Lemborexant: Difference between revisions

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 {{MedTemplate
-| generic            = Lemborexant
+| brand           = Dayvigo
-| brand              = Dayvigo
+| classes         = Dual orexin receptor antagonist (DORA)
-| structure          =
+| mechanism       = Competitive antagonist at OX1R and OX2R. Faster receptor association/dissociation kinetics than suvorexant (~16 sec dissociation vs ~57 sec) hypothesized to support sleep onset, with sufficient duration for maintenance.
-| classes            = Sedative-Hypnotic
+| uses            = Insomnia (sleep onset and/or maintenance) in adults (FDA-approved Dec 2019)
-| mechanism          = Dual orexin receptor antagonist
+| starting_dose   = 5 mg PO at bedtime; may increase to 10 mg if inadequate
-| uses               =
+| preparations    = 5 mg, 10 mg tablets
-| starting_dose      =
+| fda_max         = 10 mg/d
-| preparations       =
+| routes          = Oral
-| routes             =
+| onset           = ~30 min
-| onset              =
+| duration        = ~7-8 hours
-| duration           =
+| halflife        = ~17-19 hours (longer than daridorexant)
-| halflife           =
+| bioavailability = ~44%
-| bioavailability    =
+| pregnancy       = Limited data; avoid
-| pregnancy          =
+| legal           = Rx, Schedule IV (US)
-| legal              =
+| intro           = '''Lemborexant''' (brand name Dayvigo) is a dual orexin receptor antagonist (DORA) FDA-approved in December 2019 for insomnia in adults. Among DORAs, lemborexant has faster receptor association/dissociation kinetics than suvorexant, which is hypothesized to facilitate sleep onset while still maintaining adequate duration of antagonism for sleep maintenance. The 17-19 hour half-life can produce some next-day residual sedation in sensitive individuals.
-| intro              =
-| pharmacokinetics   =
+DORAs broadly produce sleep that more closely resembles physiologic sleep architecture than GABAergic hypnotics, with reduced REM suppression. Side effect profile favorable compared to benzodiazepines, but sleep paralysis, sleep-related hallucinations, and complex sleep behaviors have been reported.
-| pharmacodynamics   =
+| pharmacodynamics= Competitive antagonism at OX1R (Ki ~6 nM) and OX2R (Ki ~3 nM). No clinically significant activity at other receptors.
-| indications        =
+| effects         = Somnolence (next-day), headache, nightmares, abnormal dreams, sleep paralysis, hallucinations near sleep onset. Complex sleep behaviors class warning.
-| dosing             =
+| interactions     = <pharmaInteractions/>
-| effects            =
-| contraindications  =
-| interactions       =
-| pregnancy_details  =
-| monitoring         =
-| counseling         =
-| anecdotes          =
-| seealso            =
-| references         =
 }}
-[[Category:Sedative-Hypnotics]]
+[[Category:Orexin Receptor Antagonists]]
+[[Category:Sedative-hypnotics]]
+[[Category:Hypnotics]]

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