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Overview: Belsomra is used to treat insomnia, or trouble sleeping. The most common side effect of Belsomra is sleepiness. It can also cause you to feel drowsy or less alert the day after you take it. Do not drive or do other activities that require alertness or coordination within eight hours of taking Belsomra or until you feel fully awake.

Uses

What is Belsomra used for?

Belsomra (suvorexant) is commonly used to treat people who have trouble sleeping, which is called insomnia.

Belsomra may also be used for other conditions as determined by your health care provider.

How does Belsomra work (mechanism of action)?

Orexins are naturally occurring substances in the brain that promote wakefulness. Belsomra may block orexins from making connections in the brain. This blocks the wakeful effects of orexins and helps you sleep. 

How is Belsomra supplied (dosage forms)?

Dosage forms and strengths

  • 5 mg oral tablets
  • 10 mg oral tablets
  • 15 mg oral tablets
  • 20 mg oral tablets

How should I store Belsomra?

Belsomra should be stored at room temperature, between 68 F and 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place away from direct sunlight. Keep it in the original package until use. 

Side Effects

What are the most common side effects of Belsomra?

The most common side effect of Belsomra is sleepiness. Tell your health care provider if this side effect bothers you.

There may be other side effects of Belsomra that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of Belsomra?

While less common, the most serious side effects of Belsomra are described below, along with what to do if they happen.

Severe Allergic Reactions. Belsomra may cause allergic reactions, which can be serious. Stop taking Belsomra and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Decreased Awareness and Alertness. Belsomra may cause sleepiness during the day. It may keep you from being able to drive safely or think clearly. The risk of these effects is higher if you take more than prescribed, do not sleep a full night after taking a dose, or if it is taken with alcohol or other medicines that can cause drowsiness. Make sure that you only take the amount that is prescribed for you. Take it in the evening within 30 minutes before going to bed and only when you have time for at least seven hours of rest. Do not drive or do other activities that require alertness or coordination within eight hours of taking Belsomra or until you feel fully awake.

Depression and Suicidal Thoughts or Actions. Belsomra may cause or worsen depression and cause suicidal thoughts or actions. If you are about to harm yourself, call 911 or call or text 988, the Suicide & Crisis Lifeline. Call your health care provider right away if you have any of the following symptoms.

  • New or increased thoughts of suicide or death
  • Suicide attempt
  • New or increased feelings of anxiety, depression, or other unusual changes in mood or behavior

Complex Sleep Behaviors. Belsomra can cause complex sleep behaviors. These are activities that are done while not fully awake. Some examples are sleepwalking, sleep driving, preparing and eating food, making phone calls, and having sex. You usually do not remember these events, but they can be dangerous. Stop taking Belsomra right away and call your health care provider if you do any activities while not fully awake. 

Hallucinations or Temporary Inability to Move or Talk. Belsomra can cause sleep paralysis. This is the inability to move or talk for several minutes when falling asleep or waking up. It can also cause hallucinations when falling asleep or waking up, which can be intense or disturbing. Symptoms similar to mild cataplexy can also occur. This can include leg weakness that lasts for a few seconds or minutes. Call your health care provider right away if you have any of the following symptoms.

  • Inability to move or speak when falling asleep or waking up 
  • Seeing or hearing things that others do not see or hear (hallucinations)
  • Leg and/or muscle weakness

Warnings & Precautions

Who should not use Belsomra?

Allergies to Ingredients. People who are allergic to any of the following should not take Belsomra.

  • Belsomra
  • Suvorexant
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in Belsomra.

Narcolepsy. People who have been diagnosed with narcolepsy should not use Belsomra. Narcolepsy is a disorder that causes people to fall asleep at unexpected times. 

What should I know about Belsomra before using it?

Do not take Belsomra unless it has been prescribed to you by a health care provider. Take it as prescribed within 30 minutes before bedtime, when you have at least seven hours to sleep. You can take Belsomra with or without food, but it can take longer to work if you take it with or right after a meal. ​​

If you feel that Belsomra is not working after taking it for about seven to 10 days or if your sleep problems get worse, contact your health care provider. There may be another reason you are having trouble sleeping. Do not increase your dose of Belsomra without talking with your health care provider, even if you think it is not working.

Belsomra can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination within eight hours of taking Belsomra. You may be less alert and coordinated even the day after you take it. 

Do not share Belsomra with other people, even if they have the same condition as you. It may harm them. 

Keep Belsomra out of the reach of children. Belsomra is a controlled substance because it can be misused or lead to dependence. Store Belsomra in a safe place to protect it from theft. It is illegal to sell or give away this medicine.

People who are 65 and older may be at greater risk for falls due to drowsiness after taking Belsomra. Talk to your health care provider about your risks if you are in this age group.

What should I tell my health care provider before using Belsomra?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if Belsomra is right for you.

In particular, make sure that you discuss any of the following.

Pregnancy. It is not known if or how Belsomra could affect pregnancy or harm an unborn baby. Tell your health care provider if you are or plan to become pregnant.

Breastfeeding. Belsomra passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will advise you if you should take Belsomra while breastfeeding. If you breastfeed while taking Belsomra, monitor your baby for excessive sleepiness. Contact your health care provider if you notice this. 

Substance Use Disorder. Tell your health care provider if you have a history of a drug or alcohol disorder. Belsomra is a controlled substance and may be misused. 

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

  • Depression
  • History of suicidal thoughts or actions
  • Liver problems
  • Breathing problems, including obstructive sleep apnea or chronic obstructive pulmonary disease (COPD)
  • Problems with daytime sleepiness
  • History of sudden onset muscle weakness (cataplexy)

Other Medicines and Supplements. Belsomra may interact with other medicines and supplements. Before taking Belsomra, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

How can I get more information about Belsomra?

For more information about Belsomra, you can visit the manufacturer’s website at www.belsomra.com or call them at 800-444-2080.

Interactions

Does Belsomra interact with foods or drinks?

Grapefruit juice can interact with Belsomra, which can increase your risk for side effects. Talk to your health care provider if you drink grapefruit juice or plan to. 

Do not drink alcohol while taking Belsomra because it can increase the risk for drowsiness, including the next day, and other serious side effects.

Does Belsomra interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking Belsomra.

  • Fluconazole (Diflucan), itraconazole (Sporanox, Tolsura), ketoconazole, or posaconazole (Noxafil), which are used for fungal infections
  • Clarithromycin, ciprofloxacin, erythromycin (Ery-Tab and others), or rifampin, which are medicines used for bacterial infections
  • Atazanavir, fosamprenavir, nelfinavir (Viracept), or ritonavir (Norvir), which are used for HIV or AIDS
  • Nefazodone, which is a medicine used to treat depression
  • Aprepitant (Emend), which is a medicine used to prevent nausea and vomiting
  • Diltiazem (Cardizem CD and others) or verapamil (Verelan, Verelan PM), which are used for high blood pressure and other conditions
  • Imatinib (Gleevec), which is a medicine used for certain cancers
  • Carbamazepine or phenytoin, which are used for seizures 
  • Digoxin (Lanoxin), which is a medicine used to treat irregular heartbeat and some types of heart failure
  • A benzodiazepine, such as clonazepam (Klonopin), diazepam (Valium and others), or lorazepam (Ativan and others), which is a medicine used for anxiety, muscle spasms, or seizures
  • An opioid, such as codeine, fentanyl, oxycodone, or morphine, which is a medicine used for certain types of pain
  • A tricyclic antidepressant, such as amitriptyline, nortriptyline, or protriptyline, even if it is not used for depression
  • Any other medicine that causes dizziness and sleepiness, such as prescription pain medicines, sleep medicines, and medicines for anxiety
  • Any other medicine to treat insomnia, which is trouble sleeping

Some other medicines may alter the blood levels of Belsomra and vice versa. Tell your health care provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with Belsomra. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much Belsomra?

If you or someone else has used too much Belsomra, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of Belsomra?

If you miss a dose of Belsomra, do not take the missed dose later that night unless you have enough time to sleep a full night (at least seven hours) before getting out of bed. Do not take the missed dose the following day. Do not take double or extra doses.