Daridorexant
QUVIVIQ
Pronunciation: dar-i-doe-REX-ant (kyoo-VI-vik)
“Q-tip, Dorito wrecks it”
Oreo crumbling → orexin antagonist
What it isDual orexin receptor antagonist; insomnia.
Why this oneShortest half-life of the orexin antagonists, so next-morning impairment is least.
What limits itSomnolence remains, and seven hours must remain before waking. CYP3A4-dependent; Schedule IV.
Daridorexant prescription history
Animated chart of estimated U.S. prescriptions per year, Sleep meds (1869–2026). Daridorexant enters in 2022 (estimated).
FDA-approved for
- insomnia (2022)
Principal riskSomnolence; allow seven hours before waking
Classes and tags
Clinical profile
Legacy pregnancy categoryNot assigned — PLLR-era drug
Defining liabilityNext-day somnolence, abnormal sleep behaviors and additive CNS depression.
FDA label
Read the full label on DailyMed ↗
NO BOXED WARNINGS
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Insomnia (sleep onset and/or maintenance) | Adults | 25-50 mg QHS | 25-50 mg QHS | 50 mg QHS |
Renal Undefined
Hepatic Moderate (Child-Pugh 7-9): max 25 mg QHS. Severe (>=10): not recommended.
No more than once per night.
Instructions
- Take orally within 30 minutes before bed, with at least 7 hours remaining before planned awakening.
- Onset may be delayed if taken with or soon after a meal.
- With moderate CYP3A4 inhibitors: max 25 mg; avoid strong CYP3A4 inhibitors and strong/moderate CYP3A4 inducers.
Available strengths
- tab 25, 50 mg
Contraindications
- Narcolepsy
Cautions
- CNS-depressant effects / next-day daytime impairment (driving); additive with other CNS depressants
- Worsening depression / suicidal ideation
- Sleep paralysis, hypnagogic/hypnopompic hallucinations, cataplexy-like symptoms
- Complex sleep behaviors (sleepwalking/driving) — discontinue if they occur
- Compromised respiratory function
Adverse reactions
- Headache
- Somnolence or fatigue
Pregnancy No human data; pregnancy exposure registry available.
Lactation Present in human milk in low amounts (<1% RID); monitor breastfed infant for excessive sedation.
Cost
| Strength | #/mo | generic $/mo | brand $/mo | CostPlus | |
|---|---|---|---|---|---|
| 25 mg | tab | 30 qd | — | $501.14 | not offered |
| 50 mg | tab | 30 qd | — | $501.14 | not offered |
Generic entry2034 est.
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Memory aids: interaction avatars
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Self-check
- How much time must remain before waking with daridorexant?
Seven hours. - How does its half-life compare within orexin antagonists?
Shortest.