Drilldown: Medicines

None (4)

Aduhelm (1) · Belsomra (1) · Dayvigo (1) · Quviviq (1)

Anti-amyloid beta (Aβ) monoclonal antibody (1) · Dual orexin receptor antagonist (DORA) (3) · the first approved (1)

None (1) · 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. (1) · Competitive antagonist at OX1R and OX2R. First-in-class DORA. Receptor dissociation slower than lemborexant or daridorexant. (1) · Human IgG1 monoclonal antibody targeting aggregated forms of amyloid-β (Aβ), soluble oligomers and insoluble fibrils. Reduces Aβ plaque burden on PET imaging via Fc-mediated microglial clearance. Whether plaque reduction translates to clinical benefit is the core controversy. (1)

Alzheimer disease (FDA accelerated approval June 2021; '''withdrawn from market January 2024''' by manufacturer Biogen). At time of approval indicated for MCI or mild dementia stage of AD. (1) · Insomnia (sleep onset and/or maintenance) in adults (FDA-approved August 2014). Also studied for insomnia in mild-moderate Alzheimer disease. (1) · Insomnia (sleep onset and/or maintenance) in adults (FDA-approved Dec 2019) (1) · Insomnia (sleep onset and/or sleep maintenance) in adults (FDA-approved Jan 2022) (1)

10 mg PO 30 min before bedtime (with ≥7 hours of sleep planned) (1) · 25 mg PO at bedtime (no titration); may increase to 50 mg if 25 mg inadequate (1) · 5 mg PO at bedtime; may increase to 10 mg if inadequate (1) · Was 1 mg/kg IV q4w × 2, then 3 mg/kg × 2, then 6 mg/kg × 2, then 10 mg/kg q4w (1)

25 mg, 50 mg tablets (1) · 5 mg, 10 mg tablets (1) · 5 mg, 10 mg, 15 mg, 20 mg tablets (1) · Was: 170 mg/1.7 mL, 300 mg/3 mL vials for IV infusion (1)

10 mg/d (1) · 20 mg/d (1) · 50 mg/d (1) · Withdrawn 2024 (1)

IV infusion every 4 weeks (1) · Oral (3)

PET Aβ reduction over months (1) · ~30 min (3)

None · 24 hours · 4-6 hours · 12 hours · 6-8 hours · Daily dosing · 8-12 hours · 12-24 hours · Hours · Hours per application · 24 hours (HS dosing) · 24 hours (once-daily dosing) · 24 h · N/A · N/A (replacement) · Variable · ~7-8 hours · 3-5 hours · 4-6 hours (IR); 24 hours (ER) · 6-12 hours

Other values:

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~12 hours (1) · ~17-19 hours (longer than daridorexant) (1) · ~25 days (1) · ~8 hours (shorter than suvorexant and lemborexant) (1)

100% (IV) (1) · ~44% (1) · ~62% (1) · ~82% (1)

Discontinued/withdrawn (1) · Limited data; avoid (3)

Rx, Schedule IV (US) (3) · Withdrawn from US market January 2024 (1)