Do you toss and turn when you go to bed at night and can't fall asleep? Or do you wake up in the middle of the night and can't fall back asleep and wait until the sun comes up? This insomnia problem is a problem for many people. Perhaps your doctor has prescribed a medicine called Lemborexant as a solution to this problem. It is most commonly available under the brand name DAYVIGO. So, today we will talk about this medicine, what it does to the body, and the things to be careful about when using it.
What exactly is Lemborexant?
Simply put, Lemborexant is a medication that is used to treat insomnia. It mainly helps you fall asleep faster and stay asleep throughout the night. It works by controlling the activity of certain chemical messengers (neurotransmitters) in our brain that help us stay awake. This helps calm down your restless mind and make it easier to fall asleep.
This medication is not usually prescribed for long-term use. Doctors often prescribe it for a short period of time.
Things you need to tell your doctor before starting this medication
Lemborexant is not a one-size-fits-all medicine. Therefore, it is very important to tell your doctor about any other medical conditions you have or any other medications you are taking. If you have any of the conditions listed in the table below, be sure to tell your doctor.
| Your situation | Why is it important to inform the doctor? |
|---|---|
| Depression or other mental illness | This medication can sometimes alter mental states. Therefore, if you already have a mental illness, your doctor should be aware of it. |
| If you drink alcohol regularly | Combining alcohol and this medication can cause serious side effects, such as excessive drowsiness and difficulty breathing. |
| Narcolepsy (sudden onset of sleep) | Because this medication causes drowsiness, it is not suitable for someone who already has this condition. |
| A history of drug addiction | Since there is a risk of addiction to this medication, the doctor will be especially careful if there is such a history. |
| Sudden muscle weakness (Cataplexy) | Since this is also a sleep-related neurological condition, problems may occur with this medication. |
| Liver or lung diseases | Medicines are eliminated from the body through the liver. If you have liver disease, the dosage of the medicine may need to be changed. If you have lung disease, breathing difficulties may increase. |
| Sleep apnea | Because this medication slows breathing to some extent, sleep apnea can become more severe. |
| Suicidal thoughts | If you or someone in your family has had these thoughts, you should be extra careful when using this medicine. |
| Doing unusual things in your sleep (e.g., sleepwalking) | This medicine can sometimes cause these things. So if you have a history of this, tell your doctor . |
| If you are pregnant or expecting a baby | There is still no complete data on the safety of this medication during pregnancy, so it is essential to talk to your doctor. |
| If a mother is breastfeeding her child | Discuss with your doctor whether the medicine can pass to the baby through breast milk. |
How exactly do I use this medicine?
This is very simple, but very important.
- Time: Take this pill right before you go to bed. Take the pill with a glass of water after you've finished eating, brushed your teeth, and are ready to go to bed.
- Food: This pill works best when taken on an empty stomach . Taking the pill after a heavy meal may delay its action.
- Dosage: Take only the dosage prescribed by your doctor. Never take more than the prescribed amount.
- Missed dose: Since this is taken only before bed, there is no such thing as 'missed dose'. If you wake up in the middle of the night, do not go back to take a pill. Doing so may cause excessive sleepiness the next day.
Most importantly: After taking this medicine, you should have at least 7-8 hours of uninterrupted sleep. Otherwise, don't do things like take the pill at 3 am and wake up at 6 am.
What to do if you take too much medicine?
If you have even the slightest suspicion that you have taken more medicine than you think, go to the nearest hospital Emergency Department (ETU) immediately. Or call the National Poisons Information Centre at the Colombo National Hospital . Do not take this lightly.
Other medications and foods that may interact with Lemborexant
When taking this medicine, it may interact with some other medicines and foods you are taking. This means that side effects may increase or the medicine may change how well it works.
- Alcohol : This is the most dangerous combination. Taking this medication with alcohol can cause severe conditions such as excessive drowsiness, difficulty breathing , and loss of consciousness.
- Other medications that cause drowsiness: Taking this with some cough, cold, and allergy medications (antihistamines), antidepressants, and painkillers (especially opioids ) can make drowsiness unbearable.
- Antifungals and some antibiotics: Some medications, such as Ketoconazole, Itraconazole, and Clarithromycin, delay the elimination of Lemborexant from the body. This may increase side effects.
- Antiepileptic drugs: Drugs like Carbamazepine and Phenytoin can reduce the effectiveness of Lemborexant.
- Grapefruit juice: This type of fruit juice can also increase the amount of Lemborexant in the body. Therefore, avoid eating/drinking grapefruit while taking this medication.
- St. John's Wort: This is an herbal supplement. It can also reduce the effectiveness of Lemborexant.
Therefore, it is very important to tell your doctor about every medication you take, even vitamins and traditional medicines.
What are the things to be careful about when taking medication?
There are several things to consider for your safety when using this medicine.
Sleepiness the next morning
After taking this medicine, you may feel sleepy and sluggish the next morning. Therefore:
- Avoid driving or operating heavy machinery until you know exactly how this medication affects you.
- If you feel dizzy, stand up slowly when getting up from a sitting or lying position.
Abnormal sleep behaviors
Although this may seem a bit strange, some people taking this medication can do unusual things, as if in a dream. That is, after waking up from sleep:
- Driving
- Cooking or eating
- Making phone calls
- Having sex
- Sleepwalking
The worst part is that you won't remember anything when you wake up the next morning. If someone at home tells you that you did something like this, or if you realize that something like this has happened to you, stop taking the medicine immediately and talk to your doctor.
Take care of your mental health.
Watch for sudden changes in your mood, behavior, or thoughts while taking this medicine.
- Do you feel like your depression is getting worse?
- Are you having thoughts of suicide?
- Are you feeling anxious or angry?
If any of these changes occur, especially when you first start taking the medication or after changing the dosage, inform your doctor immediately.
After stopping the medication
If you stop taking the medication for a few days, you may experience a little more insomnia for the first day or two. This is called rebound insomnia . This is normal and will go away on its own in a few days. Don't worry about it.
Side effects that may occur due to medication
Like all medicines, Lemborexant can cause side effects, although not everybody gets them.
| Serious side effects that should be reported to the doctor immediately | |
|---|---|
| Severe allergies | Skin rash, itching, swelling of the face, lips, tongue, difficulty breathing. |
| Slowing of brain function and breathing (CNS Depression) | Slow breathing, shortness of breath, excessive sleepiness, and confusion. |
| Mental and behavioral changes | Sudden anger, mental confusion, hallucinations, suicidal thoughts. |
| Loss of body sensation when waking up or going to sleep | Feeling unable to speak or move for several minutes. |
| Abnormal sleep behaviors | Doing things like sleepwalking, eating, or driving, and then losing memory of them. |
| Side effects that are usually not serious, but should be reported to the doctor if they persist | |
| Sleepiness the next day | This may persist until the body gets used to the medication. |
| Body fatigue | You may feel general fatigue. |
| Headache | Some people may experience a slight headache. |
| Strange or frightening dreams | Some people may have different dream patterns. |
How to store and dispose of medicine safely?
This is very important.
- Keep away from children and pets. This medicine can be very harmful to them.
- Because there is a risk of addiction to this medicine, keep it in a safe place where it cannot be stolen.
- Never share this medicine with another person. It is illegal and could be life-threatening.
- Store at room temperature (between 20-25 degrees Celsius).
- Dispose of expired or unused medications properly. Before throwing pills in the trash, crush them up, mix them with used tea leaves, coffee grounds, or soil, and place them in a small bag, seal it, and throw them away. This will help prevent someone else from accidentally using them.
Take-Home Message
- Lemborexant is a medication that should only be taken under the advice of a doctor. It should only be taken before going to bed, and with at least 7-8 hours of sleep.
- This medication may make you feel drowsy the next morning. Therefore, do not drive or do hazardous work until you know exactly how the medication affects you.
- Tell your doctor about all other medications you take (including vitamins and herbal remedies) and any medical conditions you have.
- If you experience unusual sleep behavior, sudden changes in mental status, or suicidal thoughts, stop taking the medication immediately and inform your doctor.
- This medicine is for you only. Do not share it with anyone else for any reason.
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