section name header

Pronunciation

soo-voe-REX-ant

Classifications

Therapeutic Classification: sedative/hypnotics

Pharmacologic Classification: orexin receptor antagonists

Indications

REMS

Action

Therapeutic Effects:

Pharmacokinetics

Absorption: 82% absorbed following oral administration; a high-fat meal will delay absorption and sleep onset. absorption in obese females.

Distribution: Well distributed to tissues.

Protein Binding: >99%.

Metabolism/Excretion: Extensively metabolized by the liver via the CYP3A isoenzyme and to a lesser extent by the CYP2C19 isoenzyme to inactive metabolites. 66% excreted in feces, 23% in urine, mostly as metabolites.

Half-life: 12 hr ( in hepatic impairment).

Time/Action Profile

(sleep)

ROUTEONSETPEAKDURATION
PO30 min (delayed by food)unknown7 hr

†Excess sedation may persist for several days after discontinuation.

Contraind./Precautions

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects

Adverse reactions, especially related to CNS depression are dose-related, especially at the 20-mg dose

Neuro: drowsiness, cataplexy, complex sleep behaviors (including sleep driving, sleep walking, or engaging in other activities while sleeping), daytime drowsiness, hallucinations (during sleep), sleep paralysis, worsening of depression/suicidal ideation.

Interactions

Drug-Drug:

Drug-Food:

Route/Dosage

Availability

Assessment

Implementation

Patient/Family Teaching

Evaluation/Desired Outcomes

US Brand Names

Belsomra

Contr. Subst. Schedule

Schedule IV (C-IV)