daridorexant

Daridorexant is a prescription medication approved for the treatment of insomnia in adults. It is marketed under the brand name Quviviq and is recognized as a dual orexin receptor antagonist (DORA), a class of drugs that reduce wake-promoting signaling in the brain.

Mechanism of action for daridorexant involves blocking orexin A and orexin B peptides from activating the orexin receptors OX1 and OX2. By inhibiting these wake-promoting pathways, daridorexant helps promote sleep onset and improve sleep maintenance.

Indication and use are for adults with insomnia characterized by difficulties with sleep onset and/or sleep maintenance. In clinical practice, the goal is to reduce nocturnal wakefulness and improve overall sleep quality, with an emphasis on daytime functioning.

Administration and pharmacokinetics: daridorexant is taken orally, once per night, typically shortly before bedtime. It is available in 25 mg and 50 mg formulations, with dosing guided by physician assessment of efficacy and tolerability. The onset of action is usually within 30 to 60 minutes, and the drug has a half-life that supports nighttime sleep with the potential for limited next-day residual effects in many patients.

Safety and adverse effects: common adverse effects include somnolence, headache, nausea, and fatigue. Patients may experience daytime impairment or slowed reaction times if sleep is insufficient or if the dose is not well tolerated. Daridorexant can interact with drugs that inhibit or induce CYP3A enzymes, which may necessitate dose adjustments or avoidance of certain drug combinations. Caution is advised in certain populations, including individuals who are pregnant or breastfeeding, and in cases of significant liver impairment, where use has not been established.

See also: orexin receptor antagonists; insomnia pharmacotherapy.