Somarant

Indication
Insomnia
Administration
May be taken with or without food.
Adult Dose
Insomnia Recommended starting dose: 10 mg PO taken no more than once per night and within 30 minutes of going to bed. Not to exceed 20 mg once daily. Hepatic impairment Mild-to-moderate: No dosage adjustment required Severe: Not recommended

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Child Dose
Safety and efficacy not established
Renal Dose
Renal impairment: No dosage adjustment required
Contraindication
Hypersensitivity. Narcolepsy
Mode of Action
Orexin receptor antagonist; orexin, also called hypocretin, is a neurotransmitter that regulates arousal, wakefulness, and appetite Blocking the binding of wake-promoting neuropeptides orexin A and orexin B to receptors OX1R and OX2R is thought to suppress wake drive

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Precaution
Can impair daytime wakefulness; CNS depressant effects can last for up to several days after discontinuation Can impair driving skills and may increase the risk of falling asleep while driving Dosage adjustments of suvorexant and concomitant CNS depressants may be necessary when administered together because of potentially additive effects Use with other drugs to treat insomnia is not recommended Risk of next-day impairment, including impaired driving, is increased if taken with less than a full night of sleep remaining, if a higher than the recommended dose is taken, if coadministered with other CNS depressants, or if coadministered with other drugs that increase suvorexant blood levels Dose-dependent increase in suicidal ideation was observed in patients taking suvorexant, as assessed by questionnaire; immediately evaluate patients with suicidal ideation or any new-onset behavioral changes; worsening depression or suicidal thinking, thoughts, and actions have been reported with the use of sedative-hypnotic Consider effect on respiratory function Risk of sleep paralysis, hypnagogic/hypnopompic hallucinations, and cataplexy-like symptoms increases with increasing doses Not recommended for patients with severe hepatic impairment

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Side Effect
1-10% Somnolence, females (8%),Somnolence (7%),Headache (7%),Somnolence, males (3%),Dizziness (3%),Abnormal dreams (2%),Cough (2%), Diarrhea (2%),Dry mouth (2%),Upper respiratory tract infection (2%)

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