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Leborexan is a new type of dual orexin receptor antagonist developed and produced by Eisai of Japan. It is specially used to treat insomnia characterized by difficulty falling asleep or maintaining sleep.
Lebraxen (trade name DAYVIGO) is an orexin receptor antagonist, suitable for the treatment of adult insomnia, characterized by difficulty falling asleep and/or sleep maintenance disorders.
Recommended dose : The initial dose is 5mg, taken once every night before going to bed. Make sure you have at least 7 hours of sleep after taking the medicine. The maximum recommended dose may be increased to 10 mg based on clinical response and tolerability.
Dose adjustment :
Hepatic insufficiency : The maximum dose for patients with moderate liver damage is 5 mg/day; it is contraindicated in patients with severe liver damage.
Drug interactions : Avoid combination with strong/moderate CYP3A inhibitors (such as itraconazole, clarithromycin); the maximum dose when combined with weak CYP3A inhibitors (such as ranitidine) is 5 mg.
U200c Note when taking the medicine: You can take it on an empty stomach or after a meal, but eating may delay the onset of effect. Swallow the tablet whole, no need to make up for missed doses.
The most common adverse reaction is drowsiness (incidence rate ≥5%, 2 times higher than placebo). Other side effects that need attention include:
1. Nervous system : Sleep paralysis (unable to move or speak during waking hours), hallucinations, cataplexy-like symptoms (brief leg weakness).
2. Complex sleep behaviors : Sleepwalking, sleep driving, unconscious eating, etc. The medication needs to be stopped immediately after occurrence.
3. Mental health risk : Aggravated depression or suicidal ideation (incidence rate 0.3%-0.4%).
4. Respiratory depression : Patients with chronic obstructive pulmonary disease (COPD) or moderate to severe sleep apnea should use it with caution.
Monitoring requirements :
Avoid driving or operating machinery during medication, especially when the dose exceeds 5mg.
Regularly assess depressive symptoms and sleep behavior abnormalities.
Contraindications : Contraindicated in patients with narcolepsy; combined use with strong CYP3A inducers (such as rifampicin) will reduce the efficacy and should be avoided.
Pregnant women : Contraception is required until 1 month after stopping the drug, and the risks of use during pregnancy need to be weighed.
U200c during lactation: The drug may be secreted through breast milk, so it is recommended to suspend breastfeeding.
U200c for the elderly: The risk of drowsiness increases when patients aged ≥65 years use the 10 mg dose, and it is recommended to start with 5 mg.
Store away from light at 20-25°C (short-term 15-30°C allowed), and keep out of the reach of children.