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Belsomra is a prescription sleep medicine containing suvorexant, an orexin receptor antagonist. It is approved for insomnia marked by difficulty falling asleep, staying asleep, or both. Belsomra comes in 5 mg, 10 mg, 15 mg, and 20 mg tablets. Suvorexant is classified as a Schedule IV controlled substance in the United States.
read more about belsomra ...Suvorexant blocks the orexin OX1R and OX2R receptors. Orexin A and orexin B are neuropeptides involved in wakefulness. Blocking their activity reduces wake signaling and promotes sleep. This mechanism differs from medicines that act mainly through gamma-aminobutyric acid pathways.
Belsomra is approved for adults with insomnia involving difficulty with sleep onset, sleep maintenance, or both. It is contraindicated in people with narcolepsy. Severe liver impairment is another setting where Belsomra is not recommended. Respiratory status deserves clinical review in people with obstructive sleep apnea or chronic obstructive pulmonary disease.
The recommended starting dose is 10 mg once nightly within 30 minutes of bedtime, with at least seven hours remaining before planned waking. The dose can increase to 20 mg once nightly when 10 mg does not control insomnia and is tolerated. Taking Belsomra with or soon after food can delay its onset.
Belsomra can cause daytime sleepiness, impaired driving, falls, worsening depression, suicidal thoughts, complex sleep behaviors, sleep paralysis, hallucinations around sleep transitions, and cataplexy-like symptoms. Alcohol and other central nervous system depressants increase sedation. Treatment stops if sleepwalking, sleep-driving, or another complex sleep behavior occurs.
Yes. Suvorexant blocks OX1R and OX2R orexin receptors involved in wakefulness.
The maximum recommended dose is 20 mg once nightly.
At least seven hours should remain before the planned waking time.
No. Narcolepsy is a contraindication under current prescribing information.
BELSOMRA (suvorexant) Medication Guide. https://www.merck.com/product/usa/pi_circulars/b/belsomra/belsomra_mg.pdf. Date Accessed September 15, 2026.
BELSOMRA (suvorexant) Prescribing Information. https://www.merck.com/product/usa/pi_circulars/b/belsomra/belsomra_pi.pdf. Date Accessed September 15, 2026.
DailyMed - BELSOMRA (suvorexant) tablet, film coated. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=e5b72731-1acb-45b7-9c13-290ad12d3951. Date Accessed September 15, 2026.
FDA Label - BELSOMRA (suvorexant) Tablets. https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/204567s007lbl.pdf. Date Accessed September 15, 2026.
Suvorexant. MedlinePlus. https://medlineplus.gov/druginfo/meds/a614046.html. Date Accessed September 15, 2026.