From the Guidelines
Suvorexant (Belsomra) is generally considered safe for patients with stage 2 chronic kidney disease (CKD). Since suvorexant is primarily metabolized by the liver and not significantly eliminated by the kidneys, no dose adjustment is typically needed for patients with mild to moderate kidney impairment. CKD stage 2 represents mild kidney damage with GFR between 60-89 mL/min/1.73m², which doesn't significantly impact suvorexant clearance. However, it's essential to start with the lowest effective dose (typically 5-10 mg) and monitor for side effects such as daytime drowsiness, headache, or dizziness. As with any medication in CKD patients, be cautious about potential drug interactions, especially if you're taking multiple medications. Some medications commonly prescribed for CKD patients may interact with suvorexant. Always inform your healthcare provider about all medications you're taking, including over-the-counter drugs and supplements. Your doctor should evaluate your specific situation, considering your complete medical history and medication regimen before confirming this medication is appropriate for you 1.
Some key points to consider when prescribing suvorexant to patients with CKD include:
- Monitoring for potential side effects and adjusting the dose as needed
- Being aware of potential drug interactions with other medications commonly used in CKD patients
- Considering the patient's overall medical history and medication regimen before initiating suvorexant therapy
- Starting with the lowest effective dose and titrating upwards as needed and tolerated
It's also important to note that while suvorexant is generally considered safe for patients with stage 2 CKD, the risk of adverse effects may increase with decreasing kidney function. Therefore, close monitoring and regular follow-up with a healthcare provider are essential to ensure safe and effective use of suvorexant in patients with CKD 1.
In terms of specific guidance, the most recent and highest quality study available does not provide specific recommendations for the use of suvorexant in patients with CKD. However, based on the available evidence and general principles of medication use in CKD, it is reasonable to conclude that suvorexant can be used safely in patients with stage 2 CKD, with careful monitoring and consideration of potential drug interactions and side effects 1.
From the FDA Drug Label
Suvorexant exposure (expressed as total and unbound concentrations) was similar between patients with severe renal impairment (urinary creatinine clearance ≤30 mL/min/1.73m2) and healthy matched control subjects. No dose adjustment is required in patients with renal impairment [see Use in Specific Populations (8. 8)].
Suvorexant can be taken with CKD stage 2, as the drug label states that no dose adjustment is required in patients with renal impairment, and CKD stage 2 is a mild form of renal impairment. However, it is essential to consult a healthcare professional for personalized advice, as individual circumstances may vary 2.
- Key points:
- No dose adjustment is required in patients with renal impairment.
- Suvorexant exposure is similar in patients with severe renal impairment and healthy control subjects.
From the Research
Suvorexant and CKD Stage 2
There are no research papers to assist in answering this question regarding the safety of taking Suvorexant with CKD stage 2.
Available Information on CKD Stage 2
- The provided studies focus on the effects of exercise on patients with CKD stage 2, rather than medication interactions 3, 4, 5, 6, 7.
- These studies suggest that exercise can have beneficial effects on patients with CKD, including improved physical fitness, cardiovascular dimensions, and health-related quality of life 5, 7.
- However, they do not provide information on the safety of taking Suvorexant with CKD stage 2.
Considerations for CKD Stage 2 Patients
- Patients with CKD stage 2 should consult their healthcare provider before taking any medication, including Suvorexant, to discuss potential interactions and risks.
- Healthcare providers should consider the individual patient's health status, medical history, and current medications when prescribing medications for patients with CKD stage 2.