Belsomra (suvorexant) is a brand-name oral tablet that’s prescribed for insomnia in adults. Belsomra has interactions with alcohol, some other drugs, and certain supplements. Examples include certain antiseizure drugs, such as gabapentin (Horizant, Neurontin).
An interaction occurs when one substance causes another substance to have a different effect than expected.
To learn more about Belsomra’s interactions, keep reading. For additional information about Belsomra, including details about its uses, see this article.
In some cases, factors or conditions could prevent your doctor from prescribing Belsomra due to the risk of harm. These are known as contraindications. Belsomra contraindications include:
Having narcolepsy
If you have narcolepsy, your doctor will likely not prescribe Belsomra. (With narcolepsy, you have excessive daytime sleepiness.)
Taking Belsomra could worsen narcolepsy. Your doctor can recommend other treatments that may be better choices for your condition.
Note: Before you start treatment with Belsomra, it’s important to tell your doctor if this contraindication applies to you. They can determine whether to prescribe Belsomra.
Belsomra interacts with alcohol. Doctors typically recommend avoiding alcohol in the evenings when you take a dose of Belsomra.
This is because alcohol can worsen certain side effects from Belsomra.* Examples include drowsiness and unusual behaviors while sleeping, such as sleep driving.
If you have questions about drinking alcohol while taking Belsomra, talk with your doctor or pharmacist.
* To learn more about Belsomra’s side effects, see this article.
Before you start treatment with Belsomra, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions. (To learn whether Belsomra interacts with supplements, herbs, or vitamins, see the “Belsomra and other interactions” section below.)
If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.
Here’s a table of drugs that can interact with Belsomra. Keep in mind that this table doesn’t include all drugs that may interact with Belsomra. Some of these interactions are described in detail just below in “Drug interactions in depth.”
Drug class or drug name | Drug examples | Interaction result with Belsomra |
other sleep aids* | • zaleplon (Sonata) • zolpidem (Ambien, Ambien CR) • ramelteon (Rozerem) • eszopiclone (Lunesta) | can increase the risk of side effects from Belsomra† and other sleep aids |
certain antiseizure drugs | • gabapentin (Horizant, Neurontin) • carbamazepine (Carbatrol, Tegretol, others) • phenytoin (Dilantin, Phenytek) | can make Belsomra less effective or increase the risk of side effects from Belsomra† and certain antiseizure drugs |
certain antidepressants | • amitriptyline • nortriptyline (Pamelor) • trazodone • nefazodone | can increase the risk of side effects from Belsomra† and certain antidepressants |
certain antifungals | • itraconazole (Sporanox) • ketoconazole • fluconazole (Diflucan) | can increase the risk of side effects from Belsomra† |
certain antibiotics | • clarithromycin • erythromycin (Ery-Tab, EryPed, others) • rifampin (Rifadin, Rimactane) | can make Belsomra less effective or increase the risk of side effects from Belsomra† |
certain HIV drugs | • ritonavir (Norvir) • nelfinavir (Viracept) • fosamprenavir (Lexiva) | can increase the risk of side effects from Belsomra† |
opioids | • hydrocodone (Hysingla ER) • oxycodone (Oxycontin, Xtampza ER, others) • morphine (Mitigo, MS Contin, others) | can increase the risk of side effects from Belsomra† and opioids |
benzodiazepines | • lorazepam (Ativan) • alprazolam (Xanax) • diazepam (Valium) | can increase the risk of side effects from Belsomra† and benzodiazepines |
cyclobenzaprine (Amrix) | — | can increase the risk of side effects from Belsomra† and cyclobenzaprine |
digoxin (Lanoxin) | — | can increase the risk of side effects from digoxin |
* Belsomra is a type of sleep aid. Melatonin and valerian root, which are also used as sleep aids, may interact with Belsomra. To learn more, see the “Belsomra and other interactions” section below.
† To learn more about Belsomra’s side effects, see this article.
Here’s a closer look at certain drug interactions of Belsomra.
Other sleep aids
Sleep aids are prescribed to help treat sleep disorders, such as insomnia.
Interaction result. Taking Belsomra with other sleep aids can increase your risk of side effects from Belsomra and other sleep aids.
Interaction explained. Belsomra is a type of sleep aid. Belsomra and other sleep aids may cause excessive sleepiness as a side effect. Taking these medications together can further increase this risk.
Examples of sleep aid drugs. Here are some sleep aids that may interact with Belsomra:
- zaleplon (Sonata)
- zolpidem (Ambien, Ambien CR)
- ramelteon (Rozerem)
- eszopiclone (Lunesta)
Melatonin and valerian root, which are also used as sleep aids, may interact with Belsomra. To learn more, see the “Belsomra and other interactions” section below.
Steps you or your doctor may take. It’s recommended that you avoid taking Belsomra with other sleep aids. Before starting Belsomra treatment, tell your doctor if you’re taking other sleep aids. They can recommend which sleep aid may be right for your specific condition.
Certain antiseizure drugs
Antiseizure drugs are prescribed to treat seizures.
Interaction result. Taking Belsomra with antiseizure drugs can lead to varying effects. Certain antiseizure drugs may increase the risk of side effects from Belsomra and the antiseizure drug. Other antiseizure drugs can make Belsomra less effective.
Interaction explained. Belsomra may cause excessive sleepiness as a side effect. Certain antiseizure drugs, such as gabapentin (Horizant, Neurontin), may also have this side effect. Taking Belsomra with these medications can further increase the risk of excessive sleepiness.
Other antiseizure drugs, such as carbamazepine (Carbatrol, Tegretol, others) and phenytoin (Dilantin, Phenytek), may make Belsomra less effective. This happens because certain antiseizure drugs speed up the activity of enzymes (proteins) that help break down Belsomra in your body. As a result, taking these antiseizure drugs with Belsomra can cause Belsomra to leave your system more rapidly. This can lead to a low level of Belsomra in your body, meaning the drug may not work as well as it should.
Steps you or your doctor may take. Before taking Belsomra, be sure to tell your doctor if you take antiseizure drugs. They’ll advise you about whether these medications can be taken together. If needed, your doctor can recommend an alternative treatment to Belsomra that doesn’t interact with certain antiseizure drugs.
Cyclobenzaprine
Cyclobenzaprine (Amrix) is a muscle relaxer prescribed to treat muscle symptoms, including spasms and pain.
Interaction result. Taking Belsomra with cyclobenzaprine can increase your risk of side effects from either drug.
Interaction explained. Belsomra and cyclobenzaprine can cause excessive sleepiness and dizziness when taken individually. Taking these medications together can further increase the risk of these side effects.
Steps you or your doctor may take. Before taking Belsomra, tell your doctor if you’re taking cyclobenzaprine. They can tell you whether it’s safe to take these medications together. If needed, your doctor may adjust your dosage of either drug to help reduce your risk of side effects.
To learn about Belsomra’s dosage, see this article.
Belsomra may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all other possible interactions with Belsomra.
Belsomra interactions with supplements
Before you start treatment with Belsomra, tell your doctor and pharmacist which supplements, herbs, and vitamins you take. By sharing this information with them, you may help prevent possible interactions.
Belsomra may interact with melatonin, which is a supplement used as a sleep aid. Taking Belsomra with melatonin can increase the risk of excessive sleepiness as a side effect of Belsomra.
It’s not advised to take Belsomra with melatonin. Your doctor will likely suggest taking one or the other. They can recommend which sleep aid may be right for your specific condition.
If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.
Belsomra interactions with herbs
Belsomra may interact with the following herbs:
- St. John’s wort, which is used to ease symptoms of depression and other conditions. Taking Belsomra with St. John’s wort could make Belsomra less effective.
- Valerian root, which is used as a sleep aid. Taking Belsomra with valerian root can increase the risk of excessive sleepiness as a side effect of Belsomra.
Before you start Belsomra treatment, tell your doctor if you take St. John’s wort or valerian root. They may be able to help identify an alternative for you that doesn’t have these risks.
Belsomra and vitamins
There are no specific reports of vitamins interacting with Belsomra. However, that doesn’t mean vitamin interactions won’t occur or be recognized in the future. Because of this, you should talk with your doctor or pharmacist before taking any vitamin product with Belsomra.
Belsomra interactions with food
Belsomra may interact with grapefruit and grapefruit juice. Taking this drug with grapefruit products can raise the level of Belsomra in your body. This may increase your risk of side effects from Belsomra.
To learn more about eating grapefruit or drinking grapefruit juice during Belsomra treatment, talk with your doctor.
Belsomra and vaccines
There are no specific reports of vaccines interacting with Belsomra. To learn more about getting certain vaccines while taking Belsomra, talk with your doctor.
Belsomra and lab tests
There are no specific reports of lab tests interacting with Belsomra. To learn more about getting specific lab tests while taking Belsomra, talk with your doctor.
BELSOMRA INTERACTION WITH CANNABIS OR CBDCannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have been specifically reported to interact with Belsomra. Taking this drug with cannabis products could worsen excessive sleepiness as a side effect of Belsomra.
Before you start treatment with Belsomra, tell your doctor and pharmacist if you use cannabis. By sharing this information with them, you may help prevent possible interactions.
Note: Cannabis is illegal at a federal level but is legal in many U.S. states to varying degrees.
Certain medical conditions and other factors may increase the risk of interactions with Belsomra. Before you take this drug, be sure to talk with your doctor about your health history. Belsomra may not be the right treatment option if you have certain medical conditions or other factors affecting your health.
Health conditions or factors that might interact with Belsomra include:
- Narcolepsy. If you have narcolepsy, your doctor will likely not prescribe Belsomra. For details, see the “When to avoid Belsomra” section above.
- Depression or suicidal thoughts and behaviors. Taking Belsomra may lead to new or worsened depression or suicidal thoughts and behaviors. If you have these mental health conditions, your doctor can tell you whether Belsomra is a safe treatment option.
- Severe liver problems. Before starting Belsomra treatment, tell your doctor if you have a severe liver problem, such as liver failure. It isn’t known whether Belsomra is safe for people with severe liver problems. Your doctor may prescribe a treatment other than Belsomra.
- Lung or breathing problems. Before taking Belsomra, tell your doctor if you have a lung or breathing problem. Examples include obstructive sleep apnea and chronic obstructive pulmonary disease (COPD). It isn’t known whether Belsomra is safe for people with lung or breathing problems. Your doctor can recommend whether Belsomra is the right treatment option for you.
- Misuse of alcohol or other substances in the past. People who have experienced misuse of alcohol or other substances in the past may have an increased risk of misuse with Belsomra. (With misuse, a drug is taken differently than how a doctor prescribed it.) To learn more about the risk of misuse with Belsomra, talk with your doctor.
- Pregnancy. It isn’t known whether Belsomra is safe to take during pregnancy. If you’re pregnant or planning a pregnancy, talk with your doctor before starting Belsomra treatment.
- Breastfeeding. It’s not known whether Belsomra passes into breast milk or if the drug causes side effects in a child who is breastfed. If you’re breastfeeding or planning to do so, talk with your doctor before starting Belsomra treatment.
- Allergic reaction. If you’ve had an allergic reaction to Belsomra or any of its ingredients, your doctor will likely not prescribe Belsomra. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.
Suicide prevention
If you know someone at immediate risk of self-harm, suicide, or hurting another person:
- Ask the tough question: “Are you considering suicide?”
- Listen to the person without judgment.
- Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
- Stay with the person until professional help arrives.
- Try to remove any weapons, medications, or other potentially harmful objects if it’s safe to do so.
If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.
You can take certain steps to help prevent interactions with Belsomra. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:
- Let them know if you drink alcohol or use cannabis.
- Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
- Create a
medication list , which your doctor and pharmacist can help you fill out.
It’s also important to read the Belsomra label and other
If Belsomra doesn’t come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.
You can also help prevent interactions with Belsomra by taking it exactly as your doctor prescribes.
Besides learning about interactions, you may want to find out more about Belsomra. These resources might help:
- Overview of Belsomra. For a general overview of Belsomra, you can see this article.
- Side effects. If you’re interested in the side effects of Belsomra, see this article. Another option is to refer to Belsomra’s prescribing information.
- Dosage specifics. To learn about the dosage of Belsomra, see this article.
- Cost. If you’d like to learn about Belsomra and cost, see this article.
- Facts about insomnia. To learn more about insomnia, see our science of sleep hub.
Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.