Sunosi (Solriamfetol) - Oral

What Is Sunosi?

Sunosi (solriamfetol) is a controlled prescription medication option for the treatment of obstructive sleep apnea (OSA, airflow blockage during sleep) or narcolepsy (sleep disorder characterized by overwhelming daytime drowsiness). As a member of the dopamine and norepinephrine reuptake inhibitor (DNRI) medication class, Sunosi is thought to work by raising the amounts of certain naturally occurring chemicals in the brain—dopamine and norepinephrine.

Sunosi is available in tablet form.

Drug Facts

Generic Name: Solriamfetol

Brand Name(s): Sunosi

Drug Availability: Prescription

Therapeutic Classification: Dopamine and norepinephrine reuptake inhibitor (DNRI)

Available Generically: No

Controlled Substance: Schedule IV

Administration Route: Oral

Active Ingredient: Solriamfetol

Dosage Form(s): Tablet

What Is Sunosi Used For?

The Food and Drug Administration (FDA) approved Sunosi to help improve wakefulness in people with OSA or narcolepsy.

However, Sunosi is not the first-choice treatment for OSA. The FDA recommends treatment with continuous positive airway pressure (CPAP) for at least a month. Then, if people with OSA still have severe daytime sleepiness, they may start taking Sunosi in addition to using CPAP therapy.

Obstructive Sleep Apnea

There are different types of sleep apnea. In OSA, individuals struggle to breathe because of relaxing soft tissue in the back of the throat that blocks the movement of air. So, people with OSA tend to experience the following symptoms: 

  • Trouble breathing
  • Restless sleep
  • Loud snoring with periods of silence followed by gasps
  • Daytime sleepiness
  • Trouble concentrating

Narcolepsy

Like OSA, there are also different types of narcolepsytype 1 and type 2. In both types, daytime sleepiness is a common symptom. Sunosi is indicated for use to reduce excessive daytime sleepiness (EDS) in people with narcolepsy.

Since Sunosi only improves wakefulness, however, some people with narcolepsy might take additional medications for other symptoms.

In addition to EDS, other symptoms of narcolepsy include:

  • Hypnagogic hallucinations (experiencing a vivid dreamlike state between wakefulness and sleep) 
  • Sleep paralysis (inability to move or speak while falling asleep or when waking)
  • Sudden muscle weakness and inability to move
Sunosi (Solriamfetol) Drug Information - Illustration by Zoe Hansen

Verywell / Zoe Hansen

How to Take Sunosi

Take Sunosi once a day first thing in the morning by mouth with or without food. Do not take Sunosi within nine hours of scheduled bedtime.

Sunosi is categorized as a schedule IV controlled substance. The active ingredient, solriamfetol, has the potential for abuse. Sunosi's likelihood of causing substance use disorder (SUD) is less than schedule I through III controlled substances. However, its SUD potential is higher than a schedule V controlled substance.

If you have the following SUD-like symptoms, please notify your healthcare provider for help:

  • Agitation
  • Anxiety
  • Appetite changes
  • Changes in behavior
  • Decline in home, school, or work performance
  • Irritability
  • Lack of personal hygiene
  • Mood swings
  • Relationship troubles
  • Sleeping troubles
  • Weight changes

Storage

Like many medications, Sunosi can be stored at room temperature—68–77 degrees Fahrenheit—with a safe storage range of 59–86 degrees. Since Sunosi is a controlled substance, however, you should store the medication in a locked cabinet or a similar safe place.

If you are traveling with Sunosi, please consider talking with your healthcare provider. In order to bring Sunosi into and out of certain countries, you might need the healthcare provider to document the medical necessity of this medication in a letter with an official letterhead. Also, consider making a copy of your Sunosi prescription to take with you. If possible, keep Sunosi in its original container with your name on it from the pharmacy.

How Long Does Sunosi Take to Work?

Within one week of Sunosi therapy, you might notice some improvement in your OSA or narcolepsy symptoms.

What Are the Side Effects of Sunosi?

Similar to most medications, there are potential side effects with Sunosi.

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

Some common side effects include:

Severe Side Effects

Please seek medical attention if you experience the following serious side effects:

Your healthcare provider will regularly check your blood pressure and heart rate before and during Sunosi therapy to prevent serious heart-related side effects. Also, if you experience agitation, anxiety, appetite changes, irritability, and sleeping troubles, please notify your healthcare provider to prevent worrisome medication dependence or worsening mood conditions.

Furthermore, if you have the following current or past medical history, please inform your healthcare provider:

Report Side Effects

Sunosi 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 Sunosi 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 oral dosage form (tablets):
    • For wakefulness in patients with narcolepsy:
      • Adults—At first, 75 milligrams (mg) once a day. Your doctor may adjust your dose as needed and tolerated. However, the dose is usually not more than 150 mg per day.
      • Children—Use and dose must be determined by your doctor.
    • For wakefulness in patients with sleep apnea:
      • Adults—At first, 37.5 milligrams (mg) once a day. Your doctor may adjust your dose as needed and tolerated. However, the dose is usually not more than 150 mg per day.
      • Children—Use and dose must be determined by your doctor.

Modifications

Sunosi is available as 75 milligram and 150 milligram tablets. However, only the 75 milligram tablets are scored. So, if necessary, you can only break the 75 milligram tablets in half.

Sunosi has little data about its safety and effectiveness when taken during pregnancy or breastfeeding. If you were already taking Sunosi during pregnancy or no other treatment selections are effective for your symptoms, there is no current reason to stop the medication while nursing.

However, if you are taking Sunosi while nursing, the healthcare provider might monitor the nursing baby for the following side effects:

  • Agitation
  • Poor feeding
  • Trouble sleeping
  • Weight changes

Also, please consider calling 877-283-6220 to enroll yourself in the pregnancy exposure registry.

Kidney function does affect the dosing of Sunosi. Based on your kidney function, your healthcare provider can adjust your medication dose. If you have end-stage renal disease (ESRD), however, the manufacturer does not recommend Sunosi for you.

Missed Dose

If you ever skip your Sunosi dose for the day, you might experience excessive daytime sleepiness. If you forget a dose, try to take it as soon as you remember. However, if it is already within nine hours of your scheduled bedtime, just wait until your next dose. If you take Sunosi too close to bedtime, then you might have trouble sleeping.

Do not double up or take more than one dose at a time.

Overdose: What Happens If I Take Too Much Sunosi?

If you accidentally take multiple Sunosi doses at one time, please seek medical attention.

What Happens If I Overdose on Sunosi?

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

If someone collapses or isn't breathing after taking Sunosi, 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. Blood tests may be needed to check for unwanted effects.

This medicine does not take the place of getting enough sleep. It should not be used for occasional sleepiness that has not been diagnosed as narcolepsy or sleep apnea. Ask your doctor for advice about good sleep habits.

Do not use this medicine if you are using or have used an MAO inhibitor (MAOI), such as isocarboxazid (Marplan®), linezolid (Zyvox®), phenelzine (Nardil®), selegiline (Eldepryl®), tranylcypromine (Parnate®) within the past 14 days.

Your blood pressure might get too high while you are using this medicine. It may also increase your heat rate. This may cause headaches, dizziness, lightheadedness, fainting, or blurred vision. You might need to measure your blood pressure at home. If you think your blood pressure is too high, call your doctor right away.

This medicine may cause some people to be agitated, irritable, or display other abnormal behaviors. Make sure the doctor knows if you have trouble sleeping, get upset easily, have a big increase in energy, or start to act reckless. Also tell the doctor if you have sudden or strong feelings, such as feeling nervous, angry, restless, violent, or scared. If you or your caregiver notice any of these side effects, tell your doctor right away.

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 Sunosi?

If any of the following applies to you, taking Sunosi is not advisable:

  • Kidney concerns: It is not recommended to take Sunosi if you have end-stage kidney disease.
  • Monoamine oxidase inhibitor (MAOI) use: Due to a drug interaction that causes severe high blood pressure, the healthcare provider will not give you a prescription for Sunosi if you have taken a medication in the MAOI class within the last 14 days.

What Other Medications Interact With Sunosi?

In addition to MAOIs, due to drug interactions, take the following medications with caution:

  • Medications that raise blood pressure or heart rate: Sunosi can possibly lead to high blood pressure and fast heart rate. Therefore, use caution with other medications that have similar side effects of raising blood pressure and heart rate. 
  • Dopaminergic medications: Dopaminergics mimic dopamine. Since Sunosi raises existing dopamine levels in the brain, taking dopaminergic medications with Sunosi might result in too much dopamine activity.

Before starting Sunosi, talk to your healthcare provider about all medications you take.

What Medications Are Similar?

Although there are other medications that affect dopamine and norepinephrine in the brain, Sunosi is the only medication in the DNRI drug class that helps improve wakefulness in people with OSA and narcolepsy.

Experts generally recommend medications as second-line or add-on therapy options for OSA. Using a CPAP machine is a common treatment choice for OSA. However, if excessive daytime sleepiness is still an issue after a month of CPAP use, then Sunosi can be a potential add-on option.

Sunosi is also not the first treatment choice for narcolepsy. Modafinil (brand name Provigil)—a brain stimulant that is thought to work by raising dopamine levels—is often the initial option. However, a 2019 study suggests that the differences in side effects are minimal between Sunosi and modafinil. Although further research is necessary, Sunosi might become another first-choice treatment option for narcolepsy in the future—depending on more data.

In addition to modafinil, the two other similar medications to help decrease excessive daytime sleepiness in people with narcolepsy are:

  • Amphetamine-like stimulants: If modafinil is not effective, then the next possible medication option is an amphetamine-like stimulant, such as methylphenidate. Similar to Sunosi, this type of brain stimulant is thought to work by raising dopamine and norepinephrine. Compared to Sunosi and modafinil, however, amphetamine-like stimulants tend to have more side effects and a higher likelihood of SUD.
  • Sodium oxybate: In addition to improving wakefulness, sodium oxybate might help people with cataplexy—another potential symptom of narcolepsy. Sodium oxybate’s active component is gamma-hydroxybutyrate (GHB). GHB is the breakdown product of gamma-aminobutyric acid (GABA)—a naturally occurring chemical in the brain. This medication is thought to work by mimicking GABA in parts of the brain that have dopamine and norepinephrine.

Since all of these medications influence similar brain chemicals, they are not usually taken together. If you have any questions, please talk with your healthcare provider.

Frequently Asked Questions

  • Where is Sunosi available?

    Sunosi is only available if you have a prescription from your healthcare provider. Most retail pharmacies carry Sunosi. If they do not currently have Sunosi, they should be able to order this medication for you.

  • How much does Sunosi cost?

    Since Sunosi is a brand-name prescription medication, it can be expensive. If cost is a concern, talk to your healthcare provider about options for financial assistance.

  • Can I develop an addiction from Sunosi?

    Based on a 2018 study, Sunosi has a similar potential as phentermine—a weight-loss medication—in leading to substance use disorder (SUD). Therefore, like phentermine (brand names Lomaira or Adipex-P), Sunosi is a schedule IV controlled substance. Sunosi’s likelihood of causing SUD is less than schedule I through III controlled substances. However, its SUD potential is higher than a schedule V controlled substance.

How Can I Stay Healthy While Taking Sunosi?

While taking Sunosi for OSA or narcolepsy, lifestyle changes are important. 

Recommendations for OSA include:

  • Avoiding alcohol and sleep-inducing medications
  • Losing weight
  • Quitting smoking

As for narcolepsy, medications will help with symptoms. However, the following lifestyle changes will further improve the quality of nighttime sleep and decrease excessive daytime sleepiness:

  • Avoiding alcohol and caffeine
  • Getting regular exercise
  • Having regularly scheduled naps and bedtime
  • Quitting smoking
  • Skipping large meals

In addition to the above lifestyle changes, having a strong social support network is essential. Consider taking the first step by sharing that you have a medical condition. As your loved ones become more aware of OSA or narcolepsy, they can provide you with the encouragement and support that you need.

Please also stay in touch with your healthcare provider. If you experience side effects while taking Sunosi, please let them know to prevent serious side effects, worsening mood conditions, and SUD.

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

7 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. Sunosi.

  2. National Institute of Neurological Disorders and Stroke. Sleep Apnea Information Page.

  3. National Institute of Neurological Disorders and Stroke. Narcolepsy Information Page.

  4. Food and Drug Administration. Provigil label.

  5. Thorpy MJ, Shapiro C, Mayer G, et al. A randomized study of solriamfetol for excessive sleepiness in narcolepsy. Ann Neurol. 2019 Mar; 85(3): 359-370. doi: 10.1002/ana.25423

  6. National Institute of Neurological Disorders and Stroke. Narcolepsy Fact Sheet.

  7. Carter LP, Henningfield JE, Wang YG, et al. A randomized, double-blind, placebo-controlled, crossover study to evaluate the human use liability of solriamfetol, a selective dopamine and norepinephrine reuptake inhibitor. J Psychopharmacol. 2018 Dec; 32(12): 1351-1361.

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.