LEMBOREXANT
Background and Date of Approval
Lemborexant received approval from the U.S. Food and Drug Administration (FDA) on 20 December 2019. This medication is classified as an orexin receptor antagonist.
Uses
Lemborexant is used to treat insomnia.
How is it administered?
Lemborexant is typically administered orally shortly before bedtime. Individual factors and the severity of insomnia determine the recommended dosage. It should be taken without food, and alcohol or other sedatives should be avoided to prevent excessive drowsiness and impaired coordination.
Side Effects
Lemborexant use can result in various side effects. Common side effects include headache, somnolence (excessive sleepiness), dizziness, fatigue, abnormal dreams, and upper respiratory tract infections. Serious but less common side effects encompass sleep-related behaviors like sleep-driving and sleep-eating, allergic reactions such as rash and swelling, and the potential emergence of depression and suicidal thoughts.
Warnings
Several important warnings accompany lemborexant use. It may induce complex sleep behaviors like sleep-driving and sleep-eating, posing risks to safety. Allergic reactions are rare but serious, warranting immediate medical attention if symptoms such as rash, swelling, or difficulty breathing occur. There's a potential for the emergence of depression and suicidal thoughts, requiring vigilant monitoring of mood and behavior
Precautions
Combining lemborexant with other CNS depressants, like alcohol or opioids, can enhance sedation and should be avoided. Long-term use should be periodically reassessed, and potential cognitive effects, including memory impairment, should be considered. Overall, consultation with a healthcare provider is paramount to navigate these warnings and ensure safe usage.
Word of Advice
Lemborexant can induce drowsiness and impair cognitive and motor skills; caution is required when driving or operating machinery. Alcohol and other sedatives should be avoided as they may intensify sedation when combined with this medication. Patients with liver impairment require careful monitoring and potential dose adjustments due to hepatic metabolism of the drug. Safety during pregnancy and breastfeeding has not been established; discussion with a healthcare provider is necessary before use. Elderly patients may demonstrate increased sensitivity to the drug's effects and may require lower dosages. A comprehensive review of medical history and current medications is essential to ensure safe and effective use.
References
Rosenberg et al.; Advances in the Treatment of Chronic Insomnia: A Narrative Review of New Nonpharmacologic and Pharmacologic Therapies; Neuropsychiatric Disease and Treatment 2021:17 2549â2566; [Published on August 2021]; [Accessed on 28th August 2023]; https://www.dovepress.com/getfile.php?fileID=72977 Eisai Inc, US Food and Drug Administration, [Issued on March 2022], [Accessed on 28th August 2023], https://www.dayvigo.com/-/media/Files/DAYVIGO/PDF/prescribing-information.pdf?hash=29123669-6b3b-4728-ab27-b2e49ef34788 Yardley J, Kärppä M, Inoue Y et al. Long-term effectiveness and safety of lemborexant in adults with insomnia disorder: results from a phase 3 randomized clinical trial. Sleep Medicine; [Published on April 2021]; [Accessed on 28th August 2023]; https://www.sciencedirect.com/science/article/pii/S1389945721000654
Frequently Asked Questions
Is lemborexant habit-forming?
Lemborexant has a lower risk of physical dependence than other sleep medications. However, dependence is still possible, and it's important to follow your healthcare provider's instructions and not abruptly stop the medication without consulting them.
Can I take lemborexant with other medications?
Interactions with other medications can influence Lemborexant's effects. It's important to inform your healthcare provider about all medications, including prescription, over-the-counter, and herbal supplements, that you are taking to ensure safety and effectiveness.
How quickly does lemborexant work?
Lemborexant's onset of action can vary among individuals, but it generally starts working within the first few nights of use. It's important to take it as directed by your healthcare provider and allow sufficient time to assess its effectiveness.
What should I do if I miss a dose of lemborexant?
If you miss a dose of lemborexant, it's generally advised not to take an extra dose to compensate for it. Simply continue with the next scheduled dose. Taking extra doses can increase the risk of side effects.
Is lemborexant safe for long-term use?
Lemborexant is approved for both short-term and long-term use. However, your healthcare provider should periodically reassess the need for continued treatment to ensure its ongoing effectiveness and safety.
What should I do if I experience unusual behaviors while taking lemborexant?
Consult your healthcare provider if you experience complex sleep behaviors like sleepwalking, sleep-driving, or sleep-eating while taking lemborexant. These behaviors can be serious and should be addressed promptly.
Can I stop taking lemborexant suddenly?
Abruptly stopping lemborexant after prolonged use can lead to withdrawal symptoms such as rebound insomnia. If you wish to discontinue the medication, it's recommended to do so under the guidance of your healthcare provider.
How does lemborexant differ from other sleep medications?
Lemborexant is an orexin receptor antagonist, a type of sleep medication with a unique mechanism of action. It targets specific receptors in the brain to promote sleep while having a lower risk of dependence than other sleep medications.