Dayvigo (Lemborexant) - Oral

What Is Dayvigo?

Dayvigo (lemborexant) is a prescription medication to treat trouble sleeping (insomnia). It may help you fall asleep sooner and stay asleep longer.

Dayvigo is an orexin receptor inhibitor. It attaches to binding sites called orexin receptors. Orexin A and orexin B are brain chemicals that encourage you to stay awake. This medication prevents orexin A and orexin B from binding to their receptors. Dayvigo helps you sleep by blocking these proteins that might keep you awake.

Dayvigo is available in a prescription tablet that you take by mouth (oral).

Drug Facts

Generic Name: Lemborexant

Brand Name(s): Dayvigo

Drug Availability: Prescription

Therapeutic Classification: Orexin receptor inhibitor

Available Generically: No

Controlled Substance: Yes, schedule IV controlled substance

Administration Route: Oral (by mouth)

Active Ingredient: Lemborexant

Dosage Form(s): Tablet

What Is Dayvigo Used For?

Dayvigo is used for insomnia. It may help you fall asleep faster and stay asleep longer.

Adults generally need at least seven hours of sleep every night. However, one in three adults in the United States gets less than the recommended amount of sleep. Not sleeping enough is linked to several medical conditions, including depression, type 2 diabetes, heart disease, and obesity.

How to Take Dayvigo

Take Dayvigo once nightly, right before bedtime. Before taking Dayvigo, make sure that you have at least seven hours before you need to wake up the next day. Do not take Dayvigo with a meal or right after a meal.

Storage

Keep this medication at room temperature between 68 degrees to 77 degrees Fahrenheit. It has a short-term safety storage range between 59 degrees to 86 degrees Fahrenheit.

Keep your medications tightly closed and out of reach of children and pets. Ideally, you should keep your medication locked in a cabinet or closet.

Do not pour unused and expired drugs down the drain or toilet. Visit the FDA's website to find out where and how to discard of unused and expired medications. You can also find disposal boxes in your area. Ask your pharmacist or healthcare provider if you have any questions about the best ways to dispose of your medications.

If you plan to travel with Dayvigo, get familiar with your final destination's regulations. Checking with the U.S. embassy or consulate can be a helpful resource. Before you go, make a copy of your Dayvigo prescription.

Keep your medication in its original container from your pharmacy with your name on the label. Since Dayvigo is a controlled substance, ask your provider for a document of medical necessity on a letter with an official letterhead. Ask your pharmacist or provider if you have any questions about traveling with your medicine.

Off-Label Uses

Dayvigo currently does not have any off-label uses.

How Long Does Dayvigo Take to Work?

Dayvigo reaches maximum levels in your body after about one to three hours. People taking Dayvigo tend to fall asleep within 15 to 20 minutes of taking their dose.

What are the Side Effects of Dayvigo?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects while taking Dayvigo, contact your pharmacist or healthcare provider. You may report side effects to the Food and Drug Administration (FDA) at fda.gov/medwatch or 1-800-FDA-1088.

Common Side Effects

Common side effects of Dayvigo include:

  • Drowsiness or sleepiness
  • Headache
  • Nightmares or abnormal dreams
  • Tiredness or low energy

Severe Side Effects

Get medical help right away if you develop the following severe side effects. Call 911 if your symptoms feel life-threatening.

Potentially serious side effects of Dayvigo include:

Long-Term Side Effects

If your insomnia has not improved within seven to 10 days after starting Dayvigo, tell your healthcare provider. Another medical condition might be causing your sleeping problems.

In a clinical trial on Dayvigo's effectiveness, the medication was used for up to 12 months. The people in the study only reported mild to moderate side effects. The most common side effects were:

  • Common cold-like symptoms
  • Drowsiness or sleepiness
  • Headache

After stopping Dayvigo, the people in the study did not experience worsening (rebound) insomnia or withdrawal side effects.

Report Side Effects

Dayvigo 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 (1-800-332-1088).

Dosage: How Much Dayvigo Should I Take?

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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 the treatment of insomnia (trouble sleeping):
    • For oral dosage form (tablets):
      • Adults—5 milligrams (mg) once a day, at bedtime. Your doctor may increase your dose as needed and tolerated. However, the dose is usually more than 10 mg per day.
      • Older adults—5 mg once a day, at bedtime.
      • Children—Use and dose must be determined by your doctor.

Modifications

The following changes (modifications) should be kept in mind when using Dayvigo (lemborexant):

Severe allergic reaction: Avoid using Dayvigo if you have a known allergy to it or any of its ingredients. Ask your pharmacist or healthcare provider for a complete list of the ingredients if you're unsure.

Pregnancy: In rat and rabbit studies, very high amounts of lemborexant were found to have negative effects on a fetus. However, we don't know enough about the safety and effectiveness of Dayvigo in pregnant people and fetuses. If you plan to become pregnant or are pregnant, talk to your provider about taking Dayvigo. They will help you weigh the benefits and risks of using this medication during your pregnancy. They can also help you enroll in the Dayvigo pregnancy exposure registry by calling 1-888-274-2378.

Breastfeeding: In rat studies, lemborexant was present in breast milk. Dayvigo could possibly be present in human breast milk. Since Dayvigo binds to proteins in the bloodstream, only small amounts of medication will likely cross over into breast milk and reach a nursing infant.

There's usually no reason to stop Dayvigo if the breastfeeding parent needs the medication. The nursing infant, however, should be closely monitored for side effects, such as excessive drowsiness or sleepiness.

Talk with your healthcare provider if you plan to breastfeed while you are taking Dayvigo. They will help you weigh the benefits and harms of using Dayvigo while nursing. They can also discuss the different options you have for feeding your baby while you're using this medication.

Older adults over 65: Research has shown no differences in Dayvigo's effectiveness between older and younger adults. Older and younger adults experienced similar side effects of Dayvigo when taking 5 milligrams (mg) nightly (including drowsiness and sleepiness). However, when taking 10 milligrams (mg) nightly, older adults had more side effects than younger adults. Caution should be used in older adults taking Dayvigo at doses above 5mg.

Children: There is little information on the effectiveness and safety of Dayvigo in children.

Kidney problems: You do not need to adjust your dose if you have kidney impairment. However, use caution because you may experience more side effects like drowsiness or sleepiness from this medication.

Liver problems: If you have mild liver impairment, you might experience more drowsiness or sleepiness side effects with Dayvigo. Your healthcare provider may adjust your dose if you have moderate liver impairment. Dayvigo is not recommended if you have severe liver impairment.

Breathing or lung problems: Dayvigo did not worsen symptoms in people with mild obstructive sleep apnea (OSA). However, the medication has not been studied in people with moderate to severe OSA or lung conditions, such as chronic obstructive pulmonary disease (COPD).

Missed Dose

If you miss a dose, take it as soon as you remember as long as you have at least seven hours to devote to sleep. If you do not have at least seven hours before you need to wake up, do not take Dayvigo. Missed doses of Dayvigo are not typically linked to worsening insomnia (rebound) or withdrawal side effects.

Overdose: What Happens If I Take Too Much Dayvigo?

There is limited information on Dayvigo overdoses. A likely effect of taking too much Dayvigo would be excessive drowsiness and sleepiness.

If you think you're experiencing an overdose or life-threatening symptoms, seek immediate medical attention.

What Happens If I Overdose on Dayvigo?

If you think you or someone else may have overdosed on Dayvigo, call a healthcare provider or the Poison Control Center (1-800-222-1222).

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

Precautions

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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 lemborexant 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, especially older persons, to become drowsy, dizzy, lightheaded, clumsy or unsteady, or less alert than they are normally, which may lead to falls, fractures, or other injuries. Even though lemborexant is taken at bedtime, it may cause some people to feel drowsy or less alert on arising. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.

If you develop any unusual and strange thoughts or behavior while you are using lemborexant, be sure to discuss it with your doctor. Some changes that have occurred in people using 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 (eg, St. John's wort) or vitamin supplements.

What Are Reasons I Shouldn’t Take Dayvigo?

Before taking Dayvigo (lemborexant), talk with your healthcare provider if any of the following applies to you:

  • Severe allergic reaction: If you have a severe allergic reaction to Dayvigo or its ingredients, you should not take it.
  • Narcolepsy: Dayvigo should be avoided in people with narcolepsy. Some of Dayvigo's serious side effects are similar to the symptoms of narcolepsy, including sleep paralysis and sudden muscle weakness while awake (cataplexy). Dayvigo may cause daytime sleepiness, which is another symptom of narcolepsy.
  • Pregnancy: We do not know enough about the safety and effectiveness of Dayvigo in pregnant people and their unborn fetuses. Weigh the benefits and risks of using Dayvigo during pregnancy with your provider. They can also help you enroll in the Dayvigo pregnancy exposure registry by calling 1-888-274-2378.
  • Breastfeeding: Only small amounts of medication are likely to cross into breast milk and reach a nursing baby. There is usually no reason to stop Dayvigo if the breastfeeding parent needs the medication. The nursing infant should be closely monitored for side effects, such as excessive drowsiness or sleepiness. Talk with your healthcare provider about the benefits and possible harms of using Dayvigo while nursing.
  • Older adults over 65: There were no differences in Dayvigo's effectiveness between older and younger adults. However, at nightly doses above 5mg, older adults tended to have more side effects than younger adults.
  • Children: There is little information about the effectiveness and safety of Dayvigo in children.
  • Kidney problems: There's no need to adjust your Dayvigo dose if you have kidney impairment, but use caution because you might have more drowsiness or sleepiness.
  • Liver problems: If you have mild liver impairment, you might have more drowsiness or sleepiness from taking Dayvigo. Your provider will likely adjust your dose if you have moderate liver impairment. Dayvigo is not recommended if you have severe liver impairment.

What Other Medications Interact With Dayvigo?

Use caution when taking Dayvigo with the following medications:

CYP3A4-inhibiting medications: CYP3A4 is a liver protein responsible for breaking down and clearing out drugs like Dayvigo. CYP3A4-inhibiting medications prevent CYP3A4 from working as well. This may lead to higher levels of Dayvigo in the body and a higher likelihood of side effects.

Avoid combining Dayvigo with strong or moderate inhibitors of CYP3A4. Dayvigo's dose will need to be reduced with weak inhibitors of CYP3A4.

Examples of strong CYP3A4-inhibiting medications include clarithromycin (an antibiotic) and itraconazole (an antifungal). Examples of moderate CYP3A4-inhibiting medications include fluconazole (an antifungal) and verapamil (a heart medication). The blood thinner Brilinta (ticagrelor) blood thinner is an example of a weak CYP3A4 inhibitor.

CYP3A4-inducing medications: CYP3A4-inducing medications encourage CYP3A4 to break down Dayvigo quickly. This may lead to low Dayvigo levels in the body, resulting in decreased effectiveness. Avoid taking Dayvigo with strong or moderate CYP3A4-inducing medications.

Examples of strong CYP3A4-inducing medications include rifampin for tuberculosis (TB), carbamazepine for seizures, and St. John's wort for depression. Examples of moderate CYP3A4-inducing medications include some human immunodeficiency virus (HIV) medications, such as efavirenz.

CYP2B6 substrates: CYP2B6 is another liver protein that breaks down medications, such as bupropion for depression and methadone for pain. Medicines that are broken down by CYP2B6 are called CYP2B6 substrates.

Dayvigo encourages CYP2B6 to quickly break down CYP2B6 substrates, leading to low levels in the body and making the substrates less effective. For this reason, your healthcare provider may monitor you to ensure that CYP2B6 substrates work for you. If necessary, they may increase the doses of your CYP2B6-substrate medications.

Talk with your pharmacist or provider for more detailed information about medication interactions with Dayvigo.

Tell your provider about any other medicines you take or plan to take, including over-the-counter (OTC) nonprescription products, vitamins, herbs, supplements, and plant-based medicines.

What Medications Are Similar?

In addition to Dayvigo, other sleep medications may include:

Since these medications are used to treat insomnia, they are not usually taken together. If you have any questions, discuss them with your healthcare provider. 

The choice of sleep medication is dependent on the following factors:

  • Do you have trouble falling asleep?
  • Do you have trouble staying asleep?
  • Do you have trouble falling and staying asleep?

If you have problems with falling asleep, staying asleep, or both, Dayvigo is a potential choice.

Frequently Asked Questions

  • Where is Dayvigo available?

    Dayvigo is available with a prescription from your healthcare provider. Your local retail pharmacy may carry this medication. If your pharmacy doesn't have Dayvigo in stock, they might be able to order it for you.

  • How much does Dayvigo cost?

    Dayvigo is not available in a generic form. It might be expensive without insurance.

    If cost is a concern, talk to your healthcare provider or pharmacist about patient assistance programs. Some other potentially helpful resources may include: NeedyMeds, FundFinder, Simplefill, BenefitsCheckUp, Medicare Rights Center, State Pharmaceutical Assistance Programs (SPAPs), and Rx Outreach.

  • Why shouldn't I take Dayvigo with a meal or right after a meal?

    If you take Dayvigo with or after a meal, the medication might take longer to work.

  • What if Dayvigo doesn't work for me?

    Let your healthcare provider know if your sleeping troubles are not getting better within seven to 10 days of starting treatment with Dayvigo. Another medical condition could be the cause of your sleeping problems.

    Once your provider determines that your insomnia is not being caused by another medical condition, they can help you with the next steps—like trying another medication.

  • Does Dayvigo affect my ability to drive?

    Do not immediately drive after taking a dose of Dayvigo. You may still feel drowsy the morning after you take the medicine. Wait until you’re fully awake before driving.

  • Can I drink alcohol with Dayvigo?

    The manufacturer of Dayvigo recommends avoiding alcohol altogether. Mixing alcohol and Dayvigo may worsen side effects or result in serious side effects, such as trouble staying alert, unsteady balance, and memory problems.

  • If I stop taking Dayvigo, will I experience any side effects?

    In a clinical trial, study participants who stopped taking Dayvigo after 12 months of treatment did not experience rebound (worsening) insomnia or withdrawal side effects.

  • Can I develop an addication with Dayvigo?

    Like many other sleep medications, Dayvigo might be linked to substance use disorder (SUD). In a potential misuse trial, study participants had a history of recreational substance misuse with sedatives.

    In these people, Dayvigo between 10 to 30 milligrams (mg) resulted in "drug-liking," "take the drug again," and "good drug effect" measurements similar to other sedatives, such as zolpidem at 30 milligrams (mg) and suvorexant at 40 milligrams (mg). Both zolpidem and suvorexant are schedule IV controlled substances.

    Like zolpidem and suvorexant, Dayvigo is also a schedule IV controlled substance. Its likelihood of causing SUD is less than schedule I through III medications, but more than a schedule V controlled substance.

    If you have a history of SUD, tell your healthcare provider. You should also tell them if you develop SUD-like symptoms:

    • Agitation
    • Appetite changes
    • Changes in mood and behavior
    • Irritability
    • Less attention to personal hygiene
    • Low performance at school, work, or home
    • Relationship problems
    • Sleeping habit changes
    • Tremors
    • Unsteady muscle movement
    • Weight changes

How Can I Stay Healthy While Taking Dayvigo?

Before you start taking Dayvigo, your provider will want to make sure you don't have a sleep disorder like sleep apnea. Your provider may want you to do a sleep study to rule this or other conditions out.

Experts recommend practicing good sleep hygiene to help with sleep. Although Dayvigo may help you fall asleep and stay asleep longer, there are also other strategies you can use to get a better night's sleep and avoid ruining your sleep:

  • Have a scheduled time for going to bed and waking up
  • Avoid eating large meals before bedtime
  • Don't drink coffee or alcohol right before you go to bed
  • Avoid intense exercise right before bedtime but get enough exercise during the day
  • Avoid smoking or using tobacco products and quit if you do
  • Use your bed only for sleep
  • Do not read or watch TV in bed
  • Make sure your bedroom is a comfortable environment that is not too cold, too warm, or too loud
  • Try sleep stories or apps to relax before bed

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 provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

10 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.
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By Ross Phan, PharmD, BCACP, BCGP, BCPS
Ross is a writer for Verywell with years of experience practicing pharmacy in various settings. She is also a board-certified clinical pharmacist and the founder of Off Script Consults.