Vornorexant Tablets (Vornorexant) are a new type of orexin receptor antagonist for insomnia treatment. They work by regulating the human wake-sleep mechanism.
What Are the Precautions for Taking Vornorexant Tablets?
Contraindicated Populations
Patients allergic to the drug ingredients.
Patients with severe hepatic impairment (Child-Pugh Class C).
Patients currently taking strong CYP3A inhibitors, such as itraconazole, clarithromycin, ritonavir, etc. These drugs can significantly increase the blood concentration of Vornorexant, raising the risk of excessive sedation and other adverse effects.
Medication Adjustments for Special Patients
Patients with hepatic impairment: Patients with moderate hepatic impairment (Child-Pugh Class B) need to reduce the dose to 2.5 mg per day; patients with mild hepatic impairment also need to use the drug with caution.
Elderly patients: No dosage adjustment is required, but attention should be paid to their potential sensitivity to the drug.
Pregnant and lactating women: The drug should be used only when the benefit outweighs the risk; during lactation, the necessity of suspending breastfeeding should be evaluated.
Patients with respiratory dysfunction (except mild OSA): Safety data is insufficient, so close monitoring is required.
Management of Drug Interactions
Prohibited combinations: Strong CYP3A inhibitors (as mentioned above) can cause a sharp increase in blood drug concentration, leading to severe drowsiness.
Cautious combinations: When used with moderate CYP3A inhibitors (fluconazole, erythromycin), the dose of Vornorexant should be reduced to 2.5 mg.
Food and beverages: Avoid taking with grapefruit juice; the drug should be taken on an empty stomach or before bedtime to ensure timely efficacy.
Monitoring During Vornorexant Tablets Administration
Efficacy and Dependence Monitoring
Sleep indicator tracking: Record sleep onset time, number of nighttime awakenings, and mental state after waking up to evaluate the rationality of the dose.
Long-term use evaluation: If symptoms improve, regularly assess whether continued medication is necessary to avoid drug dependence.
Safety Monitoring
Neurological reactions: Closely observe for the occurrence of drowsiness, dizziness, sleep paralysis, or nightmares. If symptoms are significant, adjust the dose or suspend medication.
Regular liver function tests: Especially for patients with hepatic impairment, indicators such as transaminases need to be monitored.
Impact on daytime function: Evaluate daytime alertness using scales (e.g., Karolinska Sleepiness Scale) to ensure no impact on daily work and driving.
Adherence and Medication Guidance
Medication time: Take the drug strictly before going to bed; avoid taking it after getting up at night and before engaging in activities.
Medication packaging: Remind patients to take the tablets out of the PTP blister before taking them to avoid accidental swallowing of the packaging, which may cause esophageal injury.
