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Medicines > generic: None & fda max : 160 mg/d (Zollinger-Ellison); 80 mg/d for routine indications or 20 mg/d

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generic: (Click arrow to add another value)
brand:
Belsomra (1) · Trintellix (US), Brintellix (formerly) (1)
classes:
Dual orexin receptor antagonist (DORA) (1) · Multimodal antidepressant: SERT inhibitor + 5HT1A agonist + 5HT1B partial agonist + 5HT3/5HT7 antagonist (1) · the first approved (1)
mechanism:
None (1) · Competitive antagonist at OX1R and OX2R. First-in-class DORA. Receptor dissociation slower than lemborexant or daridorexant. (1)
uses:
Insomnia (sleep onset and/or maintenance) in adults (FDA-approved August 2014). Also studied for insomnia in mild-moderate Alzheimer disease. (1) · Major depressive disorder in adults (FDA-approved 2013). Notable for evidence of cognitive benefit (processing speed) that distinguishes it from other antidepressants. (1)
starting dose:
10 mg PO 30 min before bedtime (with ≥7 hours of sleep planned) (1) · 10 mg PO once daily; may increase to 20 mg as tolerated, or decrease to 5 mg if needed (1)
preparations:
5 mg, 10 mg, 15 mg, 20 mg tablets (1) · 5 mg, 10 mg, 20 mg tablets (1)
fda max: (Click arrow to add another value)
routes:
Oral (2)
onset:
Typical antidepressant 4-6 week onset (1) · ~30 min (1)
duration:
Daily dosing (1) · ~7-8 hours (1)
halflife:
~12 hours (1) · ~66 hours (1)
bioavailability:
~75% (1) · ~82% (1)
pregnancy:
Limited data; avoid (1) · Limited data; weigh benefits/risks (1)
legal:
Rx (1) · Rx, Schedule IV (US) (1)

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