Does Quviviq work?

If you have insomnia, you may have trouble falling asleep or getting a full night’s rest. Sleeping problems can lead to difficulties functioning during the daytime and have unpleasant effects on your work, social, and family life. The good news is there are a number of sleep medications that your healthcare provider can recommend or prescribe. One of these medications is Quviviq (daridorexant) from Idorsia Pharmaceuticals. It is a newer drug that belongs to a class of medications called dual orexin receptor antagonists (DORAs). Quviviq is an effective insomnia treatment that works differently from other treatment options such as Ambien (zolpidem). It blocks chemical messengers in your brain that promote wakefulness.

But is it effective? In clinical studies, people reported sleeping better after 1 week of taking Quviviq every night, with improvements continuing to increase over 3 to 4 weeks. In these studies, they were able to fall asleep about 30 minutes faster after taking Quviviq for a month. They also stayed asleep about 20 to 30 minutes longer after falling asleep and slept a total of 35 to 45 minutes longer when compared to their baseline. The effectiveness of Quviviq is based on the dose. The 50 mg dose generally had a greater effect on sleep than the 25 mg dose. People also reported reduced daytime sleepiness when compared with placebo. This was seen after 1 week and continued to improve over time. The results reported after 1 month continued until month 3 in these studies.

Quviviq is effective in helping you get better sleep and it is generally well tolerated. While it is Schedule IV controlled substance, no evidence of physical dependence or withdrawal symptoms after stopping it over the course of a year. There was also no rebound insomnia when people came off of Quviviq. It should be noted that if you have a history of abuse or addiction to alcohol or other drugs, you may be at increased risk for abuse and addiction to this medication.

What is the mechanism of action for Quviviq in treating insomnia?

Quviviq is a dual orexin receptor antagonist (DORA) that works by blocking the actions of orexin, which is a chemical that signals your brain to stay awake. By turning down these overactive wake signals, this medication help you fall asleep sooner and stay asleep longer.

What are the possible side effects of Quviviq?

The most common side effects of Quviviq that were seen in clinical trials include:

  • Headache
  • Drowsiness or fatigue

Some other side effects that may occur include:

  • Dizziness
  • Nausea

Rarely, Quviviq may cause some more serious side effects such as:

  • Serious, life-threatening allergic reactions. Seek immediate medical attention if you experience hives, swelling of your tongue, face, or throat, or trouble breathing.
  • Complex sleep behaviors, such as sleepwalking, sleep-eating, sleep-driving, making phone calls, or having sex while asleep.
  • Daytime sleepiness. This includes excessive sleepiness, decreased alertness, and slower reaction times.
  • Suicidal thoughts and behaviors or worsening depression. Call your healthcare provider if you experience these symptoms.
  • Hallucinations, sleep paralysis, and cataplexy-like symptoms. Contact your provider if these occur.
  • Breathing problems, especially in those with COPD or sleep apnea.

These are not all of the possible side effects of Quviviq. Contact your healthcare professional for medical advice about any possible adverse effects you experience while taking this medication. You can report your adverse effects to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

Are there any drug interactions with Quviviq?

When you take Quviviq with other medications, it can change how they work or make some side effects like CNS depression more likely or severe. You should ask your healthcare provider if any of the prescription drugs, over-the-counter (OTC) medications, vitamins, or supplements you take may interact with Quviviq, including:

  • Other medications used for insomnia such as Ambien (zolpidem)
  • Certain HIV protease inhibitors such as indinavir
  • Benzodiazepines such as alprazolam, diazepam, and lorazepam
  • Opioids such as hydrocodone and oxycodone
  • Certain antifungals such as itraconazole and ketoconazole
  • Certain antibiotics such as clarithromycin, ciprofloxacin, and rifampin
  • Seizure medications such as phenytoin and carbamazepine
  • Muscle relaxants such as cyclobenzaprine and baclofen
  • Certain antidepressants such as trazodone and amitriptyline
  • Herbal supplements such as St. John’s Wort, melatonin, and valerian
  • Alcohol

What should you tell your healthcare provider before starting Quviviq?

Before taking this medication, be sure your healthcare provider knows all of your other medical conditions, including:

  • A history of depression, mental illness, or suicidal thoughts or behaviors
  • A history of substance abuse or addiction
  • A history of cataplexy (sudden muscle weakness)
  • A history of a sleep disorder such as narcolepsy
  • Lung or breathing problems such as sleep apnea or COPD
  • Liver problems
  • Are pregnant or plan on becoming pregnant
  • Are breastfeeding or plan on breastfeeding

It is not known if this medication will harm your unborn baby.

There is a pregnancy registry if you take Quviviq while pregnant. It is used to collect information about the health of you and your baby. For more information or to register, call 1-833-400-9611.

Can Quviviq help with chronic insomnia?

Quviviq is one of a relatively new class of meds that have been developed for the treatment of insomnia. It works differently than many of the older insomnia treatments and has been shown to help you fall asleep faster at night and stay asleep longer. It is meant to be used as a long-term treatment if it is tolerated and works well for you.

What is the recommended dosage for Quviviq?

The typical dose of Quviviq is 25 mg to 50 mg by mouth once at night within 30 minutes of going to bed. You should only take it if you plan on getting at least 7 hours of sleep. If you sleep for less than 7 hours when taking Quviviq, you are at an increased risk of drowsiness, reduced alertness, and slowed reaction times the next day. Your dose of Quviviq will be 25 mg per night if you have certain liver problems or if you are also taking certain medications that can interact with Quviviq.

How long does it take Quviviq to start working?

Quviviq will start to work within 30 minutes of taking it. But Quviviq can take longer to start working if you take your dose with a high-fat, high-calorie meal or right after one. It is a medication that should be taken every night. Most people will begin falling asleep faster and stay asleep longer within the first week of starting Quviviq but it can take up to a month to see the full effects of this medication.

Is Quviviq better than Lunesta?

Both Quviviq and Lunesta are considered to be very effective in treating insomnia. When comparing the two medications, they are similar when it comes to effectiveness. They have some similar side effects such as headache, dizziness, and nausea. Lunesta may also cause side effects such as dry mouth and diarrhea. Talk with your healthcare provider to see if Lunesta or Quviviq may be better for you.

Related Medications

  • Ambien (zolpidem)
  • Sonata (Zaleplon)
  • Benadryl (diphenhydramine)
  • Melatonin
  • Lunesta (eszopiclone)
  • Belsomra (suvorexant)

Sources

  • Quviviq – daridorexant tablet, film coated [package insert]. Idorsia Pharmaceuticals Ltd. (2023). Accessed July 2, 2024.
  • Kunz, D., et al. (2022). Long-term safety and tolerability of daridorexant in patients with insomnia disorder. CNS Drugs. Accessed July 2, 2024.
  • Mignot, E., et al. (2022). Safety and efficacy of daridorexant in patients with insomnia disorder: Results from two multicentre, randomised, double-blind, placebo-controlled, Phase 3 trials. The Lancet. Accessed July 2, 2024.
  • Muehlan, C., et al. (2023). The orexin story and orexin receptor antagonists for the treatment of insomnia. Journal of Sleep Research. Accessed July 2, 2024.
  • Quviviq (daridorexant). Medscape. Accessed July 2, 2024.
  • Kaur H, et al. (2023). Chronic insomnia. Accessed July 2, 2024.