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Sunosi
Sunosi (generic name: solriamfetol) is a wakefulness-promoting agent used to treat excessive daytime sleepiness in adults with narcolepsy or obstructive sleep apnea (OSA). Sunosi works by stimulating certain parts of the brain to help improve wakefulness and reduce sleepiness during the day. It does not treat the underlying cause of obstructive sleep apnea and is usually used in combination with other treatments for OSA, such as continuous positive airway pressure (CPAP).
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Frequently Asked Questions
How long does it take for Sunosi to start working?
Sunosi typically starts to improve wakefulness within 1 hour of taking the medication, with peak effects seen at 2 to 3 hours after administration.
Can I stop using CPAP if I’m taking Sunosi?
No, Sunosi treats the daytime sleepiness associated with obstructive sleep apnea but does not address the underlying condition of airway obstruction. Continue using your CPAP or other treatments as prescribed.
Can I drink coffee while taking Sunosi?
Caffeine can enhance the stimulant effects of Sunosi, potentially leading to increased side effects like jitteriness or increased heart rate. It is best to limit caffeine intake while on this medication.
Can Sunosi cause weight loss?
Sunosi can cause decreased appetite, which may lead to weight loss in some patients. If you notice significant or unintentional weight loss, consult your healthcare provider.
Can I drive while taking Sunosi?
Sunosi is intended to help improve wakefulness, so it may improve your ability to drive. However, individual responses to the medication vary, so ensure you know how Sunosi affects you before operating heavy machinery or driving.
Comprehensive Drug Guide
How Does Sunosi Work?
Solriamfetol works by inhibiting the reuptake of norepinephrine and dopamine, two neurotransmitters involved in promoting wakefulness and alertness. By increasing the levels of these neurotransmitters in the brain, Sunosi helps to improve wakefulness and reduce excessive sleepiness in people with narcolepsy or obstructive sleep apnea.
Common Dosages
- 75 mg and 150 mg oral tablets.
Typical Dosing
- For narcolepsy: The recommended starting dose is 75 mg once daily. The dose may be increased to 150 mg once daily based on the patient’s response and tolerability.
- For obstructive sleep apnea (OSA): The recommended starting dose is 37.5 mg or 75 mg once daily, and the dose may be increased to 150 mg once daily.
It should be taken in the morning to avoid potential sleep disturbances.
Typical Dosing
FDA Approved Indications
- Excessive daytime sleepiness associated with narcolepsy in adults.
- Excessive daytime sleepiness associated with obstructive sleep apnea (OSA) in adults.
Who Shouldn't Take Sunosi?
- Hypersensitivity to solriamfetol or any component of the medication.
- Concurrent use of monoamine oxidase inhibitors (MAOIs) or within 14 days of stopping an MAOI, as this may lead to serious interactions, including hypertensive crises.
Advice From The Pharmacist
- Take Sunosi in the morning, as taking it later in the day can cause difficulty sleeping at night (insomnia).
- Do not stop using other OSA treatments, such as CPAP, while using Sunosi. This medication treats sleepiness but does not address the airway obstruction in OSA.
- Avoid alcohol while taking Sunosi, as it can increase the risk of side effects such as dizziness or impaired judgment.
- Monitor your blood pressure regularly, as Sunosi can raise blood pressure and heart rate, especially in patients with pre-existing hypertension or heart conditions.
Side Effects of Sunosi
Common Side Effects
- Headache
- Nausea
- Decreased appetite
- Anxiety
- Increased heart rate or blood pressure
- Insomnia
Uncommon/Severe Side Effects
- Increased blood pressure or hypertension crisis, especially in patients with uncontrolled high blood pressure.
- Mental health changes, such as agitation, hallucinations, or suicidal thoughts.
- Heart palpitations or chest pain.
Risks and Warnings of Sunosi
- Increased Blood Pressure and Heart Rate: Sunosi can cause an increase in blood pressure and heart rate. Patients with heart conditions or high blood pressure should be monitored closely, and the dose may need adjustment based on their response.
- Abuse Potential: As a Schedule IV controlled substance, Sunosi has a potential for abuse, dependence, and misuse. It should be used cautiously in patients with a history of substance abuse.
- Mental Health Effects: In rare cases, Sunosi may cause psychiatric symptoms, such as anxiety, agitation, or hallucinations. If any of these symptoms occur, consult your doctor immediately.
Interactions with Sunosi
Common Drug Interactions
- Monoamine Oxidase Inhibitors (MAOIs): Sunosi should not be used with MAO inhibitors or within 14 days of discontinuing MAOI therapy due to the risk of hypertensive crisis.
- Stimulants: Concurrent use of other stimulants (such as amphetamines) may increase the risk of cardiovascular side effects such as high blood pressure and increased heart rate.
- Blood pressure medications: Sunosi may counteract the effects of antihypertensive medications, requiring careful monitoring of blood pressure.
Alternatives to Sunosi
- Modafinil (Provigil): A wakefulness-promoting agent used to treat excessive daytime sleepiness in narcolepsy, OSA, and shift work sleep disorder.
- Armodafinil (Nuvigil): Similar to modafinil, used to treat excessive daytime sleepiness in narcolepsy and OSA.
- Amphetamines (Adderall, Vyvanse): Stimulants that can be used off-label for excessive daytime sleepiness but have a higher risk of abuse.
- Xyrem (Sodium Oxybate): Used to treat excessive daytime sleepiness and cataplexy in narcolepsy.
