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Sunosi
solriamfetol
Adult Dosing .
Dosage forms: TAB: 75 mg, 150 mg
narcolepsy
- [75-150 mg PO qam]
- Start: 75 mg PO qam, may incr. dose no more frequently than q3 days; Max: 150 mg/day
obstructive sleep apnea
- [37.5-150 mg PO qam]
- Start: 37.5 mg PO qam, may incr. dose no more frequently than q3 days; Max: 150 mg/day
renal dosing
- [see below]
- eGFR 30-59: start 37.5 mg qam x7 days, then may incr. to max 75 mg/day; eGFR 15-29: start 37.5 mg qam, max 37.5 mg/day; eGFR <15: avoid use
- HD/PD: not defined
hepatic dosing
- [not defined]
Peds Dosing .
Peds dosing is currently unavailable or not applicable for this drug.
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- MAO inhibitor use w/in 14 days
- eGFR <15
- cardiac dz, significant
- cardiac dz, unstable
- arrhythmia, severe
- caution: cardiovascular dz
- caution: cerebrovascular dz
- caution: HTN
- caution: elderly patients
- caution: eGFR 15-59
- caution: substance abuse history
- caution: bipolar disorder
- caution: psychosis history
Drug Interactions .
Overview
solriamfetol
dopamine-norepinephrine reuptake inhibitor
- dopaminergic effects (indirect)
- hypertensive effects
- tachycardia
- add MAO inhibitor to Interaction Check if recent (14 days) use
Contraindicated
- isocarboxazid
- phenelzine
- selegiline transdermal
- tranylcypromine
Avoid/Use Alternative
- albuterol
- dronabinol
- landiolol
- metoclopramide
- midodrine
- procarbazine
Monitor/Modify Tx
- abiraterone acetate
- albuterol inhaled
- almotriptan
- amiloride
- amoxapine
- amphetamine
- angiotensin II
- arformoterol inhaled
- armodafinil
- asciminib
- atogepant
- atomoxetine
- atropine ophthalmic
- axitinib
- benzphetamine
- betamethasone
- bevacizumab
- brigatinib
- budesonide
- bumetanide
- bupropion
- cabozantinib
- caffeine
- caffeine citrate
- candesartan cilexetil
- cannabis
- captopril
- carfilzomib
- celecoxib
- clomipramine
- cocaine
- copanlisib
- corticotropin
- cortisone
- cyclosporine
- danazol
- darbepoetin alfa
- deflazacort
- desipramine
- desmopressin
- desvenlafaxine
- dexamethasone
- dexmethylphenidate
- dextroamphetamine
- diclofenac
- diclofenac topical
- diethylpropion
- diflunisal
- dihydroergotamine
- dobutamine
- dopamine
- doxapram
- doxepin
- droxidopa
- eletriptan
- enalapril
- enalaprilat
- enzalutamide
- ephedra
- ephedrine injection
- ephedrine oral
- epinephrine
- eplerenone
- epoetin alfa
- eptinezumab
- erenumab
- ergotamine
- esketamine
- estetrol (contraceptive)
- estradiol (contraceptive)
- ethacrynic acid
- ethinyl estradiol (contraceptive)
- etodolac
- etrasimod
- fenfluramine
- fenoldopam
- fenoprofen
- fingolimod
- fludrocortisone
- flurbiprofen
- formoterol inhaled
- fostamatinib
- fremanezumab
- frovatriptan
- fruquintinib
- galcanezumab
- glycopyrrolate
- hoodia
- hydrocortisone
- hydroxocobalamin IV
- hyoscyamine
- ibrutinib
- ibuprofen
- imipramine
- indomethacin
- isoproterenol
- isradipine
- ketamine
- ketoprofen
- ketorolac
- leflunomide
- lenvatinib
- levalbuterol inhaled
- levomilnacipran
- levothyroxine
- licorice
- lifileucel
- linezolid
- liothyronine
- liraglutide
- lisdexamfetamine
- lorlatinib
- lumacaftor/ivacaftor
- luspatercept
- magnesium salicylate
- meclofenamate
- mefenamic acid
- meloxicam
- methamphetamine
- methoxy polyethylene glycol-epoetin beta
- methylergonovine
- methylphenidate
- methylprednisolone
- methyltestosterone
- metolazone
- milnacipran
- mirabegron
- modafinil
- moexipril
- nabumetone
- naproxen
- naratriptan
- naxitamab
- nimodipine
- niraparib
- norepinephrine
- nortriptyline
- olodaterol inhaled
- orphenadrine
- osilodrostat
- oxaprozin
- oxymetazoline nasal
- oxytocin
- ozanimod
- pazopanib
- perindopril
- pexidartinib
- phendimetrazine
- phenoxybenzamine
- phentermine
- phentolamine
- phenylephrine
- phenylephrine injection
- phenylephrine nasal
- phenylephrine ophthalmic
- phenylephrine rectal
- piroxicam
- ponatinib
- ponesimod
- pralsetinib
- prednisolone
- prednisone
- protriptyline
- pseudoephedrine
- quetiapine
- ramipril
- ramucirumab
- rasagiline
- regorafenib
- rimegepant
- ripretinib
- rizatriptan
- ropinirole
- safinamide
- salmeterol inhaled
- selegiline
- selpercatinib
- siponimod
- sorafenib
- sulindac
- sumatriptan
- sunitinib
- tacrolimus
- tagraxofusp
- terbutaline
- teriflunomide
- testosterone
- thyroid
- tivozanib
- tolmetin
- torsemide
- trametinib
- trandolapril
- triamcinolone
- triamterene
- trimipramine
- trospium
- ubrogepant
- vadadustat
- vamorolone
- vandetanib
- vasopressin
- venlafaxine
- vilanterol inhaled
- viloxazine
- voclosporin
- yohimbe
- zavegepant
- ziv-aflibercept
- zolmitriptan
Caution Advised
- amisulpride
- asenapine
- chlorpromazine
- clozapine
- droperidol
- fluphenazine
- haloperidol
- iloperidone
- kava
- loxapine
- lurasidone
- molindone
- olanzapine
- paliperidone
- perphenazine
- pimozide
- prochlorperazine
- promethazine
- risperidone
- thioridazine
- thiothixene
- trifluoperazine
- ziprasidone
Adverse Reactions .
Serious Reactions
- abuse potential
Common Reactions
- headache
- nausea
- anorexia
- anxiety
- insomnia
- diarrhea
- xerostomia
- palpitations
- irritability
- constipation
- abdominal pain
- chest discomfort
- hyperhidrosis
- dizziness
- BP incr.
- HR incr.
- hypersensitivity rxn
Safety/Monitoring .
Monitoring Parameters
BP, HR at baseline, then periodically
Pregnancy/Lactation .
Pregnancy
Clinical Summary
weigh risk/benefit during pregnancy; inadequate human data available; possible risk of fetal harm, incl. decr. fetal wt, fetal death, and teratogenicity based on animal data at >4x MRHD
Pregnancy Registry
encourage patients to enroll in Sunosi Pregnancy Registry at 1-877-283-6220 or at www.sunosipregnancyregistry.com
Lactation
Clinical Summary
weigh risk/benefit while breastfeeding; no human data available to assess risk of infant harm, though drug excreted into milk; no human data available to assess effects on milk production
Pharmacology .
Metabolism: unknown; CYP450: none
Excretion: urine (95% unchanged); Half-life: 7.1h
Subclass: Narcolepsy/Somnolence ; Sleep-related Breathing Disorders
Mechanism of Action
exact mechanism of action unknown; inhibits dopamine and norepinephrine reuptake
Formulary .
No Formulary Selected
Manufacturer/Pricing .
Manufacturer: Axsome Therapeutics, Inc.
DEA/FDA: Schedule IV
Retail Price
Estimated prices only. For current pricing, visit GoodRx.
oral tablet:
- 75 mg (30 ea): $723.00
- 150 mg (30 ea): $723.00
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