Lemborexant
Clinical data
Trade namesDayvigo
Other namesE-2006
License data
Pregnancy
category
Routes of
administration
By mouth
Drug classOrexin antagonist
ATC code
  • None
Legal status
Legal status
Pharmacokinetic data
Protein binding94%[2]
MetabolismLiver (major: CYP3A4, minor: CYP3A5)[2]
MetabolitesM10[2]
Elimination half-life17–19 hours[2]
ExcretionFeces: 57.4%[2]
Urine: 29.1%[2]
Identifiers
  • (1R,2S)-2-[(2,4-Dimethylpyrimidin-5-yl)oxymethyl]-2-(3-fluorophenyl)-N-(5-fluoropyridin-2-yl)cyclopropane-1-carboxamide
CAS Number
PubChem CID
DrugBank
ChemSpider
UNII
KEGG
ChEMBL
Chemical and physical data
FormulaC22H20F2N4O2
Molar mass410.425 g·mol−1
3D model (JSmol)
  • CC1=NC(=NC=C1OCC2(CC2C(=O)NC3=NC=C(C=C3)F)C4=CC(=CC=C4)F)C
  • InChI=1S/C22H20F2N4O2/c1-13-19(11-25-14(2)27-13)30-12-22(15-4-3-5-16(23)8-15)9-18(22)21(29)28-20-7-6-17(24)10-26-20/h3-8,10-11,18H,9,12H2,1-2H3,(H,26,28,29)/t18-,22+/m0/s1
  • Key:MUGXRYIUWFITCP-PGRDOPGGSA-N

Lemborexant, sold under the brand name Dayvigo, is a medication for the treatment of insomnia characterized by difficulties with sleep onset and/or sleep maintenance in adults.[2][3] Lemborexant was approved in the United States for use by adults with insomnia in December 2019.[4][5][3]

Medical uses

Lemborexant is used in the treatment of insomnia.[2] When compared to benzodiazepines there is a low risk of developing tolerance and dependence. [6] Memory and attention are not affected the next morning when taking this medication. [7]

Pharmacology

Pharmacodynamics

Lemborexant is a dual antagonist of the orexin OX1 and OX2 receptors.[8][9][10]

Pharmacokinetics

The time to peak levels of lemborexant is 1 to 3 hours.[2] A high-fat and high-calorie meal has been found to delay the time to peak levels by 2 hours.[2] Its plasma protein binding in vitro is 94%.[2] Lemborexant is metabolized primarily by CYP3A4 and to a lesser extent by CYP3A5.[2] The elimination half-life of lemborexant is 17 to 19 hours.[2] The medication is excreted in feces (57%) and to a lesser extent urine (29%).[2]

History

In June 2016, Eisai initiated Phase III clinical trials in the United States, France, Germany, Italy, Japan, Poland, Spain and the UK.[11]

In December 2019, lemborexant was approved for use in the United States based on results from the SUNRISE 1 and SUNRISE 2 Phase III clinical trials.[3][12]

Society and culture

Generic names

Lemborexant is the generic name of the drug and its INN.

Brand names

Lemborexant is sold under the brand name Dayvigo.[2]

References

  1. ^ a b "Dayvigo". Therapeutic Goods Administration (TGA). 23 July 2021. Retrieved 5 September 2021.
  2. ^ a b c d e f g h i j k l m n o p "Dayvigo- lemborexant tablet, film coated". DailyMed. Retrieved 17 June 2021.
  3. ^ a b c "FDA Approves Dayvigo (lemborexant) for the Treatment of Insomnia in Adult Patients". Drugs.com. 23 December 2019. Retrieved 10 January 2020.
  4. ^ "Novel Drug Approvals for 2019". U.S. Food and Drug Administration (FDA). 2 January 2020. Retrieved 10 January 2020. Public Domain This article incorporates text from this source, which is in the public domain.
  5. ^ "FDA-Approved Drugs: Lemborexant". U.S. Food and Drug Administration (FDA). Retrieved 10 January 2020.
  6. ^ Suzuki H, Hibino H (18 August 2021). "The effect of lemborexant for insomnia disorder". SAGE Open Medicine. 9: 20503121211039098. doi:10.1177/20503121211039098. PMC 8377315. PMID 34422270.
  7. ^ Murphy P, Kumar D, Zammit G, Rosenberg R, Moline M (May 2020). "Safety of lemborexant versus placebo and zolpidem: effects on auditory awakening threshold, postural stability, and cognitive performance in healthy older participants in the middle of the night and upon morning awakening". Journal of Clinical Sleep Medicine. 16 (5): 765–773. doi:10.5664/jcsm.8294. PMC 7849806. PMID 32022664.
  8. ^ Christopher JA (2014). "Small-molecule antagonists of the orexin receptors". Pharmaceutical Patent Analyst. 3 (6): 625–638. doi:10.4155/ppa.14.46. PMID 25489915.
  9. ^ Boss C, Roch C (August 2015). "Recent trends in orexin research--2010 to 2015". Bioorganic & Medicinal Chemistry Letters. 25 (15): 2875–2887. doi:10.1016/j.bmcl.2015.05.012. PMID 26045032.
  10. ^ Boss C (December 2014). "Orexin receptor antagonists--a patent review (2010 to August 2014)". Expert Opinion on Therapeutic Patents. 24 (12): 1367–1381. doi:10.1517/13543776.2014.978859. PMID 25407283. S2CID 21106711.
  11. ^ "Lemborexant". Specialist Pharmacy Service. Archived from the original on 7 November 2017. Retrieved 5 November 2017.
  12. ^ "Drug Trials Snapshot: Dayvigo". U.S. Food and Drug Administration (FDA). 20 December 2019. Retrieved 24 January 2020. Public Domain This article incorporates text from this source, which is in the public domain.

Further reading