Daridorexant - Revision history

MDElliottMD: Category taxonomy ship: retag Sedative-Hypnotics -> Sedative-hypnotics

2026-05-22T00:36:16Z

Category taxonomy ship: retag Sedative-Hypnotics -> Sedative-hypnotics

← Older revision		Revision as of 00:36, 22 May 2026
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	[[Category:Hypnotics]]		[[Category:Hypnotics]]
	[[Category:Orexin Receptor Antagonists]]		[[Category:Orexin Receptor Antagonists]]
	[[Category:Sedative-~~Hypnotics~~]]		[[Category:Sedative-hypnotics]]
	[[Category:GABAergics]]		[[Category:GABAergics]]

MDElliottMD: Tier 2 taxonomy consolidation: add Category:Sedative-Hypnotics; remove retired Category:Anxiolytics & Sedative-Hypnotics

2026-05-21T17:44:46Z

Tier 2 taxonomy consolidation: add Category:Sedative-Hypnotics; remove retired Category:Anxiolytics & Sedative-Hypnotics

← Older revision		Revision as of 17:44, 21 May 2026
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	[[Category:Hypnotics]]		[[Category:Hypnotics]]
	[[Category:Orexin Receptor Antagonists]]		[[Category:Orexin Receptor Antagonists]]
	[[Category:~~Anxiolytics &~~ Sedative-Hypnotics]]		[[Category:Sedative-Hypnotics]]
	[[Category:GABAergics]]		[[Category:GABAergics]]

MDElliottMD: Tier 1 taxonomy consolidation: Category:Orexin Antagonists to Category:Orexin Receptor Antagonists

2026-05-21T17:01:53Z

Tier 1 taxonomy consolidation: Category:Orexin Antagonists to Category:Orexin Receptor Antagonists

← Older revision		Revision as of 17:01, 21 May 2026
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	[[Category:Hypnotics]]		[[Category:Hypnotics]]
	[[Category:Orexin Antagonists]]		[[Category:Orexin Receptor Antagonists]]
	[[Category:Anxiolytics & Sedative-Hypnotics]]		[[Category:Anxiolytics & Sedative-Hypnotics]]
	[[Category:GABAergics]]		[[Category:GABAergics]]

MDElliottMD: Em-dash sweep: replace em-dash with comma per project rule; PendellsCorner verbatim quotes preserved.

2026-05-19T03:16:06Z

Em-dash sweep: replace em-dash with comma per project rule; PendellsCorner verbatim quotes preserved.

← Older revision		Revision as of 03:16, 19 May 2026
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	\| brand = Quviviq		\| brand = Quviviq
	\| classes = Dual orexin receptor antagonist (DORA)		\| classes = Dual orexin receptor antagonist (DORA)
	\| mechanism = Selective antagonist at both orexin (OX1R, OX2R) receptors. Orexin/hypocretin from lateral hypothalamus is a key wake-promoting neuropeptide; antagonizing its receptors reduces arousal and promotes sleep. Unlike GABAergic hypnotics (benzos, Z-medicines), DORAs do not enhance inhibitory tone — they reduce excitatory tone. Less effect on sleep architecture and possibly lower next-day impairment.		\| mechanism = Selective antagonist at both orexin (OX1R, OX2R) receptors. Orexin/hypocretin from lateral hypothalamus is a key wake-promoting neuropeptide; antagonizing its receptors reduces arousal and promotes sleep. Unlike GABAergic hypnotics (benzos, Z-medicines), DORAs do not enhance inhibitory tone, they reduce excitatory tone. Less effect on sleep architecture and possibly lower next-day impairment.
	\| uses = Insomnia (sleep onset and/or sleep maintenance) in adults (FDA-approved Jan 2022)		\| uses = Insomnia (sleep onset and/or sleep maintenance) in adults (FDA-approved Jan 2022)
	\| starting_dose = 25 mg PO at bedtime (no titration); may increase to 50 mg if 25 mg inadequate		\| starting_dose = 25 mg PO at bedtime (no titration); may increase to 50 mg if 25 mg inadequate
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	DORAs may be particularly useful when sleep maintenance (rather than just sleep onset) is the problem, since they reduce arousal across the night without enhancing GABA-mediated inhibition.		DORAs may be particularly useful when sleep maintenance (rather than just sleep onset) is the problem, since they reduce arousal across the night without enhancing GABA-mediated inhibition.
	\| pharmacodynamics= Selective dual antagonist at OX1R (Ki ~0.5 nM) and OX2R (Ki ~0.9 nM). No significant binding at other receptors. Minimal effect on REM/NREM sleep architecture.		\| pharmacodynamics= Selective dual antagonist at OX1R (Ki ~0.5 nM) and OX2R (Ki ~0.9 nM). No significant binding at other receptors. Minimal effect on REM/NREM sleep architecture.
	\| effects = Headache, somnolence (next-day), fatigue, dizziness, nausea. Sleep paralysis, hallucinations near sleep onset reported. Complex sleep behaviors (sleep-driving, etc.) — class warning. Lower next-day impairment than benzos/Z-medicines in trials.		\| effects = Headache, somnolence (next-day), fatigue, dizziness, nausea. Sleep paralysis, hallucinations near sleep onset reported. Complex sleep behaviors (sleep-driving, etc.), class warning. Lower next-day impairment than benzos/Z-medicines in trials.
	\| interactions = <pharmaInteractions/>		\| interactions = <pharmaInteractions/>
	}}		}}

Maintenance script: Terminology sweep: drug/medication → medicine

2026-05-16T02:27:27Z

Terminology sweep: drug/medication → medicine

← Older revision		Revision as of 02:27, 16 May 2026
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	\| brand = Quviviq		\| brand = Quviviq
	\| classes = Dual orexin receptor antagonist (DORA)		\| classes = Dual orexin receptor antagonist (DORA)
	\| mechanism = Selective antagonist at both orexin (OX1R, OX2R) receptors. Orexin/hypocretin from lateral hypothalamus is a key wake-promoting neuropeptide; antagonizing its receptors reduces arousal and promotes sleep. Unlike GABAergic hypnotics (benzos, Z-~~drugs~~), DORAs do not enhance inhibitory tone — they reduce excitatory tone. Less effect on sleep architecture and possibly lower next-day impairment.		\| mechanism = Selective antagonist at both orexin (OX1R, OX2R) receptors. Orexin/hypocretin from lateral hypothalamus is a key wake-promoting neuropeptide; antagonizing its receptors reduces arousal and promotes sleep. Unlike GABAergic hypnotics (benzos, Z-medicines), DORAs do not enhance inhibitory tone — they reduce excitatory tone. Less effect on sleep architecture and possibly lower next-day impairment.
	\| uses = Insomnia (sleep onset and/or sleep maintenance) in adults (FDA-approved Jan 2022)		\| uses = Insomnia (sleep onset and/or sleep maintenance) in adults (FDA-approved Jan 2022)
	\| starting_dose = 25 mg PO at bedtime (no titration); may increase to 50 mg if 25 mg inadequate		\| starting_dose = 25 mg PO at bedtime (no titration); may increase to 50 mg if 25 mg inadequate
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	DORAs may be particularly useful when sleep maintenance (rather than just sleep onset) is the problem, since they reduce arousal across the night without enhancing GABA-mediated inhibition.		DORAs may be particularly useful when sleep maintenance (rather than just sleep onset) is the problem, since they reduce arousal across the night without enhancing GABA-mediated inhibition.
	\| pharmacodynamics= Selective dual antagonist at OX1R (Ki ~0.5 nM) and OX2R (Ki ~0.9 nM). No significant binding at other receptors. Minimal effect on REM/NREM sleep architecture.		\| pharmacodynamics= Selective dual antagonist at OX1R (Ki ~0.5 nM) and OX2R (Ki ~0.9 nM). No significant binding at other receptors. Minimal effect on REM/NREM sleep architecture.
	\| effects = Headache, somnolence (next-day), fatigue, dizziness, nausea. Sleep paralysis, hallucinations near sleep onset reported. Complex sleep behaviors (sleep-driving, etc.) — class warning. Lower next-day impairment than benzos/Z-~~drugs~~ in trials.		\| effects = Headache, somnolence (next-day), fatigue, dizziness, nausea. Sleep paralysis, hallucinations near sleep onset reported. Complex sleep behaviors (sleep-driving, etc.) — class warning. Lower next-day impairment than benzos/Z-medicines in trials.
	\| interactions = <pharmaInteractions/>		\| interactions = <pharmaInteractions/>
	}}		}}

Maintenance script: Expand Daridorexant with Stahl-sourced detail (with skepticism)

2026-05-16T02:03:46Z

Expand Daridorexant with Stahl-sourced detail (with skepticism)

← Older revision		Revision as of 02:03, 16 May 2026
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	{{MedTemplate		{{MedTemplate
	\| brand = Quviviq		\| brand = Quviviq
	\| classes = DORA ~~(Dual Orexin Receptor Antagonist~~)~~, Hypnotic~~		\| classes = Dual orexin receptor antagonist (DORA)
	\| mechanism = Selective ~~dual~~ antagonist at OX1R ~~and~~ OX2R ~~orexin~~ receptors; reduces ~~wake drive without~~ GABAergic ~~effects~~		\| mechanism = Selective antagonist at both orexin (OX1R, OX2R) receptors. Orexin/hypocretin from lateral hypothalamus is a key wake-promoting neuropeptide; antagonizing its receptors reduces arousal and promotes sleep. Unlike GABAergic hypnotics (benzos, Z-drugs), DORAs do not enhance inhibitory tone — they reduce excitatory tone. Less effect on sleep architecture and possibly lower next-day impairment.
	\| uses = Insomnia (sleep onset and maintenance)		\| uses = Insomnia (sleep onset and/or sleep maintenance) in adults (FDA-approved Jan 2022)
	\| starting_dose = 25 mg PO at bedtime; may increase to 50 mg if ~~needed~~		\| starting_dose = 25 mg PO at bedtime (no titration); may increase to 50 mg if 25 mg inadequate
	\| preparations = 25 mg, 50 mg tablets		\| preparations = 25 mg, 50 mg tablets
	\| fda_max = 50 mg/d		\| fda_max = 50 mg/d
	\| routes = Oral		\| routes = Oral
	\| onset = ~30 min		\| onset = ~30 min
	\| duration = ~~~7–8 h~~		\| duration = ~7-8 hours
	\| halflife = ~8 h		\| halflife = ~8 hours (shorter than suvorexant and lemborexant)
	\| bioavailability = ~62%		\| bioavailability = ~62%
	\| pregnancy = Limited data; avoid		\| pregnancy = Limited data; avoid
	\| legal = Rx, Schedule IV (US)		\| legal = Rx, Schedule IV (US)
	\| intro = '''Daridorexant''' (brand name Quviviq) is a dual orexin receptor antagonist (DORA) approved ~~by the FDA~~ in 2022 for ~~adults with~~ insomnia ~~characterized by difficulties with~~ sleep onset and/or sleep ~~maintenance~~. ~~Unlike benzodiazepines or Z~~-~~drugs~~, ~~it does not enhance GABAergic transmission; instead it blocks the wake~~-~~promoting orexin~~/~~hypocretin system~~.		\| intro = '''Daridorexant''' (brand name Quviviq) is a dual orexin receptor antagonist (DORA) FDA-approved in January 2022 for insomnia. Among the three approved DORAs, daridorexant has the shortest half-life (~8 hours vs lemborexant ~17-19 h and suvorexant ~12 h), which may reduce next-day residual sedation. Mechanism: orexin/hypocretin neurons in the lateral hypothalamus drive arousal; blocking both OX1R and OX2R reduces wake-promoting signaling. The result is sleep that resembles normal physiologic sleep more closely than GABAergic hypnotics (less REM suppression, fewer abnormal sleep behaviors).

			DORAs may be particularly useful when sleep maintenance (rather than just sleep onset) is the problem, since they reduce arousal across the night without enhancing GABA-mediated inhibition.
			\| pharmacodynamics= Selective dual antagonist at OX1R (Ki ~0.5 nM) and OX2R (Ki ~0.9 nM). No significant binding at other receptors. Minimal effect on REM/NREM sleep architecture.
			\| effects = Headache, somnolence (next-day), fatigue, dizziness, nausea. Sleep paralysis, hallucinations near sleep onset reported. Complex sleep behaviors (sleep-driving, etc.) — class warning. Lower next-day impairment than benzos/Z-drugs in trials.
			\| interactions = <pharmaInteractions/>
	}}		}}

Maintenance script: Create Daridorexant page

2026-05-15T22:50:05Z

Create Daridorexant page

New page

{{MedTemplate
| brand = Quviviq
| classes = DORA (Dual Orexin Receptor Antagonist), Hypnotic
| mechanism = Selective dual antagonist at OX1R and OX2R orexin receptors; reduces wake drive without GABAergic effects
| uses = Insomnia (sleep onset and maintenance)
| starting_dose = 25 mg PO at bedtime; may increase to 50 mg if needed
| preparations = 25 mg, 50 mg tablets
| fda_max = 50 mg/d
| routes = Oral
| onset = ~30 min
| duration = ~7–8 h
| halflife = ~8 h
| bioavailability = ~62%
| pregnancy = Limited data; avoid
| legal = Rx, Schedule IV (US)
| intro = '''Daridorexant''' (brand name Quviviq) is a dual orexin receptor antagonist (DORA) approved by the FDA in 2022 for adults with insomnia characterized by difficulties with sleep onset and/or sleep maintenance. Unlike benzodiazepines or Z-drugs, it does not enhance GABAergic transmission; instead it blocks the wake-promoting orexin/hypocretin system.
}}

[[Category:Hypnotics]]
[[Category:Orexin Antagonists]]
[[Category:Anxiolytics & Sedative-Hypnotics]]
[[Category:GABAergics]]