Sunosi
Sunosi (solriamfetol) is used to improve wakefulness in adults with narcolepsy or obstructive sleep apnea. Sunosi (solriamfetol) belongs to the drug class called dopamine and norepinephrine reuptake inhibitors, and it's currently only available as a brand-name medication. Sunosi (solriamfetol) is available as tablets that are taken by mouth once daily when you first wake up. Common side effects include headache, a smaller appetite, and nausea.
What is Sunosi (solriamfetol)?
What is Sunosi (solriamfetol) used for?
Extreme daytime sleepiness caused by:
How Sunosi (solriamfetol) works
Sunosi (solriamfetol) is a dopamine and norepinephrine reuptake inhibitor. In other words, it blocks the reuptake of dopamine and norepinephrine in the brain. As a result, more dopamine and norepinephrine sticks around in your brain.
It isn't clear how Sunosi (solriamfetol) helps promote wakefulness throughout the day. But it's thought that dopamine and norepinephrine play a role in improving wakefulness.
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What are the risks and warnings for Sunosi (solriamfetol)?
Sunosi (solriamfetol) 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.
High blood pressure and fast heart rate
Risk factors: Older adults | History of heart problems | History of stroke | High blood pressure | Moderate or severe kidney problems | Taking medications that raise blood pressure or make your heart rate faster
Sunosi (solriamfetol) can raise your blood pressure and heart rate. The risk is higher if you're 65 years or older, if you already have high blood pressure, or if you're taking other medications that can raise your blood pressure or make your heart rate faster. Also, people with kidney problems can't get rid of Sunosi (solriamfetol) from the body as well, causing the medication to stay in the system longer and raising the risk for high blood pressure and fast heart rate. Talk with your prescriber to make sure the medication is safe for you.
It's important to make sure your blood pressure is under control while you're taking Sunosi (solriamfetol) because having elevated blood pressure for a long period of time can put you at risk for serious health problems, like heart attack and stroke.
Talk to your care team about checking your blood pressure and heart rate while you're taking this medication. Keep in mind that high blood pressure doesn't typically cause noticeable symptoms. But call 911 or get medical help right away if you experience chest pain, severe headache, shortness of breath, or weakness on one side of your body. These can be signs of dangerously high blood pressure.
Symptoms of mental health problems
Risk factors: History of psychosis or bipolar disorders | Moderate or severe kidney problems
During clinical studies, some people who took Sunosi (solriamfetol) felt anxious, restless (agitated), and irritable. Some also had trouble sleeping. Tell your prescriber if you notice any changes in your mood or sleep patterns. Your prescriber might lower your dose or have you stop taking Sunosi (solriamfetol).
What are the side effects of Sunosi (solriamfetol)?
Common Side Effects
- Headache (16%)
- Having a smaller appetite (9%)
- Nausea (7%)
- Anxiety (6%)
- Insomnia (trouble sleeping, 5%)
Other Side Effects
- Heart palpitations (racing heart)
- Dry mouth
- Constipation
- Stomach pain
- Diarrhea
- Feeling irritable (more easily annoyed)
- Feeling jittery
- Chest discomfort
- A lot of sweating
Serious Side Effects
- Dangerously high blood pressure: chest pain, severe headache, shortness of breath, weakness on one side of your body
- Symptoms of mental health problems: anxiety, irritability, restlessness (agitation), trouble sleeping
Source: DailyMed
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Fast or irregular heartbeat
- Heart attack—pain or tightness in the chest, shoulders, arms, or jaw, nausea, shortness of breath, cold or clammy skin, feeling faint or lightheaded
- Increase in blood pressure
- Mood and behavior changes—anxiety, nervousness, confusion, hallucinations, irritability, hostility, thoughts of suicide or self-harm, worsening mood, feelings of depression
- Stroke—sudden numbness or weakness of the face, arm, or leg, trouble speaking, confusion, trouble walking, loss of balance or coordination, dizziness, severe headache, change in vision
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
Pros and cons of Sunosi (solriamfetol)
Pros
Taken once a day
Comes in two different strengths
Unlikely to cause withdrawal symptoms if you stop taking the medication suddenly
Cons
No lower-cost generic available
Can make your blood pressure go up
Is a controlled substance so there are special requirements to getting a prescription filled
Not approved for children
Pharmacist tips for Sunosi (solriamfetol)
Take Sunosi (solriamfetol) once a day when you first wake up. Make sure you have at least 9 hours before your next planned bedtime when you take the medication. Otherwise, you might have trouble sleeping.
You can take Sunosi (solriamfetol) with or without food. Try to take the medication in the same way every day (either with or without food). This helps the medication get absorbed into your body consistently.
If you're prescribed the 37.5 mg dose of Sunosi (solriamfetol), you can break the 75 mg tablets in half at the scored line (the indented line in the middle of the tablet). Be sure to use a pill splitter to safely and evenly cut the tablet in half; don't use your fingers or a knife.
It's possible for Sunosi (solriamfetol) to make you feel anxious, restless, or irritable. Speak with your prescriber if you start noticing changes in your mood while you're taking this medication and it worries you. Your prescriber might consider making adjustments to your treatment to help.
Sunosi (solriamfetol) can make your heart rate faster and raise your blood pressure. Your prescriber will check these vital signs before you start taking the medication and also during follow-up visits. They might also recommend that you check at home as well. Let your care team know if your blood pressure is higher than usual or if your heart rate is faster than normal.
Sunosi (solriamfetol) isn't meant to be used to treat the blockage in your airway that causes obstructive sleep apnea. It's only used to help lessen excessive daytime sleepiness that's typical with sleep apnea. Talk with your prescriber about appropriate treatment options for your sleep apnea.
Keep Sunosi (solriamfetol) in a secure place and safely throw away unused or expired tablets at authorized collection sites (e.g., law enforcement locations, retail pharmacies). You can also mix the tablets with an undesirable substance (like cat litter or used coffee grounds), place it in a sealed bag, and throw it away in your household trash. Don't flush unused tablets down the toilet.
Frequently asked questions about Sunosi (solriamfetol)
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Sunosi (solriamfetol) dosage forms
Typical dosing for Sunosi (solriamfetol)
Your dose depends on what condition you’re taking Sunosi (solriamfetol) for.
Narcolepsy: The typical starting dose is 75 mg by mouth once daily when you first wake up. Your prescriber might raise your dose depending on how well the medication works for you. The recommended dose ranges from 75 mg to 150 mg once daily.
Obstructive sleep apnea: The typical starting dose is 37.5 mg by mouth once daily when you first wake up. Your prescriber might raise your dose depending on how well the medications works for well. The recommended dose ranges from 37.5 mg to 150 mg once daily.
Your dose might differ if you have kidney problems.
How much does Sunosi (solriamfetol) cost?
Sunosi (solriamfetol) contraindications
Currently take or have taken a monoamine oxidase inhibitor (MAOI) within the last 14 days
What are alternatives to Sunosi (solriamfetol)?
Extreme daytime sleepiness caused by:
Excessive daytime sleepiness or cataplexy (sudden muscle weakness) in adults with narcolepsy
Excessive daytime sleepiness in children ages 6 and older with narcolepsy
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References
Best studies we foundAmerican Academy of Sleep Medicine. (2008). Obstructive sleep apnea.
Axsome Therapeutics, Inc. (2023). Sunosi- solriamfetol tablet, film coated [package insert]. DailyMed.
MedlinePlus. (2023). Prescription drug misuse.
National Institute of Neurological Disorders and Stroke. (2024). Narcolepsy.
Thorpy, M. J., et al. (2019). A randomized study of solriamfetol for excessive sleepiness in narcolepsy. Annals of Neurology.
Watson, C. J., et al. (2010). Neuropharmacology of sleep and wakefulness. Sleep Medicine Clinics.
Weaver, T. E., et al. (2020). Effects of solriamfetol on quality-of-life measures from a 12-week phase 3 randomized controlled trial. Annals of the American Thoracic Society.
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