Belsomra and Alcohol: 4 Reasons You Should Avoid This Combination

Belsomra (suvorexant) is a sleeping medication. It’s sometimes prescribed to adults who have trouble falling or staying asleep (insomnia). Like other sleeping medications, you shouldn’t combine Belsomra with alcohol.

Both Belsomra and alcohol come with side effects. But combining them together increases your risk of serious side effects more than either does by itself. Researchers aren’t sure why this interaction happens, but the results can be dangerous.

Here are four reasons to avoid mixing Belsomra and alcohol.

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1. Alcohol makes next-day drowsiness from Belsomra more likely to happen

Next-day drowsiness is a possible Belsomra side effect. But mixing Belsomra and alcohol can raise the risk of next-day drowsiness and make it more intense. Studies have shown that the combination decreases alertness and worsens reaction time more than either substance does alone.

You should plan on getting at least 7 hours of sleep if you take Belsomra. But even with a full night’s rest, next-day drowsiness can still happen. It can also cause impairment with tasks that require full alertness, such as driving.

Daytime impairment can happen with any dose of Belsomra. But the higher your dose, the higher the risk of next-day impairment is. In fact, Belsomra’s manufacturer warns against driving the next day at all if you take the highest 20 mg dose.

EXPERT PICKS: WHAT TO READ NEXT

• Alcohol and sleeping pills don’t mix: There are no sleeping pills that are safe to mix with alcohol. Read more about why this combination can be dangerous.

• Alcohol and insomnia: Drinking alcohol can actually worsen insomnia. Read more about the negative effects that alcohol can have on your sleep.

• Belsomra basics: Is Belsomra a controlled substance? And how does it work? Read pharmacist-backed answers to the most frequently asked questions about Belsomra.

2. Mixing Belsomra and alcohol can increase the risk of falls or accidental injury

Sleeping medications, including Belsomra, can raise your risk of accidental injuries and falls. This is especially true if you're 65 years or older. Taking Belsomra with alcohol increases this risk even further. When these two are combined, alertness and stability become significantly more impaired.

Falls may not sound like a big deal, but they’re the leading cause of fatal and non-fatal injuries for older adults. But even for younger adults, it’s best to avoid situations that can cause falls or accidental injuries.

If you’re taking Belsomra, there are steps you can help prevent dangerous falls, such as:

• Remove clutter and tripping hazards in your home.

• Tape down or secure rugs.

• Wear well-fitting, non-slip shoes.

• Hold on to handrails when going up or down stairs.

• Use a grab bar when entering or exiting the shower.

• Have your eyes checked regularly and wear your glasses or contacts (if applicable).

3. Mixing Belsomra and alcohol can cause slowed or stopped breathing

Belsomra is a sedative. It can slow down certain central nervous system (brain and spinal cord), or CNS, activities. While this can be beneficial for sleep, slowing down the CNS too much can also slow down or stop breathing. This is called respiratory depression, and it can be life-threatening in severe cases. Taking Belsomra with other sedatives raises the risk of respiratory depression.

Alcohol is also a sedative. Combining it with Belsomra may slow down the CNS too much and cause respiratory depression. This can be especially risky if you have a breathing condition such as sleep apnea or chronic obstructive pulmonary disease (COPD). These conditions already make it more difficult to breathe while sleeping.

4. Alcohol can make insomnia worse

Alcohol can worsen insomnia symptoms. This can be frustrating and make it seem as though Belsomra isn’t helping enough. Even small amounts of alcohol (1 to 2 drinks) can negatively impact your sleep.

Despite what many people think, alcohol doesn’t work well as a sleep aid. This is because it affects your body’s natural sleep cycle. Although alcohol can make you feel sleepy, the quality of your sleep will likely be poor. Drinking alcohol can also disrupt your sleep later in the night, potentially causing you to wake up.

Is any amount of alcohol OK with Belsomra?

No amount of alcohol is safe to combine with Belsomra, even if it’s just a small glass of wine or beer with dinner. If you’ve had any alcohol to drink that evening, it’s recommended not to take Belsomra.

Alcohol stays in your system for a relatively long time, even if you don’t feel its effects. How long it takes your body to completely get rid of alcohol depends on lots of factors, including your age, sex, and body weight. But, generally, alcohol is detectable in the bloodstream for at least 6 hours after your last drink.

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Written by:

Tegan Smedley, PharmD, APh

Tegan Smedley, PharmD, APh, has 10 years of experience as a pharmacist. She has worked in a variety of settings, including retail, hospital, and ambulatory care.

Edited by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

Reviewed by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

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If you or someone you know struggles with alcohol or substance use, help is available. Call the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 to learn about resources in your area.