Lemborexant
DAYVIGO
Dual Orexin Receptor AntagonistSchedule IVGeneric available
The mechanism of action of lemborexant in the treatment of insomnia is presumed to be through antagonism of orexin receptors. The orexin neuropeptide signaling system plays a role in wakefulness. Blocking the binding of wake-promoting neuropeptides orexin A and orexin B to receptors OX1R and OX2R is thought to suppress wake drive.
Compare Lemborexant →FDA-Approved Indications
- Insomnia — sleep-onset and/or sleep-maintenance difficulty (adults)
Common Off-Label Uses
- Insomnia in dementia/delirium (investigational)
What Sets This Drug Apart
- Second-generation DORA with longer half-life (~17-19h) than suvorexant (~12h); may provide better sleep maintenance coverage
- FDA-approved for insomnia with both sleep onset and sleep maintenance difficulties
- No dose adjustment for mild-to-moderate renal impairment; reduce to 5 mg in moderate hepatic impairment; avoid in severe
- CYP3A4 substrate; same DORA class advantages as suvorexant (no GABA activity, no respiratory depression)
- Lower abuse potential than benzodiazepines and z-drugs; Schedule IV