Daridorexant (Quviviq)

Quviviq is an oral tablet, which contains the active ingredient daridorexant, a medicine used to treat chronic insomnia in adults.

Quviviq is used to treat chronic insomnia. Chronic insomnia is a sleep disorder where you have difficulty falling asleep or staying asleep on 3 or more nights each week for at least 3 months. Unlike other types of sleep disorders, chronic insomnia can’t be fully explained by another health condition or by an external cause such as a change in shift work.

More information on different types of sleep disorders, can be found at The Sleep Charity

Quviviq works by blocking a chemical in the brain called orexin that promotes wakefulness. By blocking the action of orexin, Quviviq helps you fall asleep and stay asleep for longer.

Quviviq is taken at night to help you sleep. Take one tablet, 30 minutes before you go to bed. You can take Qviviq with or without food. If you take it with or right after a large meal, it may take longer to work as the food slows down how quickly the medicine is absorbed.

You should avoid taking Quviviq with grapefruit or grapefruit juice as these can increase the level of Quviviq in your blood , increasing the likelihood of side effects.

You should also avoid drinking alcohol when taking Quviviq as this can cause impaired balance and coordination.

Quviviq comes in two strengths, 25mg and 50mg in a coated tablet. The usual prescribed dose is one 50mg tablet taken half an hour before bedtime. However, if you have liver problems or are taking certain medicines that can interact with Quviviq, your doctor may prescribe a lower dose of one 25mg tablet before bed.

If you forget to take Quviviq at the usual time, do not take it later during the night. Taking Quviviq later than recommended, such as if you wake up in the middle of the night, can leave you drowsy in the morning and can potentially cause problems with activities where you need to be alert such as driving. You might find it helpful to set an alarm on your phone to remind you to take your tablet at the right time.

Important: Do not take a double dose of Quviviq to make up for a missed dose. If you miss a tablet, wait until the next night to take your usual dose.

Quviviq should not be used long term. If it’s effective over 3 months, it can be reviewed and continue for a maximum of 12 months in total. If it’s not having any effect over 3 months, it should be stopped.

Quviviq is effective when taken as prescribed and is generally well tolerated. When you first take Quviviq, you may notice some improved sleep quality after a few nights. However, it may take a few weeks before you experience the full benefit of the treatment.

Quviviq is generally well tolerated by most people. However, as with any medicine, there is a possibility for side effects.

Common side effects of Quviviq include:

• headache
• excessive sleepiness
• dizziness
• tiredness
• nausea (feeling sick)

These can affect around 1 in 10 people and usually improve over time as your body gets used to the treatment.

Less common serious side effects which can affect around 1 in 100 people include:

• sleep paralysis – a brief, temporary inability to move or talk while going to sleep or waking up
• hallucinations – seeing or hearing vivid or disturbing things that are not real

If you experience either of these less common side effects, or if the side effects are interfering with your treatment, please speak to your healthcare provider.

For more information, please read the Patient Information Leaflet for Quviviq

You should stop taking Quviviq and speak to your GP or healthcare provider if you experience any of the following:

• obstructive sleep apnea or increased breathing difficulty
• low mood/anxiety, deterioration, depression or thoughts of harming yourself. If you’re struggling with your mental health please contact your GP, local mental health service or emergency services for support

It’s also important that you avoid driving or using machines at least 9 hours after taking Quviviq as it can impair your performance. This is especially important during the first few days of treatment until your body becomes used to the treatment.

If you’re pregnant or trying to get pregnant, speak to your healthcare provider before taking this medicine. Quviviq is not advised to use while pregnant unless essential.

If you’re breastfeeding, speak to your midwife, nurse or doctor about the best way to treat your insomnia as Quviviq will probably not be appropriate for you.

Note: Before taking Quviviq it’s important that you let your healthcare provider know about your complete medical history as well as any medications or supplements, including herbal supplements, that you’re taking. This is so they can make sure Quviviq is safe for you to take.

Different treatments are available for the treatment of insomnia depending on the root cause of your lack of sleep. Please speak with your healthcare provider to find out about possible alternative treatments that might be suitable for you.

If you do not want to take Quviviq to treat insomnia, there are things you can do to help yourself fall asleep and stay asleep for longer. These tips are often referred to as “sleep hygiene” and can often go a long way to solving sleep problems.

Try not to consume substances that can interfere with sleep

• Avoid food, drink or medicines containing caffeine for six hours before bedtime
• Avoid alcohol for six hours before bed. Alcohol can make you feel sleepy but interferes with the body’s natural sleep rhythms, resulting in disturbed sleep.
• Avoid heavy meals before bedtime
• Stop smoking six hours before you go to bed. Nicotine interferes with the body’s natural sleep rhythms by making it harder to fall asleep, causing you to wake up more often, and reducing the amount of sleep you get

Make the bedroom a place of rest and relaxation

• Keep the bedroom cool and dark
• Avoid watching television or looking at screens before bed
• Try to stick to the same time every day to wake up and go to sleep so that your body becomes used to the routine
• Avoid napping during the day, or trying to “catch up” on your sleep over the weekend

One of the most effective alternative insomnia treatments which is also available through the NHS is cognitive behavioural therapy for insomnia (CBTI). This can be done either face-to-face or online using apps such as Sleepio or Sleepful. This could help you manage the intrusive thoughts and behaviours that keep you from sleeping.

To explore online resources that offer CBTI, take a look here:

Sleepio

Sleepful

For more tips and advice on what you can do to improve your sleep, see Boots Health Hub:

Sleep Hygiene Tips

There is no evidence that Quviviq causes weight gain. However, it’s important to remember that being overweight can have a significant impact on your quality of sleep. People who are overweight or obese are more likely to suffer from insomnia, obstructive sleep apnoea (OSA), and restless legs syndrome.

If you think that your weight might be having a negative impact on your quality of sleep, see your healthcare provider for advice. You can also take a look at Boots Online Doctor’s free 10-week weight loss programme which includes information and advice on the relationship between a healthy weight and sleep:10 Week Weight Loss Programme

You should not drink alcohol while taking Quviviq, as both substances can slow brain activity and increase risk of impaired coordination.

Unlike some sleeping aids, there is no evidence that Quviviq (daridorexant) is addictive. It is also possible to stop taking Quviviq without reducing the dosage gradually.

You should not drive or operate heavy machinery within 9 hours of taking Quviviq for the first 5 days of treatment.