Dayvigo (lemborexant) is an orexin receptor antagonist that was approved by the U.S. FDA in 2019 for the treatment of insomnia in adults. As a novel sleep-aid medication, it exerts its therapeutic effect on insomnia by blocking the orexin neuropeptide signaling system to suppress the wakefulness drive.

Dosage and Administration of Dayvigo (Lemborexant)

Standard Recommended Dosage

The standard recommended dosage of lemborexant is 5 mg, taken at most once per night. It should be administered immediately before going to bed, and it is necessary to ensure that there are at least 7 hours of sleep time after taking the medication.

Depending on clinical response and tolerability, the dosage can be increased to the maximum recommended dosage of 10 mg once daily.

It is important to note that if the medication is taken with a meal or shortly after a meal, the time to fall asleep may be delayed.

Administration Time Requirements

Patients must only take this medication when they can ensure a full night's sleep (at least 7 hours).

The principle of "taking immediately before bedtime" must be strictly followed when administering the medication to ensure that the drug exerts its maximum effect during sleep while minimizing residual effects the next day.

Dosage Adjustment of Dayvigo (Lemborexant)

Concomitant Use with CYP3A Inhibitors

Concomitant use of lemborexant with strong or moderate CYP3A inhibitors is contraindicated.

When co-administered with weak CYP3A inhibitors, the maximum recommended dosage is 5 mg, not exceeding once per night.

Concomitant Use with Alcohol

Alcohol consumption should be avoided during lemborexant treatment, as alcohol can enhance the medication's negative effects on postural stability and memory.

Use in Special Populations for Dayvigo (Lemborexant)

Geriatric Patients

In studies involving geriatric patients aged 65 years and older, it was found that patients taking the 10 mg dosage had a higher incidence of somnolence (9.8%).

For patients over 65 years of age, caution should be exercised when using a dosage higher than 5 mg.

Considering that lemborexant may increase somnolence, geriatric patients, who have a higher risk of falls, require special attention.

Patients with Renal Impairment

No dosage adjustment is required for patients with mild, moderate, or severe renal impairment.

Patients with severe renal impairment may have increased drug exposure, which could lead to an elevated risk of somnolence.

Patients with Impaired Respiratory Function

If a patient has impaired respiratory function, the impact of lemborexant on respiratory function should be considered when prescribing the medication.

Although this drug has not been shown to increase apnea events or cause a decrease in oxygen saturation in patients with mild obstructive sleep apnea, the possibility of clinically significant respiratory effects cannot be excluded in patients with chronic obstructive pulmonary disease or moderate to severe obstructive sleep apnea.

Use During Lactation

There are no data available regarding the presence of lemborexant in human milk, its effects on breastfed infants, or its effects on milk production.

If the drug is present in animal milk, it is likely that the drug will also be present in human milk.

Infants exposed to lemborexant through breast milk should be monitored for excessive sedation.