • Sufentanil
  • Suvorexant
  • Tapentadol
  • Tasimelteon
  • Telithromycin
  • Temazepam
  • Tetrabenazine
  • Tezacaftor; Ivacaftor
  • Thalidomide
  • Thiethylperazine
  • Thioridazine
  • Ticagrelor
  • Tipranavir
  • Tizanidine
  • Tolcapone
  • Tramadol
  • Trandolapril; Verapamil
  • Tranylcypromine
  • Trazodone
  • Triazolam
  • Tricyclic antidepressants
  • Trifluoperazine
  • Trimipramine
  • Triprolidine
  • Tucatinib
  • Valerian, Valeriana officinalis
  • Valproic Acid, Divalproex Sodium
  • Verapamil
  • Voriconazole
  • Voxelotor
  • Zafirlukast
  • Ziprasidone
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