Quiviq (Daridorexant) - Sleep Medication for Insomnia
Quiviq (active ingredient: daridorexant) is a prescription sleep medication for treating insomnia in adults. It selectively targets orexin receptors in the brain.
Things worth knowing about "Quiviq"
Quiviq (active ingredient: daridorexant) is a prescription sleep medication for treating insomnia in adults. It selectively targets orexin receptors in the brain.
What is Quiviq?
Quiviq is a prescription medication containing the active ingredient daridorexant. It belongs to a class of medicines known as dual orexin receptor antagonists (DORAs) and is indicated for the treatment of insomnia in adults. Quiviq was developed by the Swiss pharmaceutical company Idorsia and received marketing authorisation from the European Medicines Agency (EMA) in 2022, as well as approval from the U.S. Food and Drug Administration (FDA).
Indication
Quiviq is approved for the treatment of insomnia in adults whose sleep disorder is considered clinically significant. This includes difficulties falling asleep, staying asleep throughout the night, or waking up too early without feeling refreshed.
Mechanism of Action
Quiviq works by inhibiting the activity of the orexin system in the brain. Orexins (also called hypocretins) are neuropeptides that promote wakefulness and regulate the sleep-wake cycle. In people with insomnia, this system is often overactive, making it difficult to fall asleep.
Daridorexant selectively blocks both orexin receptors OX1R and OX2R, reducing the wake-promoting signals in the brain. This allows the body to transition into sleep more naturally, without broadly suppressing brain activity as older sleep medications (such as benzodiazepines) do.
Dosage
The recommended dose of Quiviq is 25 mg or 50 mg, taken as a single tablet shortly before bedtime (no more than 30 minutes before going to bed). Tablets should not be split or chewed. Quiviq should only be taken when at least 7 hours of sleep time remain, to reduce the risk of next-day impairment.
Side Effects
Like all medicines, Quiviq may cause side effects. Common side effects include:
- Headache
- Dizziness
- Next-day somnolence (residual sleepiness)
- Nausea
- Nasopharyngitis (inflammation of the nose and throat)
In rare cases, sleep-related behaviours such as sleepwalking or other parasomnias may occur. If such symptoms develop, patients should seek medical advice promptly.
Drug Interactions
Quiviq is primarily metabolised by the liver enzyme CYP3A4. Substances that inhibit or induce this enzyme can therefore affect daridorexant levels in the blood:
- Strong CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin): increase daridorexant plasma concentrations and should not be taken concomitantly.
- CYP3A4 inducers (e.g., rifampicin, St John's Wort): reduce the efficacy of Quiviq.
- Alcohol and other CNS depressants: enhance the sedative effect and should be avoided.
Special Warnings
Quiviq is not recommended for use in children and adolescents under 18 years of age. It is contraindicated in patients with severe hepatic impairment. Pregnant or breastfeeding women should only use Quiviq after careful medical assessment, as safety in these populations has not been fully established. Driving or operating machinery after taking Quiviq should be avoided.
References
- European Medicines Agency (EMA): Quiviq (daridorexant) - Product Information and EPAR, 2022. Available at: https://www.ema.europa.eu
- Mignot E et al. - Daridorexant, a New Dual Orexin Receptor Antagonist to Treat Insomnia Disorder. Annals of Neurology, 2022.
- Idorsia Pharmaceuticals - Summary of Product Characteristics: Quiviq 25 mg / 50 mg Film-Coated Tablets, 2022.
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