Suvorexant interactions

Food & lifestyle

• alcohol

  Moderate

  Synergy

  Alcohol may potentiate some of the pharmacologic effects of suvorexant. Use in combination may result in additive central nervous system depression and/or impairment of judgment, thinking, and psychomotor skills. In addition, alcohol may increase the risk of cognitive and complex behavioral changes associated with the use of hypnotics including suvorexant, such as amnesia, anxiety, hallucinations, sleep-driving, and other neuropsychiatric symptoms.

  What to do: Concomitant use of suvorexant with alcohol should be avoided. Patients should be advised not to use suvorexant if they had alcohol that evening or before bed. Grapefruit juice should preferably be avoided; otherwise, the recommended dose of suvorexant is 5 mg when used with grapefruit juice and should not exceed 10 mg. Suvorexant may be taken with or without food; however, for faster sleep onset, suvorexant should not be administered with or soon after a meal.

  1 source

  1. "Product Information. Belsomra (suvorexant)." Merck & Co., Inc (2014):

Conditions

Conditions in which Suvorexant needs care, as documented in this source.

• Depressive Disorder

  Major

  A variety of abnormal thinking and behavior changes have been reported to occur in association with the use of most anxiolytics, sedatives and hypnotics. Some of these changes include decreased inhibition, aggressiveness, agitation, and hallucinations. These drugs can cause or exacerbate mental depression and cause suicidal behavior and ideation. Therapy with these drugs should be administered cautiously in patients with a history of depression or other psychiatric disorders. Patients should be monitored for any changes in mood or behavior. It may be prudent to refrain from dispensing large quantities of medication to these patients.

  14 sources

  1. "Product Information. Buspar (buspirone)." Bristol-Myers Squibb (2002):
  2. "Product Information. Ambien (zolpidem)." sanofi-aventis (2001):
  3. "Product Information. Placidyl (ethchlorvynol)." Abbott Pharmaceutical (2001):
  4. "Product Information. Aquachloral Supprettes (chloral hydrate)." Medisca Inc (2001):
  5. "Product Information. Equanil (meprobamate)." Wallace Laboratories (2001):
  6. "Product Information. Sonata (zaleplon)." Wyeth-Ayerst Laboratories (2001):
  7. "Product Information. Precedex (dexmedetomidine)." Abbott Pharmaceutical (2001):
  8. "Product Information. Xyrem (sodium oxybate)." Orphan Medical (2002):

  Show all 14 sourcesShow fewer sources

  9. "Product Information. Lunesta (eszopiclone)." Sepracor Inc (2004):
  10. "Product Information. Rozerem (ramelteon)." Takeda Pharmaceuticals America (2005):
  11. "Product Information. Silenor (doxepin)." Somaxon Pharmaceuticals (2010):
  12. "Product Information. Unisom (doxylamine)." Pfizer U.S. Pharmaceuticals Group (2013):
  13. "Product Information. Hetlioz (tasimelteon)." Vanda Pharmaceuticals Inc (2014):
  14. "Product Information. Belsomra (suvorexant)." Merck & Co., Inc (2014):

• Kidney Failure, Chronic

  Major

  Some anxiolytic, sedative and hypnotic drugs have not been studied in patients with severe renal impairment and should not be used on these patients.

  5 sources

  1. "Product Information. Buspar (buspirone)." Bristol-Myers Squibb (2002):
  2. "Product Information. Sonata (zaleplon)." Wyeth-Ayerst Laboratories (2001):
  3. "Product Information. Rozerem (ramelteon)." Takeda Pharmaceuticals America (2005):
  4. "Product Information. Hetlioz (tasimelteon)." Vanda Pharmaceuticals Inc (2014):
  5. "Product Information. Belsomra (suvorexant)." Merck & Co., Inc (2014):

• Lung Diseases

  Major

  Suvorexant has respiratory depressant effects and should be used with caution in patients with compromised respiratory function. Suvorexant has not been studied in patients with severe sleep apnea and severe COPD and should not be used in these patients.

  1 source

  1. "Product Information. Belsomra (suvorexant)." Merck & Co., Inc (2014):

• Narcolepsy

  Major

  The use of suvorexant is contraindicated in patient with narcolepsy.

  1 source

  1. "Product Information. Belsomra (suvorexant)." Merck & Co., Inc (2014):

• Glaucoma

  Moderate

  Some hypnotic drugs can have an anticholinergic effect and should be used with caution in patients with glaucoma, and trouble urinating due to retention or enlarged prostate.

  2 sources

  1. "Product Information. Benadryl (diphenhydramine)." Parke-Davis (2002):
  2. "Product Information. Unisom (doxylamine)." Pfizer U.S. Pharmaceuticals Group (2013):

• Liver Diseases

  Moderate

  In general, anxiolytics, sedatives and hypnotics are extensively metabolized by the liver. Their plasma clearance may be decreased and their half-life prolonged in patients with impaired hepatic function. Therapy with these drugs should be administered cautiously in patients with liver disease (some are not recommended in severe liver impairment), and the dosage should be adjusted accordingly. Laboratory testing is recommended prior and during treatment.

  13 sources

  1. "Product Information. Buspar (buspirone)." Bristol-Myers Squibb (2002):
  2. "Product Information. Placidyl (ethchlorvynol)." Abbott Pharmaceutical (2001):
  3. "Product Information. Aquachloral Supprettes (chloral hydrate)." Medisca Inc (2001):
  4. "Product Information. Equanil (meprobamate)." Wallace Laboratories (2001):
  5. "Product Information. Sonata (zaleplon)." Wyeth-Ayerst Laboratories (2001):
  6. "Product Information. Precedex (dexmedetomidine)." Abbott Pharmaceutical (2001):
  7. "Product Information. Xyrem (sodium oxybate)." Orphan Medical (2002):
  8. "Product Information. Lunesta (eszopiclone)." Sepracor Inc (2004):

  Show all 13 sourcesShow fewer sources

  9. "Product Information. Rozerem (ramelteon)." Takeda Pharmaceuticals America (2005):
  10. "Product Information. Silenor (doxepin)." Somaxon Pharmaceuticals (2010):
  11. "Product Information. Intermezzo (zolpidem)." Purdue Pharma LP (2011):
  12. "Product Information. Hetlioz (tasimelteon)." Vanda Pharmaceuticals Inc (2014):
  13. "Product Information. Belsomra (suvorexant)." Merck & Co., Inc (2014):

Therapeutic duplication

Drug classes that overlap with Suvorexant, so taking both doubles up the same effect. This source publishes no per-row citations for duplication.

• hypnotics

  The recommended maximum number of medicines in the 'hypnotics' category to be taken concurrently is usually one.Your list includes two medicines belonging to the 'hypnotics' category.

  Example product in the source data (US market): Xywav