Belsomra (Suvorexant): Uses, Side Effects, Dosage, & More

What Is Belsomra (Suvorexant)?

Belsomra, with the active ingredient suvorexant, belongs to the class of medications known as orexin receptor antagonists. Approved by the FDA, it is designed to address insomnia by influencing the brain’s orexin system, which regulates the sleep-wake cycle. As an orexin receptor antagonist, Belsomra blocks signals that promote wakefulness, leading to improved sleep initiation and maintenance.¹

FDA approval signifies that the drug has undergone rigorous evaluations for safety and efficacy, meeting the regulatory standards to be deemed a reliable and effective treatment for insomnia.

How Does Belsomra Work?

Belsomra works by affecting a brain chemical called orexin, a key regulator of the sleep-wake cycle. The action of Belsomra on the sleep-wake cycle may help calm the brain, making it easier for individuals to fall and stay asleep. By targeting the specific mechanism that promotes wakefulness, Belsomra may contribute to improved sleep initiation and duration for those with insomnia. It is important to follow prescribed guidelines and consult healthcare providers to optimize the benefits of Belsomra.¹

What Is Belsomra Used to Treat?

Belsomra (suvorexant) is FDA-approved specifically for the treatment of insomnia, a common sleep disorder characterized by difficulties falling asleep or staying asleep. FDA approval involves a thorough evaluation of a medication’s safety and efficacy, ensuring it meets regulatory standards. For Belsomra, this means it has demonstrated effectiveness in addressing insomnia symptoms.¹

While Belsomra is specifically approved for insomnia, healthcare providers may sometimes prescribe medications for uses not officially approved by the FDA, a practice known as “off-label” use (non-FDA approved). Off-label use one that is not FDA-approved, but a prescriber may use because it may be beneficial for a patient. Belsomra was noted in one study to alleviate opioid withdrawal and cravings in specific patients.²

Common Side Effects of Belsomra

Common side effects of Belsomra include drowsiness and dizziness, and individuals may need to exercise caution while engaging in activities requiring alertness. Stay aware of potential reactions and consult a healthcare professional if concerns arise.

Common side effects of Belsomra include:¹

• Daytime drowsiness
• Headache
• Nausea
• Difficulty staying awake during normal activities (insomnia-related symptoms)
• Unpleasant taste
• Dry mouth
• Fatigue

*All medications, including Belsomra, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.

Serious Side Effects of Belsomra

Serious side effects of Belsomra require vigilant monitoring, and individuals should promptly seek medical attention if these symptoms manifest. One notable concern is sleep paralysis, a phenomenon where a person is temporarily unable to move or speak upon waking or falling asleep. Additionally, Belsomra has been associated with complex sleep behaviors, such as sleep-driving or preparing and eating food while asleep, posing potential safety risks.¹

Serious side effects of Belsomra include:*¹

• Sleep paralysis
• Complex sleep behaviors (sleep-driving, preparing and eating food, making phone calls)
• Severe allergic reaction, including anaphylaxis, tongue or throat swelling, and facial swelling
• Respiratory compromise
• Severe facial swelling
• Anaphylaxis
• Impaired consciousness or complex behaviors
• Confusion
• Hallucinations

*All medications, including Belsomra, can cause side effects which can be mild or serious. This is not a comprehensive list of all possible side effects. You should talk with your doctor about any questions you have and to understand the potential side effects and benefits of any medication.

Belsomra Warnings & Precautions

Before starting Belsomra (suvorexant) as a treatment, there are important warnings and precautions to consider. Patients should remain watchful and promptly seek medical attention if any concerns or adverse effects arise during the course of treatment.

One critical consideration is the potential for central nervous system (CNS) depressant effects, such as drowsiness and impaired alertness. These effects could impact activities requiring mental acuity. Serious effects, including anaphylaxis shock (a sudden severe allergic response) and angioedema (severe swelling), have been reported with Belsomra. If you notice either of these symptoms or any listed below, seek immediate medical care.

Warnings and precautions for Belsomra include:¹

• CNS depressant effects: Belsomra can cause central nervous system (CNS) depressant effects, such as drowsiness and impaired alertness, which may impair the ability to perform activities requiring complete mental alertness.
• Sleep paralysis and complex sleep behaviors: Belsomra may lead to sleep paralysis and complex sleep behaviors, including sleep-driving and preparing and eating food while asleep. Patients should seek immediate medical attention if these occur.
• Worsening of depression: Belsomra may worsen symptoms in individuals with a history of depression or suicidal thoughts. Close monitoring and medical intervention may be required.
• Respiratory depression: Belsomra can cause respiratory depression, particularly in patients with compromised respiratory function. Medical attention is essential if respiratory difficulties arise.
• Suicidal ideation and behavior: Suicidal thoughts and behaviors have been reported with Belsomra. Patients should be closely monitored, and healthcare providers should be informed of any changes in mood or behavior.
• Ensuring proper diagnosis: Because sleep disturbances may be the presenting manifestation of a physical and/or psychiatric disorder, treatment of insomnia should be initiated only after careful evaluation of the patient.

Belsomra Dosages for FDA-Approved Treatment

They typical dosage of Belsomra is 10 mg, taken once daily, 30 minutes before bedtime. This dose may be adjusted depending on health history and any potential interactions with other medications that are being taken.¹

Belsomra is approved for use in adults for the treatment of insomnia. Dosages for off-label uses should be determined by healthcare professionals based on the patient’s unique circumstances, and any adjustments should be made under their guidance to optimize safety and efficacy. Patients should always take their prescribed dosage as directed by their healthcare provider.

Belsomra Forms & Strengths

Belsomra is available in tablet form, with strengths ranging from 5 mg to 20 mg. There are no extended-release or delayed-release formulations. Instead, the medication is designed for relatively rapid onset, typically taken 30 minutes before bedtime.

Belsomra is available in the following forms and strengths:¹

• 5 milligrams (mg) oral tablet
• 10 mg oral tablet
• 15 mg oral tablet
• 20 mg oral tablet

How Long Does it Take for Belsomra to Start Working?

Belsomra typically begins to take effect within 30 minutes after ingestion. The medication is designed for relatively rapid onset, making it effective for those having difficulty falling asleep. Always take Belsomra as directed to maximize its effectiveness for treating insomnia symptoms.¹

How Should I Take Belsomra?

Belsomra is typically taken about 30 minutes before bedtime, allowing it to take effect when individuals are ready to sleep. While Belsomra can be taken with or without food, it is advisable to avoid a high-fat or heavy meal before taking the medication, as it may delay the onset of action. Tablets should be swallowed whole and not crushed or divided.

What Happens If I Miss a Dose of Belsomra?

If a dose of Belsomra is missed, skip the missed dose and resume the regular dosing schedule the following night. Do not double up on doses to compensate for a missed one, as this can increase the risk of side effects. Individuals should consult with their healthcare provider for guidance on the best course of action if a dose is accidentally skipped. Following the prescribed dosing regimen consistently is key for effective treatment of insomnia symptoms.

Can You Overdose on Belsomra?

While Belsomra overdose is rare, take the medication as prescribed to minimize potential risk of overdose. Exceeding the recommended dosage can lead to an overdose, increasing the likelihood of adverse effects. Signs and symptoms of a potential overdose may include severe drowsiness, difficulty breathing, or loss of consciousness. If an overdose is suspected, seek immediate medical attention.

What Should You Do If You Take Too Much Belsomra?

If you take too much Belsomra, seek emergency medical attention immediately. Go to the nearest emergency room or contact Poison Control for more information. Bring the medication packaging or provide information about the quantity ingested to assist healthcare professionals in providing prompt and appropriate treatment. Do not wait for symptoms to escalate, and prioritize seeking medical help to address the potential consequences of an overdose.

What to Avoid When Taking Belsomra

Belsomra can interact with various medications, substances, and herbs, potentially leading to harmful effects. It is crucial for individuals to inform their healthcare providers about all the medications, both prescription and over-the-counter, as well as any supplements or herbal remedies they are taking.

Certain medications, like diltiazem, verapamil, erythromycin, may increase the levels of Belsomra in the body, intensifying its effects and leading to excessive sedation. Additionally, substances that cause central nervous system depression, such as alcohol, can increase the sedative effects of Belsomra, increasing the risk of drowsiness and impairment.¹

6 substances you should avoid while taking Belsomra include:¹

• Alcohol: Combining Belsomra with alcohol can lead to increased sedation and impairment, heightening the risk of adverse effects.
• Strong CYP3A inhibitors (ketoconazole): Medications that inhibit the CYP3A enzyme can elevate Belsomra levels, intensifying its effects and potentially causing harm.
• Central nervous system (CNS) depressants (benzodiazepines, opioids): Concurrent use of Belsomra with other CNS depressants can result in excessive sedation and impaired alertness, posing safety concerns.
• Herbs and supplements with sedative properties (valerian, kava): Combining Belsomra with sedative herbs or supplements may amplify its sedative effects, increasing the risk of drowsiness and cognitive impairment.
• Medications affecting serotonin levels (SSRIs, SNRIs): Belsomra may interact with medications that influence serotonin levels, including antidepressants such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). This interaction may lead to serotonin syndrome, a serious and potentially life-threatening condition with symptoms like agitation and rapid heartbeat.
• Grapefruit: Grapefruit and products containing it should generally be avoided while taking Belsomra. This is because grapefruit can interfere with the breakdown of Belsomra, leading to an excess of the medication in the body and an increased risk of side effects.

*This is not a comprehensive list of the possible interactions with Belsomra. You should talk with your healthcare provider and your pharmacist about all prescription and over-the-counter medications, herbs, and supplements you take before starting semaglutide.

How to Get a Prescription for Belsomra

Belsomra is a prescription-only medication, meaning it can only be obtained via a prescription from an authorized healthcare provider. Typically, psychiatrists, primary care physicians, and sleep specialists are authorized to prescribe Belsomra.

To determine if Belsomra is an appropriate and helpful treatment, a thorough evaluation is necessary. This evaluation may involve discussing the individual’s medical history, current medications, sleep patterns, and overall health. In some cases, a physical examination or additional diagnostic tests may be recommended to rule out underlying conditions contributing to insomnia.

For those seeking a psychiatrist, various resources can be utilized. Primary care physicians can provide referrals, and local mental health organizations often maintain directories of psychiatrists.

FAQs About Belsomra

These FAQs aim to address common queries, providing clarity for those considering or currently using Belsomra.

Is Belsomra the Same as Ambien?

No, Belsomra and Ambien are not the same. While both are medications used to treat insomnia, they belong to different drug classes and work through different mechanisms. Belsomra (suvorexant) is an orexin receptor antagonist, affecting the brain’s wake-sleep cycle by targeting the orexin system.

In contrast, Ambien (zolpidem) is a nonbenzodiazepine sedative hypnotic that enhances the activity of the neurotransmitter GABA in the brain. The choice between Belsomra and Ambien depends on factors like individual response, medical history, and the recommendation of the healthcare provider.

Which Is Better, Belsomra or Trazodone?

The choice between Belsomra and trazodone for treating insomnia depends on various factors and individual circumstances. Belsomra targets the brain’s wake-sleep cycle, while trazodone is an antidepressant with sedative properties often prescribed off-label for insomnia. Off-label means it is not FDA-approved for this indication but prescribers may use it because in their professional judgment they believe it could be beneficial.

Both medications have use for insomnia but the most effective option should be determined by your provider for the best possible outcomes.

Is Belsomra Similar to Other Sleep Medications & Sedatives?

Belsomra differs from other sleep medications and sedatives in its mechanism of action. This sets it apart from traditional sedatives like benzodiazepines or nonbenzodiazepine sedative hypnotics, such as zolpidem.

While each medication has unique characteristics, the choice between them depends on individual factors like the type of insomnia, medical history, and potential side effects.

Is Belsomra Habit-forming or Addictive?

Belsomra is generally considered to have a lower risk of habit formation or addiction compared to some other sleep medications. It works through a different mechanism by targeting the orexin system and lacks the potential for abuse associated with traditional sedatives like benzodiazepines.

Can Belsomra Be Used During Pregnancy or While Breastfeeding?

The safety of using Belsomra during pregnancy or breastfeeding is not well established, and it is generally recommended to avoid its use during these periods unless deemed absolutely necessary. Limited studies are available on the effects of Belsomra on pregnant individuals or infants through breastfeeding.

Questions to Ask Your Healthcare Provider About Belsomra

If you are considering Belsomra as an insomnia treatment, you may have questions. At your next appointment with your provider, ask about the medication’s suitability, potential interactions with existing medications, and how any underlying health conditions may affect the decision.

If you are contemplating a change in prescribers, online psychiatry services may be a valuable resource, providing access to qualified professionals via telehealth.

Questions to ask your care team about Belsomra include:

• How safe is Belsomra, particularly considering my medical history and current health conditions?
• What is the expected adjustment period for taking Belsomra, and what can I anticipate during this time?
• Considering my current medication regimen, am I at an increased risk of more serious symptoms or interactions with Belsomra?
• What factors will determine the most suitable dosage for me to minimize potential side effects while optimizing effectiveness?
• Are there any lifestyle changes or habits I should adjust while taking Belsomra?
• What are the potential long-term effects or considerations for using Belsomra?
• Are there non-pharmacological approaches or alternative medications I should consider for managing insomnia?
• How will Belsomra interact with any existing sleep disorders or mental health conditions I may have?
• What steps should I take if I miss a dose of Belsomra?
• Can Belsomra be safely used if I am pregnant or breastfeeding?
• Are there specific precautions or considerations I should keep in mind while using Belsomra?
• What are the signs that Belsomra might not be the right fit for me, and when should I reach out for further guidance?