Is Belsomra a Controlled Substance? Plus, 5 More Belsomra FAQs
Key takeaways:
Belsomra (suvorexant) is a sleep medication prescribed to treat insomnia in adults. It works by blocking orexin in the brain. Orexin is a natural chemical that causes wakefulness.
Belsomra is a controlled substance because it has the potential to cause dependence or misuse. There are prescribing restrictions on it to help limit these issues. However, Belsomra hasn’t been shown to cause physical dependence or withdrawal in clinical studies.
Belsomra takes about 30 minutes to start working and lasts for at least 7 hours after a dose. It’s common to feel groggy or sleepy the next morning, even if you slept for the recommended amount of time.
Table of contents
Belsomra (suvorexant) is a sleep medication that’s FDA approved to treat insomnia in adults. Insomnia makes it harder for you to fall asleep, stay asleep, or sometimes both. Sleeping medications, such as Belsomra, are one treatment that can help you get the sleep you need.
If you’re just starting Belsomra, it’s common to have questions about it. Is Belsomra a controlled substance like many other prescription sleep aids? How does it work? Below we’ll answer six frequently asked questions about Belsomra.
1. Is Belsomra a controlled substance?
Yes. Belsomra is classified by the Drug Enforcement Administration (DEA) as a Schedule 4 controlled substance. It’s in the same schedule as other well-known prescription sleep medications such as Ambien (zolpidem). This means it carries some risk for physical dependence and misuse. Clinical studies haven’t shown that Belsomra causes dependence or withdrawal. But the risk can’t be completely ruled out.
Federal and state laws place prescribing restrictions on Belsomra. For example, you may have few or no refills on your prescription. Or you may only be allowed to fill a certain amount at one time. These restrictions vary between locations. Your pharmacist can tell you what the specific rules are where you live.
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2. How does Belsomra work?
Belsomra is an orexin receptor antagonist. It works by blocking the activity of orexin, a naturally occurring chemical messenger in the brain that helps you feel awake, among other functions. By blocking orexin’s actions, Belsomra helps promote sleep in people with insomnia.
Is Belsomra a benzodiazepine?
No, Belsomra is not a benzodiazepine. Benzodiazepines help enhance the actions of a brain chemical called gamma-aminobutyric acid (GABA). More GABA activity causes other brain and nerve cells to calm down. This leads to less anxiety, relaxed muscles, and drowsiness.
While benzodiazepines are commonly prescribed for anxiety, some can also help treat insomnia and seizures.
3. How long does it take Belsomra to work?
It takes Belsomra about 30 minutes to start working. That’s why the typical dosage is to take one tablet about a half hour before bedtime. But if you take Belsomra with a high-fat meal, it may take over an hour longer for it to start working. So it’s best to take your dose on an empty stomach or with a low-fat snack.
4. How long does Belsomra stay in your system?
Belsomra stays active in your system for several hours after you take it. You should only take it if you can dedicate at least 7 hours to sleeping. Otherwise, you may be too sleepy to safely perform important tasks, such as driving.
But even if you’re able to get the recommended amount of sleep, you might still feel drowsy the next morning. There’s still a good amount of Belsomra in your system for up to 12 hours after you take it. So you may need more than the suggested 7 hours of sleep to avoid feeling groggy the next morning.
Make sure that you’ve gotten the recommended amount of sleep and that you know how Belsomra makes you feel the following day before driving or doing anything that requires full alertness. Let your prescriber know if you feel an excessive amount of next-day drowsiness with this medication. They may suggest a lower dose or a different medication.
5. Can Belsomra tablets be cut in half or crushed?
No, you shouldn’t cut or crush Belsomra tablets. According to the manufacturer, Belsomra tablets are film-coated. In general, it’s not recommended to cut or crush film-coated tablets. There’s also no score (a line for cutting) on the tablets. Cutting tablets without a designated line can result in uneven halves and potentially an incorrect dose.
If you’re considering splitting Belsomra tablets due to its side effects, reach out to your prescriber. Belsomra comes in four different doses ranging from 5 mg to 20 mg. So you have some flexibility to find the dose that works best for you.
If you’re having trouble swallowing pills, your pharmacist is a great resource for tips on getting them down the hatch. If these strategies don’t seem to help, your prescriber can help look into alternatives that are easier to swallow.
6. Does Belsomra show up on a drug test?
It hasn’t been well studied whether Belsomra shows up on common drug tests. There are ways for scientists to identify the medication in urine. But many drug tests don’t specifically test for it. However, it’s best to assume that it’s possible for Belsomra to show up or give a false-positive on a test.
If you’re scheduled to take a drug test, let your prescriber or the lab giving the test know all the medications you’re taking — both prescription and over the counter. If you believe Belsomra has given a false-positive result, your prescriber may be able to verify this using the information you give them.
The bottom line
Belsomra (suvorexant) is a sleep medication that can treat insomnia. It works by blocking orexin, a brain chemical that helps you feel awake. Because it carries a risk of dependence and misuse, Belsomra is a controlled substance.
Belsomra starts working about 30 minutes after you take it and will stay active in your body for several hours. You should only take Belsomra if you can dedicate at least 7 hours to sleep. Feeling tired or drowsy the next morning is a common side effect, even if you sleep for the recommended amount of time.
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References
Bounds, C. G., et al. (2024). Benzodiazepines. StatPearls.
Code of Federal Regulations. (2024). 21 CFR § 1306.22: Refilling of prescriptions.
Han, A. H., et al. (2023). Suvorexant, a novel dual orexin receptor antagonist, for the management of insomnia. Health Psychology Research.
Lee-Iannotti, J. K., et al. (2016). Suvorexant: A promising, novel treatment for insomnia. Neuropsychiatric Disease and Treatment.
Merck Sharp & Dohme LLC. (2023). Belsomra- suvorexant tablet, film coated [package insert].
National Center for Biotechnology Information. (2024). PubChem compound summary for CID 24965990, suvorexant.
Sullinger, S., et al. (2017). Identification of suvorexant in urine using liquid chromatography-quadrupole/time-of-flight mass spectrometry (LC-Q/TOF-MS). Journal of Analytical Toxicology.
U.S. Drug Enforcement Administration. (n.d.). Drug scheduling.
Xia, L., et al. (2023). A review of physiological functions of orexin: From instinctive responses to subjective cognition. Medicine.
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