Dayvigo (Lemborexant): Usage and Inventory Management
Dayvigo (lemborexant) is a dual orexin receptor antagonist (DORA) approved for the treatment of insomnia in adults and should be stored in a controlled substance inventory at 20-25°C (68-77°F) in a dry place protected from light.
Medication Classification and Indication
Dayvigo (lemborexant) is a dual orexin receptor antagonist (DORA) that works by blocking both orexin receptor 1 (OX1R) and orexin receptor 2 (OX2R), with stronger inhibitory effects on OX2R 1. It was approved by the FDA in December 2019 for the treatment of adult patients with insomnia characterized by difficulties with sleep onset and/or sleep maintenance 2.
Unlike traditional sleep medications such as benzodiazepines and Z-drugs, lemborexant targets the orexin system, which is a key mediator controlling the sleep-wake cycle 1. This mechanism allows it to induce more physiological sleep patterns.
Inventory Management and Storage Requirements
Storage Conditions
- Store at controlled room temperature (20-25°C/68-77°F)
- Keep in a dry place
- Protect from light
- Avoid exposure to moisture due to the hygroscopic nature of many medications 3
Controlled Substance Classification
Dayvigo is classified as a Schedule IV controlled substance, similar to other sleep medications, due to its potential for abuse and dependence. This classification requires:
- Secure storage in a locked cabinet or safe
- Inventory tracking and documentation
- Limited access to authorized personnel only 3
- Regular inventory counts and reconciliation
Dosing and Administration
Dayvigo is available in two dosage strengths:
- 5 mg tablets (recommended starting dose)
- 10 mg tablets (maximum recommended dose)
The medication should be taken immediately before bedtime, with at least 7 hours remaining before the planned time of awakening 4.
Clinical Considerations for Inventory Management
Efficacy Profile
Lemborexant has demonstrated efficacy in:
- Reducing latency to persistent sleep compared to placebo
- Improving sleep maintenance
- Helping patients with early morning awakenings 5
- Maintaining effectiveness in long-term use 6
Safety Profile
When managing inventory, consider these safety aspects:
- Common adverse effects: somnolence and headache 6
- Minimal residual effects on morning alertness at recommended doses (5-10 mg) 4
- Lower incidence of complex sleep behaviors compared to some other sleep medications 6
- Minimal effects on body sway and driving skills 8-9 hours after administration 1
Special Population Considerations
When determining inventory needs, consider:
- Elderly patients may benefit from this medication due to fewer cognitive and psychomotor impairments compared to traditional hypnotics 6
- Patients with comorbid conditions show similar efficacy and safety profiles 1
Practical Inventory Management Tips
Inventory Tracking System:
- Implement electronic or paper-based tracking system
- Document dispensing, returns, and wastage
- Conduct regular audits to ensure accuracy
Staff Education:
- Train staff on proper handling and storage requirements
- Ensure understanding of controlled substance regulations
- Provide information on clinical use to assist with patient counseling
Expiration Date Management:
- Implement first-in, first-out (FIFO) dispensing practices
- Regularly check for approaching expiration dates
- Properly document and dispose of expired medication
Security Measures:
- Store in a locked, secure location with limited access
- Maintain access logs for the storage area
- Consider temperature monitoring systems for storage areas
Conclusion
Dayvigo (lemborexant) represents a newer option for treating insomnia with a potentially improved safety profile compared to traditional sleep medications. Proper inventory management requires attention to its Schedule IV controlled substance status, appropriate storage conditions, and systematic tracking of dispensing and usage.