suvorexant
Brand names: Belsomra
Belsomra is a prescription medicine used to treat insomnia. It helps you fall asleep and stay asleep.
Drug Pricing (NADAC)
Brand Price
$14.19/unit
Generic Available
No
MERCK SHARP DOHME
Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →
What it does
Belsomra is used to treat insomnia in adults.
Common side effects
Sleepiness
Key warnings
Belsomra can cause you to feel sleepy during the day and can impair your ability to drive.
How It Works
Belsomra works by blocking orexin, a chemical in your brain that keeps you awake. By blocking orexin, Belsomra helps to reduce wakefulness and allows you to fall asleep.
How to Take It
Take Belsomra no more than once per night, within 30 minutes before going to bed. Make sure you have at least 7 hours to sleep before you plan to wake up. The usual starting dose is 10 mg. Your doctor may increase the dose to 20 mg if the 10 mg dose does not work well enough. Do not take with or soon after a meal, as this may delay the effect.
Pregnancy & Breastfeeding
It is not known if Belsomra can harm your unborn baby. Talk to your doctor if you are pregnant or plan to become pregnant. It is also not known if Belsomra passes into breast milk. Talk to your doctor about the best way to feed your baby if you take Belsomra.
Missed Dose
If you forget to take Belsomra, skip that dose and take it the next night. Do not take two doses at once.
Storage
Store Belsomra at room temperature, between 68°F to 77°F, in its original packaging to protect it from light and moisture.
Side Effects (from patient reports)
Based on 7,855 FDA adverse event reports.
FDA Adverse Event Report Analysis
Detailed analysis of 12,687 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2014–2025.
Total Reports
12,687
Death-Related Reports
686
Hospitalization Reports
1,975
Top Indication
Insomnia
Gender Distribution
Age Distribution
Most Reported Adverse Reactions (FAERS)
| # | Reaction | Reports |
|---|---|---|
| 1 | DRUG INEFFECTIVE | 2,994 |
| 2 | NIGHTMARE | 736 |
| 3 | SOMNOLENCE | 726 |
| 4 | INSOMNIA | 674 |
| 5 | ABNORMAL DREAMS | 599 |
| 6 | HEADACHE | 535 |
| 7 | FEELING ABNORMAL | 485 |
| 8 | NAUSEA | 381 |
| 9 | HALLUCINATION | 372 |
| 10 | FATIGUE | 353 |
| 11 | NO ADVERSE EVENT | 350 |
| 12 | DIZZINESS | 325 |
| 13 | ANXIETY | 308 |
| 14 | FALL | 258 |
| 15 | OFF LABEL USE | 258 |
Reactions in Death Reports
Reactions in Hospitalization Reports
Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation
Serious Warnings
Belsomra can cause you to feel sleepy during the day and can impair your ability to drive. Do not drive or do other activities that require you to be fully alert, especially if you take the 20 mg dose. Belsomra may also worsen depression or cause suicidal thoughts. Tell your doctor right away if you have any new or worsening mood changes. Complex sleep behaviors like sleepwalking have also been reported. Stop taking Belsomra and tell your doctor if this happens.
Known Drug Interactions
CYP3A Inhibitors Concomitant use of BELSOMRA with strong inhibitors of CYP3A (e.g., ketoconazole, itraconazole, posaconazole, clarithromycin, nefazodone, ritonavir, saquinavir, nelfinavir, indinavir, boceprevir, telaprevir, telithromycin and conivaptan) is not recommended [see Clinical Pharmacology (12.3) ].
Mechanism: Ketoconazole stops your body from breaking down suvorexant, which can lead to much higher levels of the sleep medicine in your blood. This can make you feel overly tired or cause other side effects.
What to do: You should avoid taking these two medications together. Ask your doctor for an alternative medicine that does not have this interaction.
CYP3A Inhibitors Concomitant use of BELSOMRA with strong inhibitors of CYP3A (e.g., ketoconazole, itraconazole, posaconazole, clarithromycin, nefazodone, ritonavir, saquinavir, nelfinavir, indinavir, boceprevir, telaprevir, telithromycin and conivaptan) is not recommended [see Clinical Pharmacology (12.3) ].
Mechanism: Clarithromycin blocks the enzyme that breaks down suvorexant, which can cause the sleep medicine to build up to high levels in your body.
What to do: Taking these two drugs together is not recommended and should be avoided.
CYP3A Inhibitors Concomitant use of BELSOMRA with strong inhibitors of CYP3A (e.g., ketoconazole, itraconazole, posaconazole, clarithromycin, nefazodone, ritonavir, saquinavir, nelfinavir, indinavir, boceprevir, telaprevir, telithromycin and conivaptan) is not recommended [see Clinical Pharmacology (12.3) ].
Mechanism: Posaconazole stops your body from clearing suvorexant, which can lead to higher levels of the sleep medicine in your system than intended.
What to do: You should avoid using these two medications at the same time.
Neuropsychiatric agents suvorexant ↑ suvorexant Avoid concomitant use of suvorexant with PAXLOVID.
Mechanism: Ritonavir slows down how quickly your body clears suvorexant, which can make the effects of the sleep medicine much stronger.
What to do: You should avoid taking these two medications together.
The recommended dose of BELSOMRA is 5 mg in subjects receiving moderate CYP3A inhibitors (e.g., amprenavir, aprepitant, atazanavir, ciprofloxacin, diltiazem, erythromycin, fluconazole, fosamprenavir, grapefruit juice, imatinib, verapamil).
Mechanism: Diltiazem blocks the enzyme that breaks down suvorexant, which can cause the sleep medicine to build up in your body.
What to do: Your doctor should lower your dose of suvorexant to 5 mg if you are also taking diltiazem.
Common Questions
Can I drink alcohol while taking Belsomra?
Can I take Belsomra with other sleep medicines?
What should I do if I feel sleepy during the day?
Can Belsomra cause sleepwalking?
Is it okay to drive the day after taking Belsomra?
What if the 10mg dose isn't strong enough?
Can I take Belsomra if I have liver problems?
What if I am taking other medications?
Can Belsomra cause nightmares?
How long should I take Belsomra?
What are the common side effects of suvorexant?
Does suvorexant interact with other medications?
What drug class is suvorexant?
Is suvorexant safe during pregnancy?
Related Medications in Orexin Receptor Antagonist
Other drugs grouped near suvorexant — same-class peers and common alternatives.
eszopiclone
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lemborexant
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melatonin
Melatonin
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ramelteon
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tasimelteon
Hetlioz
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Medication Guides
Understanding Drug Interactions
How CYP450 enzymes, inhibitors, and inducers affect your medications
Generic vs Brand Name Drugs
FDA requirements, cost savings, and when the difference matters
Narrow Therapeutic Index Drugs
Why some drugs demand precise dosing and monitoring
Common Drug Interactions
Dangerous medication combinations and how to protect yourself
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What the FDA Data Shows for suvorexant
The FDA label for suvorexant (sold under brand names such as Belsomra) classifies it as a prescription-only medication in the Orexin Receptor Antagonist class. Belsomra is used to treat insomnia in adults. Official labeling lists 1 commonly reported side effect, including Sleepiness.
Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 7,855 voluntary reports. The database also lists 15 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated moderate severity. NADAC pricing from CMS.
Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.
Data Sources
Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).
FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.
Last updated: March 10, 2025
Read our methodology — how this data is sourced, computed, and verified.
All federal data sources used on this page
- FDA Orange Book — approved drug products with therapeutic equivalence. accessdata.fda.gov/cder/ob
- FDA DailyMed — NIH-hosted drug labeling for FDA-approved meds. dailymed.nlm.nih.gov
- FDA Adverse Event Reporting System (FAERS) — post-marketing safety surveillance. fda.gov/drugs/faers
- NLM RxNorm — standardized clinical drug nomenclature. nlm.nih.gov/research/umls/rxnorm
- CMS Medicare Part B Drug Average Sales Price Files — federal drug pricing data. cms.gov/medicare/part-b-drugs/asp
- FDA Drug Shortages Database — current and resolved drug shortage tracking. accessdata.fda.gov/drugshortages