Belsomra (suvorexant) is used to treat insomnia, to help if you fall asleep faster and stay asleep longer, so you have have a better nights sleep. Belsomra works on orexin receptors which plays a role in wakefulness, and helps regulate your sleep and wake cycle. Belsomra is a dual orexin receptor antagonists (DORAs).

Belsomra is a controlled substance, Schedule IV. Schedule IV controlled substances have a low potential for drug abuse and low risk of dependence. But some patients with a history of abuse or addiction may still be at an increased risk of abuse.

Belsomra is a tablet that you take half an hour before you go to bed.

Belsomra side effects

Common Belsomra side effects include strange dreams or drowsiness during the day after taking this medicine.

Serious Belsomra side effects

Get emergency medical help if you have signs of an allergic reaction to Belsomra: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Some people using this medicine have engaged in activity while not fully awake and later had no memory of it. This may include walking, driving, eating, having sex, or making phone calls. If this happens to you, call your doctor right away.

Call your doctor at once if you have:

• trouble moving or talking when you first wake up;
• a weak feeling in your legs;
• unusual thoughts or behavior;
• anxiety, agitation, depression;
• memory problems;
• confusion, hallucinations; or
• thoughts about hurting yourself.

You may be more likely to have side effects if you are overweight.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.

Warnings

Do not take more Belsomra than your doctor has prescribed.

You should not use Belsomra if you have narcolepsy.

Take Belsomra 30 minutes before bedtime. Never take this medicine if you do not have 7 hours to sleep before being active again.

Some people using this medicine have engaged in activity while not fully awake and later had no memory of it. If this happens to you, call your doctor right away.

Before taking this medicine

You should not use Belsomra if you are allergic to suvorexant, or if you have narcolepsy.

To make sure this medicine is safe for you, tell your doctor if you have ever had:

• depression, mental illness, or thoughts about suicide;
• drug or alcohol abuse or addiction;
• breathing problems, sleep apnea (breathing stops during sleep);
• liver disease;
• sudden muscle weakness;
• excessive sleepiness during normal waking hours; or
• if you have ever fallen asleep at unexpected times.

Tell your doctor if you are pregnant or breastfeeding.

Belsomra is not approved for use by anyone younger than 18 years old.

How should I take Belsomra?

Take Belsomra exactly as prescribed by your doctor. Follow the directions on your prescription label and read all medication guides. Never use this medicine in larger amounts, or for longer than prescribed. Tell your doctor if you feel an increased urge to use more of this medicine.

Belsomra may be habit-forming. Misuse can cause addiction, overdose, or death. Keep the medication in a place where others cannot get to it. Selling or giving away this medicine is against the law.

Take Belsomra only once per night, 30 minutes before bedtime.

You may take Belsomra with or without food. Avoid taking the medicine shortly after eating a meal, or the medicine may take longer to work.

Belsomra will make you fall asleep. Never take this medicine if you do not have 7 hours to sleep before being active again.

You may have trouble speaking or moving while you are falling asleep. It may take longer for you to wake up, speak, or move around when you wake up. You may feel like you are still dreaming for several minutes after waking.

Call your doctor if your insomnia symptoms do not improve, or if they get worse after using Belsomra for 7 to 10 nights in a row.

Store at room temperature away from moisture, heat, and light. Keep track of your medicine. You should be aware if anyone is using it improperly or without a prescription.

Dosing information

Usual Adult Dose for Insomnia:

10 mg orally once a day at bedtime
Maximum dose: 20 mg once a day

Comments:
-Take within 30 minutes of going to bed, with at least 7 hours remaining before the planned time of awakening.
-If 10 mg is well-tolerated but not effective, the dose can be increased.
-Time to effect may be delayed if taken with or soon after a meal.

Use: Insomnia characterized by difficulties with sleep onset and/or sleep maintenance.

What happens if I miss a dose?

Since Belsomra is taken only at bedtime if needed, you are not likely to miss a dose. Never take this medicine if you do not have 7 hours to sleep before being active again.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line .

What to avoid

For at least 8 hours after taking Belsomra, do not drive or do anything that requires you to be alert. Your reactions may be impaired.

Avoid drinking alcohol. Do not take Belsomra if you have consumed alcohol within a few hours before getting ready for sleep.

What other drugs will affect Belsomra?

Using Belsomra with other drugs that make you drowsy can worsen this effect. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures.

Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.

Ativan (lorazepam) belongs to a class of medications called benzodiazepines. It is thought that benzodiazepines work by enhancing the activity of certain neurotransmitters in the brain.

Ativan is used in adults and children at least 12 years old to treat anxiety disorders.

Ativan is also used to treat insomnia caused by anxiety or temporary situational stress.

Ativan is sometimes used to treat nausea and vomiting from cancer treatment and to control agitation caused by alcohol withdrawal.

Warnings

Ativan can slow or stop your breathing, especially if you have recently used an opioid medication, alcohol, or other drugs that can slow your breathing. These effects can be fatal.

MISUSE OF ATIVAN CAN CAUSE ADDICTION, OVERDOSE, OR DEATH. Keep this medicine where others cannot get to it.

Lorazepam may be habit-forming and should be used only by the person it was prescribed for. Ativan should never be shared with another person, especially someone who has a history of drug abuse or addiction.

Do not stop using Ativan without asking your doctor. You may have life-threatening withdrawal symptoms if you stop using the medicine suddenly after long-term use. Some withdrawal symptoms may last up to 12 months or longer.

Get medical help right away if you stop using Ativan and have symptoms such as: unusual muscle movements, being more active or talkative, sudden and severe changes in mood or behavior, confusion, hallucinations, seizures, or thoughts about suicide.

Do not use Ativan if you are pregnant. Lorazepam can cause birth defects or life-threatening withdrawal symptoms in a newborn.

You should not use this medicine if you have narrow-angle glaucoma, severe respiratory insufficiency, myasthenia gravis, or if you are allergic to Valium or a similar medicine.

Before taking this medicine

You should not use Ativan if you have:

• narrow-angle glaucoma; or
• a history of allergic reaction to any benzodiazepine (lorazepam, alprazolam, diazepam, Valium, Xanax, Versed, Klonopin, and others).

To make sure Ativan is safe for you, tell your doctor if you have ever had:

• asthma, chronic obstructive pulmonary disease (COPD), sleep apnea, or other breathing disorder;
• drug or alcohol addiction;
• depression, mental illness or psychosis, mood changes, or suicidal thoughts or actions;
• seizures;
• an allergy to aspirin or yellow food dye; or
• kidney or liver disease.

Tell your doctor if you are pregnant or plan to become pregnant. If you use Ativan during pregnancy, your baby could be born with life-threatening withdrawal symptoms, and may need medical treatment for several weeks.

If you are pregnant, your name may be listed on a pregnancy registry to track the effects of lorazepam on the baby.

You should not breastfeed.

If you do breastfeed, tell your doctor if you notice drowsiness, feeding problems, or slow weight gain in the nursing baby.

How should I take Ativan?

Take Ativan exactly as prescribed by your doctor. Follow the directions on your prescription label and read all medication guides or instruction sheets. Never use Ativan in larger amounts, or for longer than prescribed. Tell your doctor if you feel an increased urge to use more of this medicine.

Never share Ativan with another person, especially someone with a history of drug addiction. MISUSE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH. Keep the medicine where others cannot get to it. Selling or giving away this medicine is against the law.

Do not stop using Ativan without asking your doctor. You may have life-threatening withdrawal symptoms if you stop using the medicine suddenly after long-term use.

Store Ativan tablets tightly closed at room temperature, away from moisture and heat.

Keep your medicine in a place where no one can use it improperly.

Dosing information

Usual Adult Dose for Anxiety:

Initial dose: 2 to 3 mg orally per day, given 2 to 3 times per day
Maintenance dose: 1 to 2 mg orally 2 to 3 times a day

Uses:
-Management of anxiety disorders
-Short-term relief of the symptoms of anxiety or anxiety associated with depressive symptoms

Usual Adult Dose for Insomnia:

2 to 4 mg orally once a day at bedtime

Comments:
-The dosage should be increased gradually when needed to help avoid adverse effects.
-Clinical studies have not evaluated this drug for efficacy in long-term treatment (e.g., greater than 4 months).

Use: Management of insomnia due to anxiety of transient situational stress

Usual Geriatric Dose for Anxiety:

Older or debilitated patients:
-Initial dose: 1 to 2 mg orally per day, given in divided doses

-Management of anxiety disorders
-Short-term relief of the symptoms of anxiety or anxiety associated with depressive symptoms

Usual Pediatric Dose for Anxiety:

12 years or older:
-Initial dose: 2 to 3 mg orally per day, given 2 to 3 times per day
-Maintenance dose: 1 to 2 mg orally 2 to 3 times a day

-The daily dosage may vary from 1 to 10 mg/day.
-The dosage should be increased gradually when needed to help avoid adverse effects.
-When higher dosage is indicated, the evening dose should be increased before the daytime doses.
-Use of anxiolytic agents is typically not needed to treat anxiety/tension associated with the stress of everyday life.
-Clinical studies have not evaluated this drug for efficacy in long-term treatment (e.g., greater than 4 months).

Uses:
-Management of anxiety disorders
-Short-term relief of the symptoms of anxiety or anxiety associated with depressive symptoms

Usual Pediatric Dose for Insomnia:

12 years or older: 2 to 4 mg orally once a day at bedtime

Comments:
-For debilitated patients, an initial dosage of 1 to 2 mg/day in divided doses is recommended.
-The dosage should be increased gradually when needed to help avoid adverse effects.
-Clinical studies have not evaluated this drug for efficacy in long-term treatment (e.g., greater than 4 months).

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line . An overdose of lorazepam can be fatal if you also drink alcohol or use other drugs that cause drowsiness or slow breathing.

Overdose symptoms may include severe drowsiness, confusion, slurred speech, feeling restless, muscle weakness, loss of balance or coordination, feeling light-headed, slow heartbeats, weak or shallow breathing, or coma.

What should I avoid while taking Ativan?

Do not drink alcohol. Dangerous side effects or death could occur.

Avoid driving or hazardous activity until you know how Ativan will affect you. Dizziness or drowsiness can cause falls, accidents, or severe injuries.

Ativan side effects

Get emergency medical help if you have signs of an allergic reaction to Ativan: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Lorazepam can slow or stop your breathing, especially if you have recently used an opioid medication or alcohol. A person caring for you should seek emergency medical attention if you have slow breathing with long pauses, blue colored lips, or if you are hard to wake up.

Ativan may cause serious side effects. Call your doctor at once if you have:

• severe drowsiness;
• unusual changes in mood or behavior, being agitated or talkative;
• sudden restless feeling or excitement;
• seizures, depression, thinking problems, thoughts of suicide or hurting yourself;
• confusion, aggression, hallucinations;
• sleep problems (insomnia);
• vision changes; or
• dark urine, or jaundice (yellowing of the skin or eyes).

Drowsiness or dizziness may last longer in older adults. Use caution to avoid falling or accidental injury.

Common Ativan side effects may include:

• dizziness, sedation, drowsiness;
• weakness; or
• feeling unsteady.

You will need frequent blood tests to check your blood counts and liver function.

After you stop using Ativan, seek medical help right away if you have symptoms such as: unusual muscle movements, being more active or talkative, sudden and severe changes in mood or behavior, confusion, hallucinations, seizures, suicidal thoughts or actions.

Some withdrawal symptoms may last up to 12 months or longer after stopping Ativan suddenly. Tell your doctor if you have ongoing anxiety, depression, problems with memory or thinking, trouble sleeping, ringing in your ears, a burning or prickly feeling, or a crawling sensation under your skin.