Suvorexant

Suvorexant

Clinical data
Trade names	Belsomra
AHFS/Drugs.com	belsomra
MedlinePlus	a614046
Pregnancy category	US: C (Risk not ruled out)
Dependence liability	Moderate
Routes of administration	By mouth
ATC code	None
Legal status
Legal status	US: Schedule IV
Pharmacokinetic data
Bioavailability	82% (at 10 mg)
Protein binding	>99%
Metabolism	hepatic, CYP3A, CYP2C19
Biological half-life	~12 hours
Excretion	Feces (66%), urine (23%)
Identifiers
IUPAC name [(7R)-4-(5-chloro-1,3-benzoxazol-2-yl)-7-methyl-1,4-diazepan-1-yl][5-methyl-2-(2H-1,2,3-triazol-2-yl)phenyl]methanone
Synonyms	MK-4305
CAS Number	1030377-33-3 N
PubChem (CID)	24965990
IUPHAR/BPS	2890
ChemSpider	4589156 N
UNII	081L192FO9 N
ChEMBL	CHEMBL1083659 N
ECHA InfoCard	100.210.546
Chemical and physical data
Formula	C23H23ClN6O2
Molar mass	450.92 g/mol
3D model (Jmol)	Interactive image
SMILES C[C@@H]1CCN(CCN1C(=O)C2=C(C=CC(=C2)C)N3N=CC=N3)C4=NC5=C(O4)C=CC(=C5)Cl
InChI InChI=1S/C23H23ClN6O2/c1-15-3-5-20(30-25-8-9-26-30)18(13-15)22(31)29-12-11-28(10-7-16(29)2)23-27-19-14-17(24)4-6-21(19)32-23/h3-6,8-9,13-14,16H,7,10-12H2,1-2H3/t16-/m1/s1 N Key:JYTNQNCOQXFQPK-MRXNPFEDSA-N N
NY (what is this?)

Suvorexant, sold under the trade name Belsomra, is a medication for the treatment of insomnia. It is effective for insomnia, at least for four weeks and as compared to a placebo.

Suvorexant is a selective, dual orexin receptor antagonist made by Merck & Co. It was approved for sale by the U.S. Food and Drug Administration (FDA) on August 13, 2014. The U.S. Drug Enforcement Administration (DEA) has placed it on the list of schedule IV controlled substances, as it may lead to limited physical dependence or psychological dependence relative to the drugs or other substances in schedule III. The potential for psychological dependence is similar to that of zolpidem. The drug became available in Japan in November 2014 and in the United States in February 2015.

Suvorexant is used for the treatment of insomnia, characterized by difficulties with sleep onset and/or sleep maintenance.

It is unclear how this medication compares to others used for insomnia as no comparisons have been done. It is also unclear if this medication is safe among people with a history of addiction, as they were excluded from the clinical trials of suvorexant.

The most common complaint about the drug is from users who report that it did not help them to sleep. Some people reported that the drug caused a sleep disturbance such as a nightmare, sleep terror, or abnormal dream. Others reported that the drug caused them to be more awake.

Issues include sleepiness the next day and issues with driving. Other concerns include thoughts of suicide.