Sunosi (solriamfetol)

What is Sunosi?

Sunosi is a brand-name prescription medication. It’s FDA-approved to treat excessive daytime sleepiness (EDS) in adults who have either of the following conditions:

• narcolepsy
• obstructive sleep apnea (OSA)

People with narcolepsy or OSA have abnormal sleep patterns and can feel extremely tired during waking hours. Sunosi helps people with these conditions stay awake for longer periods of time.

Sunosi contains the active drug solriamfetol, which belongs to a class of drugs called dopamine-norepinephrine reuptake inhibitors. (A drug class describes a group of drugs that work in a similar way.) It comes as tablets that are taken by mouth once daily, typically when you first wake up. Sunosi is available in two strengths: 75 milligrams (mg) and 150 mg.

Note: In people with OSA, Sunosi should not be used to treat airway obstruction. In fact, the drug should only be used if a person has had at least 1 month of therapy to treat their airway obstruction. This can include therapy such as continuous positive airway pressure CPAP.

FDA approval

In 2019, the Food and Drug Administration (FDA) approved Sunosi to treat EDS in adults who have either narcolepsy or OSA. It’s the first drug in its class that’s approved for this use.

Is Sunosi a controlled substance?

Yes, Sunosi is a controlled substance. Controlled substances are drugs that are regulated by the federal government. This is because their use may lead to misuse or addiction in some people.

Controlled substances are assigned schedule numbers ranging from Schedule I to Schedule V. Drugs with a lower schedule number are more likely to lead to misuse than are drugs with a higher schedule number. Sunosi is a Schedule IV controlled substance.

Although Sunosi acts like a stimulant by helping you stay awake, this drug isn’t classified as a stimulant drug. This is because Sunosi works in a different way than stimulants do. It’s thought that Sunosi has a lower risk of misuse and dependence than stimulant medications have. (With dependence, your body needs the drug in order for you to feel like usual.)

Effectiveness

For information on the effectiveness of Sunosi, see the “Sunosi for narcolepsy or obstructive sleep apnea” section below.

Sunosi generic

Sunosi contains the active drug solriamfetol. It’s available only as a brand-name medication. It’s not currently available in generic form. (A generic drug is an exact copy of the active drug in a brand-name medication.)

Sunosi side effects

Sunosi can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Sunosi. These lists do not include all possible side effects.

For more information on the possible side effects of Sunosi, talk with your doctor or pharmacist. They can give you tips on how to deal with any side effects that may be bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs they have approved. If you would like to report to the FDA a side effect you’ve had with Sunosi, you can do so through MedWatch.

Mild side effects

Mild side effects of Sunosi can include*:

• headache
• decreased appetite
• irritability
• dizziness
• nausea or vomiting
• diarrhea
• constipation
• belly pain
• dry mouth
• grinding your teeth
• cough

Most of these side effects may go away within a few days or a couple of weeks. But if they become more severe or don’t go away, talk with your doctor or pharmacist.

* This is a partial list of mild side effects from Sunosi. To learn about other mild side effects, talk with your doctor or pharmacist, or visit Sunosi’s medication guide.

Serious side effects

Serious side effects from Sunosi aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include:

• Heart palpitations (heartbeat that’s irregular or too hard, fast, or slow). Symptoms can include:
  • chest pain
  • feeling pounding in your chest
  • shortness of breath
  • lightheadedness
• Hyperhidrosis (excessive sweating). Symptoms can include:
  • clammy palms of your hands or soles of your feet
  • sweating that soaks through your clothes
• Allergic reaction.*
• Sleep problems, such as trouble falling asleep or staying asleep.*
• Increased blood pressure and heart rate.*
• Anxiety.*

* This serious side effect is explained further in the “Side effect details” section below.

Side effect details

You may wonder how often certain side effects occur with this drug, or whether certain side effects pertain to it. Here’s some detail on certain side effects this drug may or may not cause.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Sunosi. But it’s not known how often an allergic reaction happened in people using Sunosi during clinical studies.

Symptoms of a mild allergic reaction can include:

• skin rash
• itchiness
• flushing

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

• swelling under your skin, typically in your eyelids, lips, hands, or feet
• swelling of your tongue, mouth, or throat
• trouble breathing

Call your doctor right away if you have a severe allergic reaction to Sunosi. But call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Weight loss

Weight loss wasn’t reported as a side effect of Sunosi during clinical trials. However, decreased appetite was reported in the trials. And with a decreased appetite, you may experience weight loss. This is because you may eat less often or eat smaller amounts of food than usual.

In clinical trials of Sunosi, decreased appetite occurred in:

• 9% of people with narcolepsy who took Sunosi
• 1% of people with narcolepsy who took a placebo (treatment with no active drug)
• 6% of people with obstructive sleep apnea (OSA) who took Sunosi
• 1% of people with OSA who took a placebo

If you notice weight loss or changes in your eating habits while taking Sunosi, talk with your doctor. They can recommend ways to help you manage a healthy body weight.

Increased blood pressure and heart rate

It’s possible to have increased blood pressure and heart rate while you’re taking Sunosi. Symptoms of these conditions can include:

• chest pain
• dizziness
• feeling lightheaded
• nervousness

If you have any of these symptoms or if your blood pressure readings are higher than usual while you’re taking Sunosi, talk with your doctor. If high blood pressure isn’t managed, it can increase your risk for stroke or heart attack.

How common is increased blood pressure and heart rate with Sunosi?

In clinical trials of Sunosi, it wasn’t reported how many people had increased blood pressure or heart rate. However, the following blood pressure changes were seen in people taking Sunosi or a placebo (treatment with no active drug). These trials involved people with either narcolepsy or obstructive sleep apnea (OSA).

* Systolic blood pressure is the first number listed on a blood pressure measurement. It’s the pressure inside your blood vessels when your heart contracts.
** Diastolic blood pressure is the second number listed on a blood pressure measurement. It’s the pressure inside your blood vessels when your heart relaxes.
† This pressure range varied based on the strength of Sunosi that people were taking.
‡ Millimeters of mercury (mmHg) is the unit of measurement that’s used to describe blood pressure.

Sleep problems

Sunosi can cause insomnia in some people. With insomnia, you can have trouble falling asleep or staying asleep. For example, in clinical studies, insomnia occurred in:

• 5% of people with narcolepsy who took Sunosi
• 4% of people with narcolepsy who took a placebo (treatment with no active drug)

However, insomnia wasn’t reported in Sunosi’s clinical studies of people with obstructive sleep apnea (OSA).

If you have trouble falling asleep or staying asleep while you’re taking Sunosi, talk with your doctor. They may adjust your dosage of Sunosi or have you try a medication other than Sunosi. And they may recommend ways to help improve your sleep.

Anxiety

It’s possible to feel anxious while you’re taking Sunosi. With anxiety, you may feel nervous or have panic attacks.

In clinical studies, anxiety was reported in:

• 6% of people with narcolepsy who took Sunosi
• 1% of people with narcolepsy who took a placebo (treatment with no active drug)
• 4% of people with obstructive sleep apnea (OSA) who took Sunosi
• 1% of people with OSA who took a placebo

If you feel anxious while you’re taking Sunosi, let your doctor know. The anxiety could be a side effect of Sunosi. And talk with your doctor about ways to help manage your anxiety.

Headache

Headache is a possible side effect of Sunosi. In clinical studies, headache occurred in:

• 7% to 16%* of people who took Sunosi, depending on the dose of the drug they took
• 7% to 8%* of people who took a placebo (treatment with no active drug)

If you have headaches that don’t get better or become worse while you’re taking Sunosi, talk with your doctor right away. Your doctor may recommend ways to help reduce your discomfort.

* This percentage range varied depending on the condition being treated.

Alternatives to Sunosi

Other drugs are available that can treat excessive daytime sleepiness (EDS). Some may be a better fit for you than others. If you’re interested in finding an alternative to Sunosi, talk with your doctor. They can tell you about other medications that may work well for you.

Note: Some of the drugs listed below are used off-label to treat these specific conditions. Off-label use is when a drug that’s approved to treat one condition is used to treat a different condition.

Examples of other drugs that may be used to treat EDS include:

• methylphenidate (Ritalin, Ritalin LA, Ritalin SR, and others)
• amphetamine/dextroamphetamine (Adderall, Adderall XR, Mydayis)
• armodafinil (Nuvigil)
• modafinil (Provigil)
• pitolisant (Wakix)
• sodium oxybate (Xyrem)
• atomoxetine (Strattera)
• clomipramine (Anafranil)

Sunosi vs. Adderall

You may wonder how Sunosi compares with other medications that are prescribed for similar uses. Here we look at how Sunosi and Adderall are alike and different.

Ingredients

Sunosi contains the active drug solriamfetol, while Adderall contains the active drugs dextroamphetamine and amphetamine. These medications belong to different classes of drugs. (A drug class describes a group of medications that work in a similar way.)

Uses

Sunosi is approved to treat excessive daytime sleepiness (EDS) in adults with either of the following conditions:

• narcolepsy
• obstructive sleep apnea (OSA)

Adderall is approved to treat both narcolepsy and attention deficit hyperactivity disorder (ADHD). This drug can be used in adults and in children older than 3 years.

Drug forms and administration

Sunosi comes as tablets that are taken by mouth once daily.

Adderall also comes as tablets that are taken by mouth. But Adderall can be taken several times throughout the day. How often you’ll take Adderall depends on how well your body tolerates the drug and the condition you’re treating.

Side effects and risks

Sunosi and Adderall both work to increase wakefulness in people with narcolepsy. Therefore, they can cause very similar side effects, but some different ones as well. Below are examples of these side effects.

Mild side effects

These lists contain up to 10 of the most common mild side effects that can occur with each drug, or with both Sunosi and Adderall (when taken individually).

• Can occur with Sunosi:
  • headache
  • decreased appetite
  • dizziness
  • nausea or vomiting
  • belly pain
  • grinding your teeth
• Can occur with Adderall:
  • blurred vision
  • irritability unpleasant taste in your mouth
• Can occur with both Sunosi and Adderall:
  • irritability
  • dry mouth
  • diarrhea
  • constipation
  • tremor

Serious side effects

These lists contain examples of serious side effects that can occur with Sunosi, with Adderall, or with both drugs (when taken individually).

• Can occur with Sunosi:
  • sleep problems, such as trouble falling asleep or staying asleep
  • anxiety
  • hyperhidrosis (excessive sweating)
• Can occur with Adderall:
  • heart attack
  • alopecia (hair loss)
  • changes in sex drive
  • rhabdomyolysis (breakdown of muscle tissue)
  • psychosis
  • seizures
  • weight loss
• Can occur with both Sunosi and Adderall:
  • allergic reaction
  • heart palpitations
  • increased blood pressure and heart rate

Effectiveness

Sunosi and Adderall have different approved uses, but they’re both used in people with narcolepsy.

These drugs haven’t been directly compared in clinical studies. But separate studies have found both Sunosi and Adderall to be effective for treating certain forms of narcolepsy.

Costs

Sunosi generally costs more than Adderall. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

Sunosi and Adderall are both brand-name drugs. There is currently a generic form of Adderall available, but not one of Sunosi. (A generic drug is an exact copy of the active drug in a brand-name medication.) Brand-name medications usually cost more than generics.

Sunosi vs. Provigil (modafinil)

Like Adderall (above), other medications are prescribed for similar uses as Sunosi. Here we look at how Sunosi and Provigil are alike and different.

Ingredients

Sunosi contains the active drug solriamfetol, while Provigil contains the active drug modafinil. These medications belong to different classes of drugs. (A drug class describes a group of medications that work in a similar way.)

Uses

Both Sunosi and Provigil are approved for use in adults to treat excessive daytime sleepiness (EDS) that’s related to either of the following conditions:

• narcolepsy
• obstructive sleep apnea (OSA)

In addition, Provigil is also approved to treat shift work sleep disorder in adults.

Drug forms and administration

Both Sunosi and Provigil come as tablets that are taken by mouth once daily.

Side effects and risks

Sunosi and Provigil are both used to decrease EDS that’s related to narcolepsy or OSA. Therefore, these medications can cause very similar side effects, but some different ones as well. Below are examples of these side effects.

Mild side effects

These lists contain up to 10 of the most common mild side effects that can occur with each drug, or with both Sunosi and Provigil (when taken individually).

• Can occur with Sunosi:
  • decreased appetite
  • irritability
  • belly pain
  • grinding your teeth
• Can occur with Provigil:
  • back pain
  • chills
  • neck stiffness
  • ulcers in your mouth
• Can occur with both Sunosi and Provigil:
  • headache
  • dry mouth
  • diarrhea
  • nauseac
  • onstipation
  • dizziness

Serious side effects

These lists contain examples of serious side effects that can occur with Sunosi, with Provigil, or with both drugs (when taken individually).

• Can occur with Sunosi:
  • no unique side effects
• Can occur with Provigil:
  • dark urine
  • yellowing of your skin or the white part of your eyes
  • serious rash, including Stevens-Johnson syndrome
  • abnormal heart rhythm
  • depression
• Can occur with both Sunosi and Provigil:
  • increased blood pressure and heart rate
  • heart palpitations
  • anxiety
  • sleep problems, such as trouble falling asleep or staying asleep
  • hyperhidrosis (excessive sweating)
  • allergic reaction

Effectiveness

Sunosi and Provigil are both approved for use in people with either narcolepsy or OSA.

These drugs haven’t been directly compared in clinical studies. But separate studies have found both Sunosi and Provigil to be effective in treating excessive sleepiness that’s related to narcolepsy or OSA.

Costs

Sunosi and Provigil generally cost about the same. The actual price you’ll pay for either drug depends on your insurance plan, your location, and the pharmacy you use.

Sunosi and Provigil are both brand-name drugs. There is currently a generic form of Provigil available, but not one of Sunosi. (A generic drug is an exact copy of the active drug in a brand-name medication.) Brand-name medications usually cost more than generics.

Sunosi vs. Wellbutrin

You might be interested to know how Sunosi compares to the brand-name drug Wellbutrin. Sunosi contains the active drug solriamfetol, while Wellbutrin contains the active drug bupropion.

Sunosi is FDA-approved to treat excessive daytime sleepiness (EDS) in adults who have either narcolepsy or obstructive sleep apnea (OSA).

Wellbutrin comes in two forms: Wellbutrin XL (an extended-release tablet) and Wellbutrin SR (a sustained-release tablet). Wellbutrin XL is released into your body over a longer period of time than Wellbutrin SR. The immediate-release form of Wellbutrin has been discontinued.

Both forms of Wellbutrin can be used to treat depression. Wellbutrin XL can also be prescribed to help prevent seasonal affective disorder (SAD) episodes. For more information, see the prescribing information for Wellbutrin XL and Wellbutrin SR.

Common questions about Sunosi

Here are answers to some frequently asked questions about Sunosi.

Is Sunosi a stimulant?

No, Sunosi isn’t a stimulant drug. It’s not known exactly how Sunosi works to treat excessive sleepiness. But it’s thought that the drug increases the levels of certain chemicals in your brain, causing you to feel more awake. This includes the brain chemicals dopamine and norepinephrine.

While stimulant drugs work in a similar way, Sunosi is not considered a stimulant. And unlike Sunosi, stimulant drugs can cause a sudden feeling of a rush or excitement.

Stimulant drugs are available to treat the same conditions that Sunosi treats. These drugs include:

• dextroamphetamine/amphetamine (Adderall)
• methylphenidate (Ritalin)
• lisdexamfetamine (Vyvanse)

Will Sunosi make me feel ‘high’?

Sunosi is a controlled substance, which means that it has some potential for misuse. However, this drug shouldn’t make you feel “high.”

Sunosi may cause other side effects, including feeling jittery or dizzy. For more information on possible side effects of Sunosi, see the “Sunosi side effects” section above.

If you’re having side effects from Sunosi that make you feel impaired or “high,” talk with your doctor right away. Your doctor will determine whether it’s safe for you to continue taking this drug.

Can Sunosi be used to treat insomnia?

No, Sunosi isn’t approved to treat insomnia. With insomnia, you have trouble falling asleep or staying asleep.

Instead, Sunosi is used to treat excessive daytime sleepiness (EDS). It’s approved for this use in adults with either narcolepsy or obstructive sleep apnea (OSA). People with narcolepsy or OSA have abnormal sleep patterns and can feel extremely tired during waking hours.

It’s important to note that Sunosi may cause insomnia as a side effect in some people. For more information on possible side effects of Sunosi, see the “Sunosi side effects” section above.

If you have trouble sleeping, talk with your doctor about ways to help improve your sleep.

Does Sunosi show up on drug screens?

No, Sunosi shouldn’t show up on drug screens. Stimulant drugs that contain amphetamine salts may show up on certain drug screens. But keep in mind that Sunosi isn’t a stimulant drug.

However, before taking any drug screen tests, be sure to tell your doctor about all of the medications you’re taking. This way, they can let you know if anything you’re taking may show up on the test.

What happens if I take Sunosi too close to my bedtime?

Sunosi is used to decrease excessive sleepiness that’s due to narcolepsy or obstructive sleep apnea (OSA). Taking Sunosi too close to your bedtime may keep you awake and unable to go to sleep for several hours.

Because of this, it’s recommended that you avoid taking Sunosi within 9 hours of when you’re planning to go to bed.

If you have questions about the best time of day to take Sunosi, talk with your doctor.

Can I take Sunosi if I’m also using CPAP?

Yes, you can. Keep in mind that while Sunosi does improve wakefulness in people with obstructive sleep apnea (OSA), the drug doesn’t treat OSA itself. So, it’s important that if you’re using continuous positive airway pressure (CPAP) for OSA, you keep using it while you’re taking Sunosi.

In fact, if you have OSA, you should use CPAP or another OSA treatment for at least 1 month before starting Sunosi.

If you have questions about using CPAP while you’re taking Sunosi, talk with your doctor.

What is Sunosi’s half-life?

Sunosi’s half-life is approximately 7.1 hours. (A drug’s half-life is the amount of time it takes for your body to remove half a dose of a drug from your system.)

If you have more questions about how Sunosi works, talk with your doctor.

Sunosi for narcolepsy or obstructive sleep apnea

The Food and Drug Administration (FDA) approves prescription drugs such as Sunosi to treat certain conditions. Sunosi is FDA-approved to treat excessive daytime sleepiness (EDS) in adults who have either of the following conditions:

• Narcolepsy. Narcolepsy is a condition that affects your nervous system. With narcolepsy, you have disturbed sleep and excessive tiredness.
• Obstructive sleep apnea (OSA). With sleep apnea, you don’t breathe for short periods of time while you’re sleeping. With OSA, these episodes are caused by narrowing of your airway in your throat.

People with either narcolepsy or OSA have abnormal sleep patterns and can feel extremely tired during waking hours. Sunosi helps people with these conditions stay awake for longer periods of time.

It’s important to note that Sunosi should not be used to treat airway obstruction in people with OSA. In fact, in people with OSA, the drug should only be used by those who’ve already started therapy to treat their airway obstruction. (These therapies could include continuous positive airway pressure [CPAP].) And the people should have used this therapy for at least 1 month before starting Sunosi.

Effectiveness in people with narcolepsy or obstructive sleep apnea

In clinical studies, Sunosi was effective in improving wakefulness and reducing EDS in adults with narcolepsy or OSA. Below, we describe results of these studies.

Effectiveness in people with narcolepsy

One clinical study looked at adults with narcolepsy. Some people took either 75 mg or 150 mg of Sunosi once daily. Other people took a placebo (treatment with no active drug) once daily.

After 12 weeks of treatment, people who took Sunosi had significant improvement on the Maintenance of Wakefulness Test (MWT) and the Excessive Sleepiness Scale (ESS). The MWT measures how long someone can stay awake during the daytime in a quiet, dark environment.

The ESS, on the other hand, is a questionnaire that’s used to measure how likely someone is to fall asleep. A decrease in ESS score indicates improvement in your condition and that you’re less likely to fall asleep.

Compared with people taking the placebo, people taking Sunosi 75 mg once daily had an average:

• improvement of 2.6 minutes on the MWT
• decrease of 2.2 on the ESS

And also compared with people taking the placebo, people taking Sunosi 150 mg once daily had an average:

• improvement of 7.7 minutes on the MWT
• decrease of 3.8 on the ESS

Effectiveness in people with obstructive sleep apnea

Another clinical study looked at adults with OSA. In this study, some people took either 37.5 mg, 75 mg, 150 mg, or 300 mg of Sunosi once daily. Other people took a placebo (treatment with no active drug) once each day.

During the trial, all of the people continued using their current therapy to treat airway obstruction from their OSA.

At the end of 12 weeks, people who took Sunosi had significant improvement on the MWT and ESS. The MWT measures how long someone can stay awake during the daytime in a quiet, dark environment.

The ESS, on the other hand, is a questionnaire that’s used to measure how likely someone is to fall asleep. A decrease in ESS score indicates improvement in your condition and that you’re less likely to fall asleep.

Compared with people taking the placebo, people taking Sunosi had the following results.

• Those taking Sunosi 37.5 mg once daily had an average:
  • improvement of 4.5 minutes on the MWT
  • decrease of 1.9 on the ESS
• Those taking Sunosi 75 mg once daily had an average:
  • improvement of 8.9 minutes on the MWT
  • decrease of 1.7 on the ESS
• Those taking Sunosi 150 mg once daily had an average:
  • improvement of 10.7 minutes on the MWT
  • decrease of 4.5 on the ESS

Sunosi and children

It’s not known whether Sunosi is safe or effective for use in children. Sunosi is only approved for use in adults.

Off-label use for Sunosi

As described above, Sunosi is FDA-approved to treat excessive daytime sleepiness (EDS) in people with narcolepsy or obstructive sleep apnea (OSA).

In addition, Sunosi may be used off-label for other purposes. Off-label drug use is when a drug that’s approved for one or more uses is prescribed for a different one that’s not approved. Below is an example of an off-label use for Sunosi.

Sunosi for idiopathic hypersomnia

Sunosi is sometimes used off-label to decrease excessive daytime sleepiness (EDS) in people with idiopathic hypersomnia (IH). With this sleep disorder, people have excessive sleepiness even after they’ve gotten a full night of rest. In addition, people with IH don’t feel refreshed after taking naps.

If you have questions about treatment options for IH, talk with your doctor. They can recommend safe and effective options for this condition.

Sunosi dosage

The Sunosi dosage your doctor prescribes will depend on several factors. These include:

• the type and severity of the condition you’re using Sunosi to treat
• your age
• other medical conditions you may have
• other medications you may be taking

Typically, your doctor will start you on a low dosage of Sunosi. Then they’ll adjust your dose over time to reach the amount that’s right for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Drug forms and strengths

Sunosi comes as tablets that are taken by mouth once daily, typically when you first wake up. This drug is available in two strengths: 75 milligrams (mg) and 150 mg.

Dosage for excessive daytime sleepiness

The usual starting dosage of Sunosi for excessive daytime sleepiness (EDS) varies depending on the condition’s cause. Below, we describe the typical dosage of Sunosi for EDS that’s due to either narcolepsy or obstructive sleep apnea (OSA).

For either condition, the maximum daily dose of Sunosi is 150 mg.

Dosage for EDS due to narcolepsy

The typical starting dosage of Sunosi for EDS that’s due to narcolepsy is 75 mg once daily. Depending on how well your body tolerates the drug, your doctor may increase your daily dose at least every 3 days. Your dosage can be increased until the maximum recommended daily dose of 150 mg has been reached.

Dosage for EDS due to obstructive sleep apnea

The usual starting dosage of Sunosi for EDS that’s due to OSA is 37.5 mg once daily. Depending on how well your body tolerates the drug, your doctor may increase your daily dose at least every 3 days. Your dosage can be increased until the maximum recommended daily dose of 150 mg has been reached.

What if I miss a dose?

If you miss a dose of Sunosi, take the missed dose as soon as you remember. However, it’s recommended that you don’t take Sunosi within 9 hours of going to bed. This is because the drug might keep you awake.

So, if you miss a dose of Sunosi and you’re planning to go to bed within the next 9 hours, skip the missed dose. Then, take Sunosi the next day as usual.

To help make sure that you don’t miss a dose, try setting a reminder on your phone. A kitchen timer may be useful, too.

Will I need to use this drug long term?

Sunosi is meant to be used as a long-term treatment. If you and your doctor determine that Sunosi is safe and effective for you, you’ll likely take it long term.

Sunosi and alcohol

It’s not known whether Sunosi interacts with alcohol. However, alcohol can increase sleepiness, which Sunosi is used to treat in people with certain conditions. So, drinking alcohol may counteract the effects of Sunosi in your body.

Also keep in mind that Sunosi has a risk of misuse and dependence. (With dependence, your body needs a drug in order for you to feel like usual.) Because of this, it’s recommended that people who’ve ever been dependent on alcohol or misused alcohol in the past should avoid taking Sunosi.

If you have questions about the risks of drinking alcohol while taking Sunosi, talk with your doctor.

Sunosi interactions

Sunosi can interact with several other medications. It can also interact with certain supplements as well as certain foods.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.

Sunosi and other medications

Below are lists of medications that can interact with Sunosi. These lists do not contain all of the drugs that may interact with Sunosi.

Before taking Sunosi, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Sunosi and monoamine oxidase inhibitors

Taking Sunosi with monoamine oxidase inhibitors (MAOIs) could cause dangerous side effects. MAOIs are a group of drugs that are typically used to treat depression. Examples of MAOIs include:

• selegiline (Emsam)
• isocarboxazid (Marplan)
• phenelzine (Nardil)
• tranylcypromine (Parnate)

Specifically, you shouldn’t take Sunosi with an MAOI or within 14 days of stopping an MAOI. Taking these medications together can cause serious side effects due to a potential severe increase in blood pressure. For example, these side effects may include:

• stroke
• heart attack
• fluid in your lungs
• kidney failure

If you’re taking an MAOI or you’ve recently stopped taking an MAOI, let your doctor know right away. They’ll recommend when it’s safe for you to start taking Sunosi.

Sunosi and drugs that increase blood pressure or heart rate

Sunosi can cause increased blood pressure and heart rate. Taking Sunosi along with other medications that also cause these side effects can possibly lead to dangerous increases in your blood pressure or heart rate. Taking Sunosi with these types of drugs should be avoided.

Examples of drugs that can cause increased blood pressure or heart rate include:

• decongestants such as,
  • phenylephrine (Neofrin, Sudafed, Neo-Synephrine, and others)
  • pseudoephedrine (Sudafed, Nexafed, Zephrex-D, and others)
• antidepressants such as,
  • extended-release venlafaxine (Effexor XR)
  • bupropion (Wellbutrin, Zyban)
• stimulants such as,
  • dextroamphetamine/amphetamine (Adderall)
  • methylphenidate (Ritalin)
  • lisdexamphetamine (Vyvanse)

If you take any medications that can cause increased blood pressure or heart rate, let your doctor know right away. Your doctor may monitor you more closely than usual for side effects during treatment.

Sunosi and dopaminergic drugs

Dopaminergic drugs are medications that can increase the amount of dopamine in your body. (Dopamine is a brain chemical.)

Sunosi also affects levels of dopamine in your body. So, taking Sunosi with dopaminergic drugs may lead to interactions. However, it’s not known how these interactions may affect your body.

Examples of dopaminergic drugs that are used to treat Parkinson’s disease and restless leg syndrome, include:

• pramipexole (Mirapex)
• extended-release ropinirole (Requip XL)
• rotigotine (Neupro)

Before starting Sunosi, tell your doctor about all of the medications you’re taking. Your doctor will determine whether any of your other medications work on dopamine in your body. And they’ll recommend if it’s safe for you to take Sunosi.

Sunosi and herbs and supplements

There aren’t any herbs or supplements that have been specifically reported to interact with Sunosi. However, you should still check with your doctor or pharmacist before using any of these products while taking Sunosi.

Sunosi and foods

There aren’t any foods that have been specifically reported to interact with Sunosi. If you have any questions about eating certain foods with Sunosi, talk with your doctor.

How Sunosi works

Sunosi is approved to treat excessive daytime sleepiness (EDS) in adults who have either of the following conditions:

• narcolepsy
• obstructive sleep apnea (OSA)

People with narcolepsy or OSA have abnormal sleep patterns and can get extremely tired during waking hours. Sunosi helps people with these conditions stay awake for longer periods during the day.

Sunosi contains the active drug solriamfetol. It belongs to a class of drugs called dopamine-norepinephrine reuptake inhibitors. (A drug class describes a group of drugs that work in a similar way.)

It’s not known exactly how Sunosi works to decrease EDS that’s due to narcolepsy or OSA. However, the drug’s effect could be related to its ability to stop dopamine and norepinephrine (chemicals in your brain) from being stored away. This increases these brain chemicals in your body, allowing your brain to use them to help you stay awake.

When reuptake is stopped, the levels of these brain chemicals are increased in your body. And this may improve wakefulness and help you feel less tired.

How long does it take to work?

Sunosi starts working as soon as you take it. But for most people, they can feel the effects of Sunosi within 1 hour of when it was taken.

Sunosi withdrawal and dependence

With some drugs, your body can become dependent. (With dependence, you need to take the drug in order to feel like usual.) And being dependent on a drug can lead to withdrawal symptoms if you suddenly stop taking the drug.

Examples of withdrawal symptoms of some drugs may include:

• shakiness
• anxiety
• nausea or vomiting
• stomach pain or cramps

However, in clinical studies of Sunosi, people who took the drug for 6 months and then abruptly stopped taking it didn’t have symptoms related to dependence or withdrawal.

If you feel that you’re becoming dependent on Sunosi or you have any symptoms of withdrawal, talk with your doctor. They may want to see you right away to check your condition.

Sunosi and pregnancy

It’s not known whether it’s safe to use Sunosi during pregnancy. In animal studies, Sunosi caused problems with fetal growth and development. The drug also caused some problems with fertility (ability to reproduce). However, animal studies don’t always predict what will happen in people.

Talk with your doctor to learn more about the risks and benefits of using Sunosi during pregnancy.

Sunosi’s pregnancy registry

If you’re pregnant or you become pregnant while taking Sunosi, you’re encouraged to join the drug’s pregnancy registry. This registry collects information from women who use the drug during pregnancy. The information gathered helps doctors and other people to better understand how Sunosi affects pregnancy.

For more information about enrolling in this pregnancy registry, talk with your doctor.

Sunosi and birth control

It’s not known if Sunosi is safe to take during pregnancy. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re using Sunosi.

For more information about taking Sunosi during pregnancy, see the “Sunosi and pregnancy” section above.

Sunosi and breastfeeding

It isn’t known whether Sunosi can pass into human breast milk. However, in animal studies Sunosi did pass into the milk of lactating animals. And when a drug is passed into animal milk, it’s very likely it will also be passed into human breast milk.

If you’re breastfeeding and taking Sunosi, it’s important that you monitor your child for side effects from the drug. These side effects could include:

• agitation
• problems sleeping
• loss of appetite
• inability to gain weight

To learn more about the risks of taking Sunosi while breastfeeding, talk with your doctor.

Sunosi cost

As with all medications, the cost of Sunosi can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Before approving coverage for Sunosi, your insurance company may require you to get prior authorization. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide if the drug will be covered.

If you’re not sure if you’ll need to get prior authorization for Sunosi, contact your insurance company.

Financial and insurance assistance

If you need financial support to pay for Sunosi, or if you need help understanding your insurance coverage, help is available.

Jazz Pharmaceuticals Inc., the manufacturer of Sunosi, offers a savings card that may help lower the cost of the drug. The manufacturer also offers a free trial program that may provide Sunosi to you at no cost for a limited period of time.

For more information and to find out if you’re eligible for support, you can call 800-805-8621. Or, visit the manufacture’s site for details on both the cost savings card and free trial offer.

Generic version

Sunosi isn’t available in a generic form. A generic drug is an exact copy of the active drug in a brand-name medication. Generics tend to cost less than brand-name drugs.

How to take Sunosi

You should take Sunosi according to your doctor or healthcare professional’s instructions.

When to take

Typically, Sunosi is taken once daily in the morning, upon waking.

It’s recommended that you don’t take Sunosi within 9 hours of when you’re planning to go to bed. If you take Sunosi too close to when you’re planning to sleep, the drug may make it harder for you to fall asleep.

To help make sure that you don’t miss a dose, try setting a reminder on your phone. A kitchen timer may be useful, too.

Taking Sunosi with food

Sunosi can be taken with or without food.

Can Sunosi be crushed, split, or chewed?

Sunosi comes as a scored tablet that can be split in half at the score line. If your doctor recommends it, you can split Sunosi tablets in half before taking your dose. In this case, your doctor or pharmacist can show you how to properly split the tablets.

However, Sunosi tablets shouldn’t be crushed or chewed. If you’re having trouble swallowing these tablets, talk with your doctor or pharmacist.

Sunosi precautions

Before taking Sunosi, talk with your doctor about your health history. Sunosi may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

• Increased blood pressure or heart rate. Sunosi can cause significant increases in blood pressure and heart rate. Because of this, it’s important to check your blood pressure before starting Sunosi. And you should continue to regularly check your blood pressure while you’re taking this drug. Untreated high blood pressure or increased heart rate can increase your risk for heart attack or stroke. For more information on Sunosi and high blood pressure or heart rate, see the “Sunosi side effects” section above.
• Psychiatric conditions. Some people have anxiety, irritability, and problems sleeping while taking Sunosi. And this could worsen psychiatric conditions you may already have. If you have a psychiatric disorder, such as bipolar disorder, talk with your doctor about the safety of taking Sunosi.
• Allergic reaction. If you’ve had an allergic reaction to Sunosi or any of its ingredients, you shouldn’t take Sunosi. Ask your doctor what other medications are better options for you. And if you’re unsure about your medication allergies, talk with your doctor.
• Pregnancy. It’s not known whether Sunosi is safe to use in pregnancy. For more information, please see the “Sunosi and pregnancy” section above.
• Breastfeeding. It isn’t known if Sunosi is safe to use while breastfeeding. For more information, please see the “Sunosi and breastfeeding” section above.

Note: For more information about the potential negative effects of Sunosi, see the “Sunosi side effects” section above.

Sunosi overdose

Using more than the recommended dosage of Sunosi can lead to serious side effects. Do not use more Sunosi than your doctor recommends.

What to do in case you take too much Sunosi

If you think you’ve taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use its online tool. But if your symptoms are severe, call 911 or your local emergency number, or go to the nearest emergency room right away.

Sunosi expiration, storage, and disposal

When you get Sunosi from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. This date is typically 1 year from the date they dispensed the medication.

The expiration date helps guarantee that the medication is effective during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk with your pharmacist about whether you might still be able to use it.

Storage

How long a medication remains good can depend on many factors, including how and where you store the medication.

Sunosi tablets should be stored at room temperature (68°F to 77°F / 20°C to 25°C). It should be kept in a tightly sealed container. Avoid storing this medication in areas where it could get damp or wet, such as in bathrooms.

In addition, keep in mind that Sunosi is a controlled substance. Because controlled substances may lead to misuse or addiction in some people, these drugs are regulated by the government. So, it’s recommended that you store Sunosi in a locked area, where only you can access it.

Disposal

If you no longer need to take Sunosi and have leftover medication, it’s important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

This article provides several useful tips on medication disposal. You can also ask your pharmacist for information on how to dispose of your medication.