Daridorexant (Brand name QuviviQ) for Insomnia
Daridorexant (Brand name QuviviQ) is a sleep medication that is non-habit forming and increased sleep duration by an average of one hour per night with minimal hangover the following AM for most patients. The side effect profile was very favorable and was very similar to taking sugar pill (placebo). See below for more on dosing and the pharmacy it is sent from, directly to your home.
Dosing
- 50mg dose is most effective but 25mg is sometimes used in patients with liver damage.
- It is taken 30 mins prior to bed with or without food
- Make sure to give 7 hours prior to waking preferred
- Approved for ages 18 and over
- Official Dx: Insomnia
- Mechanism: It is a dual Orexin Antagonist in Hypothalamus — disrupts wake drive similar to but slightly different Belsomra & Dayvigo
- “3rd to market” — this one is shorter acting so less sedation the next day
- 1/2 life of 8 hours
Safety
- Contraindicated in patients narcolepsy
- “Comparable to placebo” across 25 & 50mg doses
- No evidence of dependence OR rebound insomnia
- Headaches 7%
- Fall rates same as placebo — had patients > 80 on it
- Dizziness 3%
- Watch for SI (standard precaution in this class)
Benefits
- Decreased to 30 mins time to fall asleep
- Picks up an extra hour of sleep on average
- Next day level of functioning did improve compared to placebo
When to use lower dose?
- Patients with liver damage
- On moderate vs strong inhibitors of CYP3A4 (Erthyromycin, fluconazole, diltiazem, verapamil, clarithromycin, itrazconazole)
- May be less effective because a patient is on these meds that increase CYP3A4?
- Efavirenz, Phenytoin, rifampin
Coverage / Costs
- Use Vitacare 877-478-8484 951 Yamato Rd Suite 160, Boca Raton FL 33431. NCPDP #5728045
- They will work with your insurance to do a prior authorization and make sure It is never over $25/month. The first 30 days is free.
