From the Guidelines
Yes, QUVIVIQ (daridorexant) is similar to Dayvigo (lemboorexant) in terms of their mechanism of action as dual orexin receptor antagonists (DORAs) for the treatment of insomnia in adults. Both medications work by blocking orexin receptors in the brain, which helps regulate the sleep-wake cycle by reducing wakefulness and promoting sleep 1. They share similar side effect profiles, including headache, somnolence, and fatigue.
Key Similarities
- Both are taken orally once daily in the evening
- Both carry warnings about complex sleep behaviors, CNS depression, and worsening of depression/suicidal ideation
- Neither should be taken with alcohol or other CNS depressants
- Both are controlled substances (Schedule IV) due to their potential for abuse and dependence
Key Differences
- Specific half-lives: QUVIVIQ has a half-life of 8 hours, while Dayvigo has a half-life of 17-19 hours
- Exact binding affinities to orexin receptors, which may result in subtle differences in efficacy and side effects for individual patients
- Available doses: QUVIVIQ is available in 25mg and 50mg doses, while Dayvigo is available in 5mg and 10mg doses The most recent study comparing daridorexant and zopiclone found that daridorexant had a similar effect on driving performance as zopiclone, suggesting that it may have a similar safety profile to other hypnotics, including lemborexant 1. However, more research is needed to fully compare the safety and efficacy of QUVIVIQ and Dayvigo. Some key points to consider when prescribing either medication include:
- Monitoring for signs of complex sleep behaviors, such as sleepwalking or sleep-driving
- Counseling patients on the risks of CNS depression and worsening of depression/suicidal ideation
- Advising patients to avoid taking the medication with alcohol or other CNS depressants
- Encouraging patients to report any side effects or concerns to their healthcare provider.
From the Research
Similarities and Differences between QUVIVIQ (daridorexant) and Dayvigo (lemboorexant)
- Both QUVIVIQ (daridorexant) and Dayvigo (lemboorexant) are dual orexin receptor antagonists (DORAs) used for the treatment of insomnia disorder 2, 3.
- They work by inhibiting the actions of the wake-promoting orexin neuropeptides, thereby reducing the wake drive and promoting sleep 4, 3.
- Both drugs have shown efficacy in improving sleep outcomes, such as sleep onset latency, wake time after sleep onset, and subjective total sleep time, in clinical trials 2, 5, 3.
Efficacy Comparison
- A systematic review and meta-analysis found that lemborexant (Dayvigo) was more effective in reducing wake after sleep onset and improving subjective sleep onset latency compared to daridorexant (QUVIVIQ) 5.
- However, daridorexant at a dose of 50 mg demonstrated superior efficacy compared to lower doses, indicating a dose-dependent effect 5.
- The efficacy of lemborexant was consistent across the 5 mg and 10 mg doses 5.
Safety Profiles
- Both drugs have been generally well-tolerated, with common adverse events including somnolence, fatigue, and dizziness 2, 5, 3.
- However, lemborexant was associated with a higher risk of somnolence compared to daridorexant 5.
- Daridorexant was associated with higher rates of treatment-emergent adverse events, particularly at the 25 mg dose 5.