Names and pronunciation
(lem-boe-rex′ant) Dayvigo
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Drug reference
(lem-boe-rex′ant) Dayvigo
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Func. class.: Hypnotic
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Chem. class.: Orexin receptor Controlled substance schedule IV
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ACTION: Competitive antagonism of orexin recep- tors that are responsible for wakefulness
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USES: Insomnia
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CONTRAINDICATIONS: Hyper- sensitivity, narcolepsy Precautions: Substance abuse, breast- feeding, pregnancy, depression, suicidal ideation, elderly, sleep apnea, COPD
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SIDE EFFECTS CNS: Fatigue, headache, nightmares, hallu cinations, sleep paralysis, suicidal ideation
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INTERACTIONS Increase: CNS depression—other CNS depressants Increase: lemborexant level: CYP3A4 inhibitors Decrease: lemborexant level: CYP3A4 inducers Decrease: effect of—CYP2B6 substrates
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DOSAGE AND ROUTES Insomnia with sleep onset and/or sleep maintenance difficulties: • Adults: PO 5 mg nightly immediately before going to bed, with at least 7 hr remaining before the planned time of awakening. The dose may be increased to the 10 mg max if needed
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Available forms: Tabs 5, 10 mg
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Administer: • Give immediately before going to bed, with at least 7 hr remaining before the planned time of awakening • Do not use >10 mg per night
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Assess: • Mental status: reason for medica- tion, type of sleep problem, trouble fall- ing asleep, staying asleep, complex sleep- related behaviors, sleep paralysis, suicidal ideation, depression
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Evaluate: • Therapeutic response: Ability to sleep throughout the night
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CLINICAL CONSIDERATIONS
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Patient and caregiver information: • Suicidal ideation: have patient report immediately • To report complex sleep disorders, sleep paralysis, hallucinations, night- mares • To avoid other CNS depressants • Not to take others, medication, herbs L without discussing with prescriber • Pregnancy/breastfeeding: to notify prescriber if pregnancy is planned or suspected or if breastfeeding HIGH ALERT
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PHARMACOKINETICS Peak 1-3 hr, half-life 17-19 hr, protein binding 94%
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• Adults: PO 5 mg nightly immediately before going to bed, with at least 7 hr remaining before the planned time of awakening. The dose may be increased to the 10 mg max if needed
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