Is Quviviq safer than Ambien?

Quviviq (daridorexant) and Ambien (zolpidem tartrate) are both brand-name medications approved by the U.S. Food and Drug Administration (FDA) to treat insomnia. Insomnia is a common sleep disorder that is defined as continuing difficulty in sleep onset (falling asleep), or sleep maintenance (staying asleep), which can leave you tired or sleepy the next day.

Quviviq and Ambien belong to 2 separate medication classes that work differently in to treat insomnia. Quviviq contains daridorexant, which is a dual orexin receptor antagonist (DORA). Ambien contains the active ingredient zolpidem tartrate, a non-benzodiazepine hypnotic medication that works like a gamma-aminobutyric acid (GABA) agonist.

Quviviq and Ambien are both generally well-tolerated and effective when taken as prescribed by your healthcare provider. However, each medication may cause some side effects. Some common side effects of Ambien and Quviviq and Ambien include headache, drowsiness, daytime sleepiness, nausea, and dizziness. Also, they have both been thought to cause complex sleep behaviors. These are activities such as sleepwalking or eating, driving, or having sex while you are asleep. Typically, you will not remember doing them.

In general, more side effects have been reported in clinical trials with Ambien than Quviviq. In addition to the side effects above Ambien may cause dry mouth, back pain, sinusitis (inflammation of your sinuses), sore throat, diarrhea, flu-like symptoms, constipation, and stomach pain. And while both medications are controlled substances because they have some potential for misuse and abuse, the risks are higher with Ambien. Withdrawal symptoms can occur if you suddenly stop taking Ambien, but this does not appear to be a concern with Quviviq. Because of this, Ambien should be used for short-term treatment of insomnia, while Quviviq may be used long-term.

As with all medications, your results and how well you tolerate these medications will vary. Keep reading as we go into depth about how these 2 sleep medications compare in regards to side effects, drug interactions, effectiveness, and other important information.

Quviviq vs. Ambien

How they work

Ambien contains zolpidem tartrate. It is considered a sedative-hypnotic medication that works on proteins in your brain called gamma-aminobutyric acid (GABA) A receptors. This causes your brain to slow down, which makes it an effective sleep aid that helps you fall asleep faster.

Quviviq’s active ingredient is daridorexant, which is a dual orexin receptor antagonist (DORA). DORAs block a chemical in your brain called orexin that promotes wakefulness. By blocking orexin, it can no longer signal your brain to stay awake, allowing you to fall asleep.

Effectiveness

Ambien and Quviviq are both FDA-approved to treat insomnia in adults. There have not been any clinical studies that directly compared these 2 medications. However, both medications were found to be more effective than placebo, according to the results of clinical trials. Your healthcare provider will determine which medication is better for you depending on several factors such as your response, cost, if your insurance plan covers the medication, side effects, other health conditions, and possible drug interactions.

Side effects

Some common side effects of Quviviq and Ambien include:

  • Headache
  • Fatigue or drowsiness
  • Daytime drowsiness
  • Nausea
  • Dizziness

Some other potential side effects seen with Ambien include:

  • Dry mouth
  • Back pain
  • Flu-like symptoms
  • Lightheadedness
  • Chest pain
  • Strange dreams
  • Amnesia
  • Stomach pain
  • Sinus infection
  • Constipation
  • Sore throat

Ambien and Quviviq may also rarely cause serious side effects such as:

Ambien:

  • Central nervous system (CNS) depression
  • Complex sleep behaviors
  • Severe allergic reaction
  • Behavior changes or worsening depression
  • Suicidal thoughts or behaviors

Quviviq:

  • Central nervous system (CNS) depression
  • Complex sleep behaviors
  • Severe allergic reaction
  • Sleep paralysis
  • Hallucinations

Disclaimer: These are not all of the possible side effects of Quviviq or Ambien. Contact your healthcare professional for medical advice about any possible adverse effects you experience while taking one of these medications. You should also read the full Prescribing Information and Medication Guide that comes with your prescription each time it is filled. You can report your adverse effects to the FDA at www.fda.gov/medwatch or call 1-800-FDA-1088.

Warnings and precautions

Quviviq:

Do not take if you have narcolepsy or are allergic to daridorexant or any inactive ingredients. Inform your provider if you have:

  • History of depression or suicidal thoughts
  • History of substance abuse
  • History of cataplexy
  • History of sleep disorders
  • Breathing problems such as sleep apnea or COPD
  • Liver problems
  • Are pregnant or breastfeeding

Ambien:

Do not take if you’ve experienced abnormal sleep behaviors after use or are allergic to zolpidem or any inactive ingredients. Inform your provider if you have:

  • History of depression or suicidal thoughts
  • History of drug or alcohol abuse
  • Kidney or liver disease
  • Breathing issues like sleep apnea or COPD
  • Are pregnant or breastfeeding

Drug interactions

Taking either medication with other substances may increase side effect risks or alter effectiveness.

Quviviq:

  • Other insomnia medications
  • HIV protease inhibitors (e.g., indinavir)
  • Benzodiazepines (e.g., alprazolam, lorazepam)
  • Opioids
  • Antifungals (e.g., ketoconazole)
  • Antibiotics (e.g., rifampin, ciprofloxacin)
  • Seizure medications
  • Muscle relaxants
  • Antidepressants
  • Herbal supplements
  • Alcohol

Ambien:

  • Alcohol
  • Other sedatives (cold meds, painkillers, anxiety meds)
  • Chlorpromazine
  • Antifungals (e.g., ketoconazole)
  • Rifampin
  • Certain antidepressants

How they are taken

Quviviq:

Available in 25 mg and 50 mg tablets. Take within 30 minutes before bed. Only take if you can sleep at least 7 hours. May take longer to work with food. Contact your provider if insomnia continues after 7–10 days.

Ambien:

Available in 5 mg and 10 mg immediate-release, and 6.25 mg and 12.5 mg extended-release (Ambien CR). Take right before bed and only if planning to sleep 7–8 hours. May take longer to work with food. Contact your provider if insomnia persists.

Related Medications

  • Ambien CR (zolpidem extended-release)
  • Dayvigo (lemborexant)
  • Benadryl (diphenhydramine)
  • Melatonin
  • Lunesta (eszopiclone)
  • Belsomra (suvorexant)

Sources

  • Quviviq – daridorexant tablet, film coated [package insert]. Idorsia Pharmaceuticals Ltd. (2023). Accessed July 5, 2024.
  • Mignot, E., et al. (2022). Safety and efficacy of daridorexant in patients with insomnia disorder. The Lancet. Accessed July 5, 2024.
  • Quviviq (daridorexant). Medscape. Accessed July 5, 2024.
  • Sateia (2017). Clinical practice guidelines for the pharmacologic treatment of chronic insomnia in adults. Accessed July 5, 2024.
  • Ambien (zolpidem tartrate) Prescribing Information. FDA. Accessed July 5, 2024.
  • Zolpidem (Rx). Medscape. Accessed July 5, 2024.