Lemborexant (Dayvigo) is a selective orexin receptor antagonist indicated for the treatment of insomnia in adults (characterized by difficulty falling asleep or sleep maintenance disorders). It promotes sleep by inhibiting the orexin receptors OX1R and OX2R to reduce wakefulness signals.

How to Use Lemborexant (Dayvigo)

Administration Regimen

Recommended Dosage: The initial dose is 5mg, taken once daily, immediately before bedtime, with at least 7 hours of sleep time guaranteed after administration. Based on clinical response and tolerability, the dose can be increased to the maximum recommended dose of 10mg.

Timing of Administration: Avoid taking with meals or immediately after meals, as this may delay the time to fall asleep.

Management of Missed Doses: If a dose is missed, there is no need to make up for it; take the dose at the originally scheduled time on the next day.

Contraindications for Concomitant Use

Strong/moderate CYP3A inhibitors (e.g., itraconazole, clarithromycin): Concomitant use is prohibited.

Weak CYP3A inhibitors (e.g., ranitidine): The maximum dose is limited to 5mg.

CYP3A inducers (e.g., rifampicin, carbamazepine): Concomitant use should be avoided, as it may reduce the efficacy of the drug.

Dosage Adjustment of Lemborexant (Dayvigo)

Patients with Hepatic Impairment

Moderate hepatic impairment (Child-Pugh Class B): The maximum dose is 5mg per day.

Severe hepatic impairment (Child-Pugh Class C): Use is contraindicated.

Mild hepatic impairment (Child-Pugh Class A): No dosage adjustment is required, but the risk of drowsiness should be monitored.

Patients with Renal Impairment

Mild to severe renal impairment (CLcr ≥ 15 mL/min): No dosage adjustment is required.

End-stage renal disease (ESRD): Use with caution, as safety data are insufficient.

Precautions for Lemborexant (Dayvigo) Use in Special Populations

Pregnancy and Lactation

Pregnancy: Animal studies have shown embryotoxicity at high doses, and human data are limited. Use only when the benefit outweighs the risk.

Lactation: Whether the drug passes into breast milk is unknown. It is recommended to weigh the pros and cons before deciding to discontinue the drug or suspend breastfeeding.

Patients with Respiratory Impairment

Mild to moderate obstructive sleep apnea (OSA): Use with caution, as it may exacerbate respiratory depression.

Chronic obstructive pulmonary disease (COPD): Insufficient research data are available; use should be avoided.