Daridorexant (Quviviq) is a novel orexin receptor antagonist indicated for the treatment of insomnia in adults, particularly targeting difficulties with sleep onset and sleep maintenance.

How to Use Daridorexant (Quviviq)

Administration Time and Method

Recommended Dosage: 25mg to 50mg, orally once daily at night.

Timing of Administration: Take within 30 minutes before bedtime, and ensure there is at least 7 hours of potential sleep time after taking the medication.

Effect of Food: Taking with food may delay sleep onset; it is recommended to take on an empty stomach or with an interval after meals.

Dosage Form Selection

Two strengths are available: 25mg (light purple tablets) and 50mg (light orange tablets). The tablet surfaces are marked with "25" and "50" respectively.

Dosage Adjustment of Daridorexant (Quviviq)

Patients with Hepatic Impairment

Moderate Hepatic Impairment (Child-Pugh 7-9 points): The maximum dosage should not exceed 25mg per night.

Severe Hepatic Impairment (Child-Pugh ≥10 points): Use is contraindicated.

Adjustment Due to Drug Interactions

Strong CYP3A4 Inhibitors (e.g., itraconazole): Avoid concurrent use.

Moderate CYP3A4 Inhibitors (e.g., diltiazem): The dosage is limited to 25mg per night.

CYP3A4 Inducers (e.g., rifampicin): Avoid concurrent use, as they may reduce the efficacy of the drug.

Other Precautions

Concurrent use with alcohol or other central nervous system (CNS) depressants increases the risk of daytime sleepiness; caution is required and dosage reduction should be considered if necessary.

Daridorexant (Quviviq) Use in Special Populations

Elderly Patients (≥65 Years Old)

No dosage adjustment is needed, but vigilance for sleepiness-related side effects is required due to the increased risk of falls.

Pregnant and Lactating Women

Pregnancy: No human data are available; animal studies have not shown teratogenicity, and the risks must be weighed against the benefits.

Lactation: The drug may be excreted in breast milk; infants should be monitored for excessive sedation, and breastfeeding may need to be temporarily discontinued if necessary.

Children and Adolescents

Efficacy has not been established, and use is not recommended.

Patients with Impaired Respiratory Function

Obstructive Sleep Apnea (OSA): Data on moderate to severe OSA (especially in patients requiring CPAP treatment) are insufficient; use with caution.

Chronic Obstructive Pulmonary Disease (COPD): May be used in patients with moderate COPD; use in severe cases (FEV1 < 40%) has not been studied and should be avoided.

Key Safety Warnings

Daytime Functional Impairment: May affect the ability to drive or operate machinery, especially when used concurrently with CNS depressants.

Mental Health Risks: May exacerbate depression or suicidal ideation; close monitoring is required.

Abnormal Sleep Behaviors: Such as sleepwalking and sleep driving; discontinue the drug immediately if these occur.

Respiratory Depression: Patients with moderate to severe respiratory diseases require careful assessment before use.