Wakix
Wakix (pitolisant) is a medication that treats excessive daytime sleepiness in adults and children ages 6 and older with narcolepsy. It's also used to treat cataplexy, or sudden muscle weakness after having strong emotions, in adults with narcolepsy. This medication is taken by mouth once a day in the morning. You'll typically start the medication at a lower dose and then slowly raise the dose over time. Side effects include headache, nausea, and trouble sleeping.
What is Wakix (pitolisant)?
What is Wakix (pitolisant) used for?
- Excessive daytime sleepiness or cataplexy (sudden muscle weakness) in adults with narcolepsy
- Excessive daytime sleepiness in children ages 6 and older with narcolepsy
How Wakix (pitolisant) works
Wakix (pitolisant) is a histamine-3 (H3) receptor antagonist/inverse agonist. It's not entirely clear how the medication works to treat daytime sleepiness and cataplexy in people with narcolepsy. But it's thought to work by raising histamine levels in your brain, which helps you stay awake.
Drug facts
Side effects of Wakix (pitolisant)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
Adults:
- Headache (18%)
- Trouble sleeping (6%)
- Nausea (6%)
- Anxiety (5%)
Children:
- Headache (19%)
- Trouble sleeping (7%)
Less Common Side Effects
- Upper respiratory infection
- Muscle, bone, or joint pain
- Fast heart rate
- Seeing or hearing things that aren't there
- Irritability (cranky mood)
- Stomach pain
- Poor appetite
Wakix (pitolisant) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Abnormal heart rhythm (QT prolongation): chest pounding, irregular heartbeat, chest pain, short of breath, feeling faint or lightheaded
The following Wakix (pitolisant) 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
- Heart rhythm changes—fast or irregular heartbeat, dizziness, feeling faint or lightheaded, chest pain, trouble breathing
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
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Pros and cons of Wakix (pitolisant)
Pros
- Lowers how many cataplexy attacks you get per week
- A narcolepsy treatment that's not a controlled substance
- Only need to take it once a day
Cons
- Not the best medication if you have liver or kidney problems
- Might need to take more than one tablet for your dose
- Can take a couple months to see the full effects of this medication
Pharmacist tips for Wakix (pitolisant)
- Wakix (pitolisant) comes in two different tablet strengths: 4.45 mg and 17.8 mg. Depending on your dose, you might need to take more than one tablet at a time. Talk with your prescriber or pharmacist if you're unsure about how many tablets you need to take for each dose.
- Take Wakix (pitolisant) in the morning when you first wake up, with or without breakfast. Food doesn't affect the way the medication works.
- If you wake up and forget to take your Wakix (pitolisant) dose, it's recommended that you skip that dose. Take your next dose the following morning when you wake up. Don't double up on missed doses because this can raise your risk of side effects.
- Before you start Wakix (pitolisant), make sure to tell your prescriber and pharmacist about all the medications you take. And once you start treatment, tell them about any new medications you plan to take. Wakix (pitolisant) interacts with a lot of common medications, including antihistamines, heart medications like amiodarone (Pacerone), and sertraline (Zoloft). Some medications can either make Wakix (pitolisant) work less well or raise your risk of side effects.
- Wakix (pitolisant) can make hormonal birth control not work as well. Using a nonhormonal form of birth control (like condoms or spermicide) during treatment and for at least 3 weeks after stopping the medication if you use birth control.
Common questions about Wakix (pitolisant)
No, Wakix (pitolisant) isn't a controlled substance. This medication doesn't have a risk of addiction or dependence.
In clinical studies that lasted 2 months, people who took Wakix (pitolisant) for excessive daytime sleepiness reported that they were less likely to fall asleep while they were going about their daily lives. People who took Wakix (pitolisant) for cataplexy reported that they had half as many cataplexy attacks per week. Make sure to follow up with your provider to discuss how well Wakix (pitolisant) is working for you.
It takes about 2 to 3 weeks for Wakix (pitolisant) to start working. But it can take a couple months to get the full effect of the medication.
No, Wakix (pitolisant) isn't a stimulant medication. Both Wakix (pitolisant) and stimulants can be used for narcolepsy to keep you awake, but they work in different ways. Stimulants, such as methylphenidate and Adderall (dextroamphetamine / amphetamine salts), are medications that work by raising the levels of dopamine and serotonin in your brain. But Wakix (pitolisant) is a histamine-3 (H3) receptor antagonist/inverse agonist that works by raising histamine levels in the brain.
Some people who took Wakix (pitolisant) noticed that they gained some weight during treatment. A small study reported that 6% of people gained weight during treatment; these people gained between 2% and 12% of their baseline body weight. To help manage your weight while you're taking Wakix (pitolisant), eat a variety of fruits and vegetables that you enjoy and get regular exercise. Contact your provider if you're concerned about any changes in weight that you've had while you're taking this medication. Your provider can recommend other tips to help manage your weight.
There isn't enough information available to know whether Wakix (pitolisant) is safe to take during pregnancy. Speak with your provider about the risks and benefits of taking this medication if you're pregnant. In animal studies, high doses of Wakix (pitolisant) caused harm to pregnant mothers and their unborn babies. But currently available data haven't shown that there's a clear risk of harm to babies if you take the medication during pregnancy. There's a pregnancy registry that you're encouraged to enroll in if you're taking Wakix (pitolisant) while pregnant. This registry is currently studying how safe Wakix (pitolisant) is for mothers and babies during pregnancy. Enroll in the pregnancy registry by calling 1-800-833-7460.
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Risks and warnings for Wakix (pitolisant)
Wakix (pitolisant) 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.
Life-threatening abnormal heart rhythm (QT prolongation)
- Risk factors: History of heart problems | Heart rhythm problem called long QT syndrome | Taking medications that can affect heart rhythm | Liver or kidney problems | Low potassium or low magnesium
In some people, Wakix (pitolisant) can cause heart rhythm changes called QT prolongation, which can be life-threatening. Avoid this medication if you have a history of heart problems or if you're taking other medications that cause changes in heart rhythm. In addition, having severe liver or kidney problems can lead to higher levels of Wakix (pitolisant) in the body, which can also raise your risk of having heart problems. Talk to your provider about your medical history, including your heart health and all the medications you take. Seek medical help immediately if you feel faint or have an irregular heartbeat while you're taking Wakix (pitolisant).
Wakix (pitolisant) dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 4.45mg | 14 tablets | $0.00 | $0.00 |
| 17.8mg | 60 tablets | $0.00 | $0.00 |
Typical dosage for Wakix (pitolisant)
You'll typically start Wakix (pitolisant) at a lower dose, and the dose will be slowly increased over time.
Adults:
- Week 1: The typical starting dose is 8.9 mg by mouth once a day in the morning.
- Week 2: Your prescriber will raise the dose to 17.8 mg by mouth once a day in the morning.
- Week 3: If needed, your prescriber might raise your dose to a maximum of 35.6 mg once a day in the morning.
Children:
- Week 1: The typical starting dose is 4.45 mg by mouth once a day in the morning.
- Week 2: Your child's pediatrician will raise the dose to 8.9 mg by mouth once a day in the morning.
- Week 3: Your child's pediatrician will raise the dose to 17.8 mg by mouth once a day in the morning.
- Week 4: For those who weigh 40 kg (88 lbs) or more, if needed, your child's pediatrician might raise the dose to a maximum of 35.6 mg once a day in the morning.
Your dose might differ if you have kidney or liver problems, if you're taking a medication that interacts with Wakix (pitolisant), or if you have certain genetics that affects how well your body gets rid of Wakix (pitolisant).
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Wakix (pitolisant) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Wakix (pitolisant) will not be safe for you to take.
- Severe liver problems
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