From the Research
Dayvigo (lemborexant) is contraindicated in patients with narcolepsy, as it may worsen their condition by further promoting sleep, and individuals with a history of complex sleep behaviors after taking sleep medications, such as sleepwalking or sleep-driving, should also avoid its use. The medication should not be used in patients with severe hepatic impairment due to increased drug exposure and potential for enhanced side effects 1. Additionally, Dayvigo is contraindicated during concurrent use of strong CYP3A inhibitors (like ketoconazole, clarithromycin, or itraconazole) which can significantly increase lemborexant blood levels and risk of adverse effects 1. Patients should not take Dayvigo with alcohol or other CNS depressants as this combination can dangerously enhance sedative effects 2. Pregnant or breastfeeding women should generally avoid Dayvigo due to limited safety data 1. These contraindications exist because Dayvigo works by inhibiting orexin receptors to promote sleep, and these specific conditions or combinations either increase the risk of adverse effects or may lead to dangerous outcomes when the medication's sedative properties are enhanced or misapplied. Some key points to consider when prescribing Dayvigo include:
- Monitoring for signs of complex sleep behaviors
- Avoiding use in patients with a history of substance abuse
- Counseling patients on the risks of combining Dayvigo with other CNS depressants
- Regularly reviewing the patient's medical history and current medications to minimize potential interactions 3, 1, 2. It is essential to weigh the benefits and risks of Dayvigo in each patient, considering their individual medical history and current health status, to ensure safe and effective treatment of insomnia.