Quviviq
Quviviq (daridorexant) is an orexin antagonist that's used as a sleeping pill to help adults fall and stay asleep. It's available as a tablet that you take once every night, about 30 minutes before bedtime. You should take Quviviq (daridorexant) only if you can get at least 7 hours of sleep before waking up the next day. This medication might cause side effects like headache, daytime sleepiness, and dizziness. It's a schedule IV controlled substance because it has a risk for misuse.
What is Quviviq (daridorexant)?
What is Quviviq (daridorexant) used for?
Trouble falling or staying asleep (insomnia)
How Quviviq (daridorexant) works
Quviviq (daridorexant) is an orexin antagonist. Unlike some other insomnia medications that sedate the brain, Quviviq (daridorexant) is thought to work by turning down overactive wake signals, one of the biological causes of insomnia, helping you fall asleep and stay asleep.
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What are the risks and warnings for Quviviq (daridorexant)?
Quviviq (daridorexant) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Daytime sleepiness
Risk factors: Taking a higher-than-recommended dose | Age 65 years and older | Alcohol use | Taking other medications that cause sleepiness or slow your body down | Fewer than 7 hours of sleep
Quviviq (daridorexant) can make you very sleepy and affect your ability to focus, think, or react during the daytime. These side effects are more likely to happen or be more intense if you're 65 years or older. In addition, your risk for these side effects is higher if you drink alcohol while you're taking Quviviq (daridorexant) or if you take other medications that cause sleepiness (like benzodiazepines or other sleep medications). Daytime sleepiness and trouble with concentrate is also possible if you sleep for fewer than 7 hours after you've taken Quviviq (daridorexant).
Don't drive or operate machinery until you know how Quviviq (daridorexant) affects you. Keep in mind that these side effects can sometimes last for up to several days after the last dose of the medication for some people.
Suicidal thoughts and behaviors or worsening depression
Risk factors: History of mental health problems, including insomnia
Some people with mental health problems, including insomnia or depression, who take medications like Quviviq (daridorexant) can have worsened depression. They're also at higher risk for having thoughts of suicide, thoughts of harming themselves, or suicidal actions.
Your prescriber will check for your risk for self-harm and worsening depression before you start Quviviq (daridorexant) and also at follow-up visits. Call your prescriber right away if you or your loved ones notice that you have suicidal thoughts or worsening depression (e.g., anxiety, difficulty sleeping, feeling angry or irritated) while you take Quviviq (daridorexant).
Sleep paralysis, hallucinations, and cataplexy-like symptoms
Some people who take Quviviq (daridorexant) might experience sleep paralysis. This happens when you're not able to move or speak for up to several minutes after you start to wake up. Some people have also had hallucinations (seeing things that aren't real) and cataplexy-like symptoms (sudden muscle weakness and paralysis that's triggered by sudden, strong emotions like laughter, surprise, or stress). Contact your prescriber if you or your loved ones notice any of these effects.
Abnormal sleep behaviors
Some people who take sleep medications like Quviviq (daridorexant) have experienced abnormal sleep behaviors. These unusual behaviors can include sleepwalking, sleep-driving, and sleeping during activities (e.g., cooking and eating food, having a conversation, having sex).
These abnormal sleep behaviors can happen in anyone who takes Quviviq (daridorexant) and at any time during treatment. You might not remember doing these things. Stop taking this medication and contact your prescriber right away if your loved ones say they've noticed these behaviors.
Caution in people with breathing problems
Risk factors: History of breathing problems (e.g., sleep apnea, chronic obstructive pulmonary disease or COPD)
Let the prescriber know if you have breathing problems before you start taking Quviviq (daridorexant). It's not completely clear whether this medication can worsen breathing problems such as sleep apnea or chronic obstructive pulmonary disease (COPD). Talk with your prescriber to see whether Quviviq (daridorexant) is safe for you to take.
What are the side effects of Quviviq (daridorexant)?
Common Side Effects
- Headache (up to 7%)
- Sleepiness or fatigue (up to 6%)
Other Side Effects
- Dizziness
- Nausea
Serious Side Effects
- Excessive sleepiness: daytime sleepiness, trouble focusing or staying alert
- Suicidal thoughts or behaviors
- Depression: anxiety, trouble sleeping, feeling angry or irritated, restlessness
- Abnormal sleep behaviors: sleepwalking, sleep-driving, sleeping during activities, sleep paralysis (temporarily unable to move or talk while waking up)
Source: DailyMed
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The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions or angioedema—skin rash, itching or hives, swelling of the face, eyes, lips, tongue, arms, or legs, trouble swallowing or breathing
- CNS depression—slow or shallow breathing, shortness of breath, feeling faint, dizziness, confusion, trouble staying awake
- Mood and behavior changes—anxiety, nervousness, confusion, hallucinations, irritability, hostility, thoughts of suicide or self-harm, worsening mood, feelings of depression
- Sudden and temporary muscle weakness
- Unable to move or speak for several minutes upon waking or going to sleep
- Unusual sleep behaviors or activities you do not remember such as driving, eating, or sexual activity
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Drowsiness the day after use
- Fatigue
- Headache
Pros and cons of Quviviq (daridorexant)
Pros
Taken once per day
Can take with or without food (but food will slow down how quickly it works)
Hasn't been shown to cause physical dependence unlike some other medications for insomnia
Cons
Should only take if you plan to sleep for at least 7 hours (otherwise you could feel overly sleepy or groggy during the daytime)
Hasn't been studied in children
Brand name only
Pharmacist tips for Quviviq (daridorexant)
Be sure to take Quviviq (daridorexant) every night, rather than as needed. This is how people took the medication during clinical studies. Discuss with your prescriber about your options if you have questions about how often to take Quviviq (daridorexant).
Only take Quviviq (daridorexant) if you plan to sleep for at least 7 hours. If you aren't able to get 7 full hours of sleep after you take the medication, you might feel sleepier during the daytime the next day.
You can take Quviviq (daridorexant) with or without food. But taking it with high-fat and high-calorie foods or right after a meal can slow down how long it takes for your body to absorb the medication by about 1 hour. This means that it can take a little longer to start working to help you sleep.
You might feel sleepy the next day after you take Quviviq (daridorexant). Make sure to avoid doing anything that requires you to be alert or to give your full attention to (like driving or operating heavy machinery) until you know how this medication affects you.
Don't drink alcohol while you're taking Quviviq (daridorexant). Also, don't take other medications that also make you sleepy while you're taking Quviviq (daridorexant) unless your prescriber said it's safe for you. Taking Quviviq (daridorexant) with alcohol or with these medications can make side effects like daytime sleepiness worse.
Contact your prescriber if Quviviq (daridorexant) doesn't help you sleep after taking it for up to 10 days. You'll need to be evaluated for other causes of your sleep problems.
Make sure to tell your healthcare team about all of the medications you're taking, including prescription and over-the-counter medications, vitamins, and herbal supplements. Don't start any new medications without talking to your care team first. They can look for dangerous interactions between Quviviq (daridorexant) and your other medications and help guide you to safer options.
Talk to your prescriber about the risks and benefits of taking Quviviq (daridorexant) if you're pregnant or if you become pregnant during treatment. There haven't been any studies looking at how safe this medication is to take while pregnant. It's recommended that you enroll in a pregnancy exposure registry that keeps track of your health and your baby's health by calling 1-833-400-9611.
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Quviviq (daridorexant) dosage forms
Typical dosing for Quviviq (daridorexant)
The typical dose is 25 mg to 50 mg by mouth once per night within 30 minutes of going to bed.
Your dose will be no more than 25 mg per night if you have certain liver problems or if you're also taking certain medications that can interact with Quviviq (daridorexant).
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References
Best studies we foundDepartment of Justice and Drug Enforcement Administration. (2022). Schedules of controlled substances: Placement of daridorexant in Schedule IV. Federal Register.
Idorsia Pharmaceuticals Ltd. (2023). Quviviq- daridorexant tablet, film coated [package insert]. DailyMed.
National Institute of Neurological Disorders and Stroke. (2024). Narcolepsy.
Onge, E. S., et al. (2022). Daridorexant: A new dual orexin receptor antagonist for insomnia. The Journal of Pharmacy Technology.
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