Belsomra (Suvorexant) – Oral

What Is Belsomra?

Belsomra (suvorexant) is a prescription medication used to help with sleep. Specifically, it is for adults with insomnia, having difficulty falling asleep or difficulty staying asleep.

Belsomra is an orexin antagonist, meaning that it works by preventing the binding of the wake-promoting neuropeptides, orexin-A and orexin-B, to the orexin type 1 (OX1R) and type 2 (OX2R) receptors. This process is thought to calm down the body’s natural wake drive, helping to treat insomnia.

Belsomra contains suvorexant, which is a controlled substance. This means there is a risk of abuse or dependence on this medication.

Drug Facts

Generic Name: Suvorexant

Brand Name: Belsomra

Drug Availability: Prescription

Administration Route: Oral

Therapeutic Classification: Orexin antagonist

Available Generically: No

Controlled Substance: Schedule IV

Active Ingredient: Suvorexant

Dosage Form: Tablet

What Is Belsomra Used For?

The Food and Drug Administration (FDA) approved Belsomra to treat insomnia in adults only. The safety and effectiveness of Belsomra in children have not been established.

Because of its potential for abuse, Belsomra is categorized as a Schedule IV controlled substance. Controlled substances are drugs that are regulated depending on how potentially dangerous they are. Belsomra carries the risk of abuse and dependence.

Belsomra (Suvorexant) Drug Information - Illustration by Zoe Hansen

Verywell / Zoe Hansen

How to Take Belsomra

Belsomra comes available as a film-coated tablet of either 5 milligrams (mg), 10 mg, 15 mg, or 20 mg, to be taken by mouth.

The usual dosage is 10 mg by mouth once daily at night, within 30 minutes of bedtime, and with at least seven hours available to sleep before awakening. The maximum daily dose is 20 mg by mouth nightly. No matter the dose of the tablet you are taking, take as instructed by your healthcare provider and do not take it more than once per night.

This medication can be taken with or without food, but it works better if you do not take it with food. Belsomra may take longer to work if you take it with or after a meal.

While taking Belsomra:

  • Do not eat grapefruit or drink grapefruit juice since grapefruit can increase the concentration of Belsomra in your body, increasing your risk of unwanted side effects. 
  • Do not drive or do other tasks that require you to be alert for at least eight hours after taking Belsomra.
  • Do not drink alcohol, either that evening or before going to bed.

Talk with your healthcare provider before using any form of cannabis or other medications, whether prescription or over the counter (OTC), that may slow your actions or cause you to fall asleep. Call your provider if you still have trouble sleeping after seven to 10 days.

Storage

Store Belsomra in a closed container at room temperature (68 degrees to 77 degrees Fahrenheit), away from heat, moisture, and direct light. Do not remove the tablets from the blister pack until you are ready to use them. As with all medication, keep Belsomra out of the reach of children. Do not share your medicine with anyone.

How Long Does It Take Belsomra to Work?

It takes approximately 30 minutes for Belsomra to work. This is why you should take it within 30 minutes of your bedtime. You should start to see an improvement in your sleep within seven to 10 days.

What Are the Side Effects of Belsomra?

This is not a complete list of side effects and others may occur. A medical professional can advise you on side effects. If you experience other effects, contact your pharmacist or a medical professional. You may report side effects to the FDA at www.fda.gov/medwatch or 800-FDA-1088.

Common Side Effects

Common side effects associated with Belsomra include:

  • Headache
  • Dizziness
  • Diarrhea 
  • Dry mouth
  • Cough
  • Abnormal dreams
  • Daytime drowsiness

Severe Side Effects

This medication may cause you to do things while still asleep, such as driving or eating. You may not remember doing these things the following day. Please tell your healthcare provider right away if you learn that this has happened. This medicine can also be habit-forming. Do not use more than your prescribed dose. Notify your provider if you think your medicine is not working.

Call your provider right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and symptoms of Belsomra can include the following:

  • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat
  • Anxiety, depression, nervousness, unusual behavior/changes in mood, or thoughts of hurting yourself
  • Memory loss
  • Seeing, hearing, or feeling things that are not there
  • Severe confusion, drowsiness, muscle weakness
  • Sleep paralysis (temporary inability to move or talk while you are going to sleep or waking up)

Women seem to be more at risk of developing certain side effects to Belsomra than men.

Report Side Effects

Belsomra may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much of Belsomra Should I Take?

Drug Content Provided and Reviewed by IBM Micromedex®

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For treatment of insomnia:
      • Adults—10 milligrams (mg) at bedtime. Your doctor may increase your dose as needed. However, the dose is usually not more than 20 mg per day.
      • Children—Use and dose must be determined by your doctor.

Missed Dosage

This medication should not be taken on a regular schedule, so you do not have to worry about missing a dose. This medication should only be taken when you cannot sleep.

Overdose: What Happens If I Take Too Much Belsomra?

Taking too much Belsomra may result in a higher risk of side effects. However, there is limited data on Belsomra overdoses in a clinical setting. In studies, people given morning doses of up to 240 mg showed increases in drowsiness (somnolence).

What Happens If I Overdose?


If you think you or someone else may have overdosed on Belsomra, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Belsomra, call 911 immediately.

Precautions

Drug Content Provided and Reviewed by IBM Micromedex®

It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly and to check for unwanted effects.

If you think you need to take suvorexant for more than 7 to 10 days, be sure to discuss it with your doctor. Insomnia that lasts longer than this may be a sign of another medical problem.

This medicine will add to the effects of alcohol and other CNS depressants (medicines that make you drowsy or less alert). Some examples of CNS depressants are antihistamines or medicine for hay fever, other allergies, or colds, sedatives, tranquilizers, or sleeping medicine, prescription pain medicine or narcotics, medicine for seizures or barbiturates, muscle relaxants, or anesthetics, including some dental anesthetics. Check with your doctor before taking any of the above while you are using this medicine.

This medicine may cause some people to become drowsy or less alert than they are normally. Even though suvorexant is taken at bedtime, it may cause some people to feel drowsy or less alert on arising. Make sure you know how you react to suvorexant before you drive, use machines, or do anything else that could be dangerous if you are not alert.

If you develop any unusual and strange thoughts or behavior while you are taking suvorexant, be sure to discuss it with your doctor. Some changes that have occurred in people taking this medicine are like those seen in people who drink alcohol and then act in a manner that is not normal. Other changes may be more unusual and extreme, such as confusion, worsening of depression, hallucinations (seeing, hearing, or feeling things that are not there), suicidal thoughts, and unusual excitement, nervousness, or irritability.

This medicine may cause you to do things while you are still asleep that you may not remember the next morning. You could drive a car, sleepwalk, have sex, make phone calls, or prepare and eat food while you are asleep or not fully awake. Tell your doctor right away if any of these things occur.

This medicine may cause sleep paralysis (temporary inability to move or talk for up to several minutes while you are going to sleep or wake up) or have cataplexy-like symptoms (temporary weakness in your legs). Tell your doctor right away if you have these symptoms while you are using this medicine.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

What Are Reasons I Shouldn't Take Belsomra?

Before starting Belsomra, tell your healthcare provider if you:

  • Are pregnant or breastfeeding
  • Have liver disease
  • Have breathing or lung problems, such as chronic obstructive pulmonary disease (COPD) or sleep apnea (sleep disorder in which breathing stops and restarts throughout the night)
  • Have muscle problems or weakness
  • Have a history of alcohol or drug addiction, depression, or mental health illness

You should not take this medication if you have narcolepsy (overwhelming daytime drowsiness). Because Belsomra causes drowsiness, if you are 65 years or older, you may be at a higher risk of falls while taking this medication.

What Other Medications Interact With Belsomra?

Some foods and medicines can affect how Belsomra works. Depending on what other medications you are taking, your healthcare provider may adjust your dose of Belsomra or choose a different medication.

Tell your provider if you are using any of the following medications:

  • Emend (aprepitant)
  • Victrelis (boceprevir)
  • Tegretol (carbamazepine)
  • Cipro (ciprofloxacin)
  • Biaxin, Biaxin Filmtab, Biaxin XL (clarithromycin)
  • Vaprisol (conivaptan)
  • Digitek or Digox (digoxin)
  • Cardizem (diltiazem)
  • Erythromycin
  • Diflucan (fluconazole)
  • Gleevec (imatinib)
  • Serzone (nefazodone)
  • Dilantin (phenytoin)
  • Rifadin, Rimactane (rifampin)
  • Incivek (telaprevir)
  • Ketek (telithromycin)
  • Isoptin or Covera HS (verapamil)
  • Medications used to treat human immunodeficiency virus (HIV), such as Agenerase (amprenavir), Reyataz (atazanavir), and Lexiva (fosamprenavir)
  • Medications used to treat fungal infections, such as Sporanox (itraconazole), Nizoral (ketoconazole), Noxafil (posaconazole)

This is not an all-inclusive list of medications that may interact with Belsomra. Speak to your health practitioner or pharmacist if you have any concerns about your current medications, prescription, or OTC medications. 

Taking medications that decrease central nervous system activity, such as benzodiazepines, opioids, alcohol, and tricyclic antidepressants, with Belsomra can increase your risk of adverse effects.

Frequently Asked Questions

  • What is Belsomra used for?

    Belsomra is used to treat insomnia in adults.

  • How does Belsomra work?

    Belsomra prevents the binding of the wake-promoting neuropeptides, orexin-A, and orexin-B, to the orexin type 1 (OX1R) and type 2 (OX2R) receptors, allowing you to get to sleep faster and stay asleep longer.

  • When should I take Belsomra?

    Belsomra should be taken by mouth within 30 minutes of your bedtime and with at least seven hours available to sleep before awakening. This medication works better when taken without food.

  • Who should not take Belsomra?

    People with the following conditions should not use Belsomra:

    • Narcolepsy
    • Liver disease
    • Breathing or lung problems (such as COPD or sleep apnea)
    • Muscle problems or weakness
    • Depression/suicidal thoughts
    • History of alcohol or drug addiction

How Can I Stay Healthy While Taking Belsomra?

Sleep disorders like insomnia can affect your daily functioning, quality of life, and health. Effective treatments like Belsomra can help. In addition to taking your medication, there are other steps you can take to improve your condition, including:

Good sleep hygiene practices can involve following a relaxing nightly routine, limiting caffeine intake several hours before bedtime, and reducing stress. 

While taking Belsomra, avoid using other substances that may also make you drowsy or cause you to fall asleep. After taking your Belsomra dose, stay away from activities or tasks that require you to be alert. Be sure to let your healthcare provider know whether Belsomra is working for you.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare professional. Consult with your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

2 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Food and Drug Administration. Belsomra label.

  2.  U.S. National Library of Medicine. Medline Plus. Suvorexant.