Belsomra: Side Effects, Dosage, Uses, and More

What is Belsomra?

If you have insomnia (trouble sleeping or staying asleep), your doctor may prescribe Belsomra. It's a prescription drug used in adults with this condition.

Belsomra basics

Belsomra contains the active ingredient suvorexant. (An active ingredient is what makes a drug work.) It belongs to a group of drugs called dual orexin receptor antagonists (DORAs).

Belsomra is a tablet that you'll swallow. It's available in four strengths: 5 milligrams (mg), 10 mg, 15 mg, and 20 mg.

Belsomra is a brand-name medication and isn't available in a generic version.

Is Belsomra a controlled substance?

Yes, Belsomra is a controlled substance. The government regulates how controlled substances are prescribed and dispensed because of their potential for misuse or dependence. ("Misuse" means using a drug in a way other than how it was prescribed. With dependence, you rely on a drug to function or feel a certain way.)

Belsomra is a Schedule IV controlled substance, which means it carries a low risk of misuse or dependence.

If you have concerns about the risk of misuse or dependence with Belsomra, talk with your doctor before starting treatment.

What are Belsomra's side effects?

Like most drugs, Belsomra may cause mild or serious side effects. The lists below describe some of the more common side effects that Belsomra may cause. These lists don't include all possible side effects.

Keep in mind that side effects of a drug can depend on:

your age
other health conditions you have
other medications you take

Your doctor or pharmacist can tell you more about the potential side effects of Belsomra. They can also suggest ways to help reduce side effects.

Mild side effects

Here's a short list of some of the mild side effects that Belsomra can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read Belsomra's prescribing information.

Mild side effects of Belsomra may include:

feeling sleepy the day after you take Belsomra
headache
dry mouth
unusual dreams
coughing
upper respiratory infection such as the common cold
diarrhea
dizziness
mild allergic reaction*

Mild side effects of many drugs may go away within a few days to a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.

* To learn more about this side effect, see the "Allergic reaction" section below.

Serious side effects

Serious side effects from Belsomra can occur, but they aren't common. If you have serious side effects from Belsomra, call your doctor right away. But if you think you're having a medical emergency, you should call 911 or your local emergency number.

Serious side effects of Belsomra may include:

unusual sleep behaviors, such as sleepwalking or sleep-driving
temporary muscle weakness, such as in your legs
excessive drowsiness
sleep paralysis (not being able to move or talk as you fall asleep or wake up)
hallucinations (seeing or hearing things that aren't really there) as you're falling asleep or waking up
suicidal thoughts or behaviors
severe allergic reaction*

* To learn more about this side effect, see the "Allergic reaction" section below.

Help is out there

If you or someone you know is in crisis and considering suicide or self-harm, please seek support:

Call the 988 Suicide and Crisis Lifeline at 988.
Text HOME to the Crisis Textline at 741741.
Not in the United States? Find a helpline in your country with Befrienders Worldwide.
Call 911 or your local emergency services number if you feel safe to do so.

If you're calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.

If you are not in the same household, stay on the phone with them until help arrives.

Allergic reaction

Some people may have an allergic reaction to Belsomra. Allergic reaction wasn't reported in studies of Belsomra, but it could still occur.

Symptoms of a mild allergic reaction can include:

skin rash
itchiness
flushing (temporary warmth, redness, or deepening of skin color)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include swelling under your skin, usually in your eyelids, lips, hands, or feet. They can also include swelling of your tongue, mouth, or throat, which can cause trouble breathing.

Call your doctor right away if you have an allergic reaction to Belsomra. But if you think you're having a medical emergency, call 911 or your local emergency number.

What are some frequently asked questions about Belsomra?

Find answers to some commonly asked questions about Belsomra.

What should I know about alternatives to Belsomra, such as Belsomra vs. Ambien, Lunesta, or Dayvigo?

Belsomra, Ambien, Lunesta, and Dayvigo are all prescription drugs for treating insomnia (trouble falling asleep or staying asleep) in adults. They're all controlled substances, which means the government regulates them due to their potential for misuse or dependence.

Of these alternatives, Dayvigo is the most comparable to Belsomra. They work in a similar way in the body to treat insomnia.

Both Dayvigo and Belsomra are the most recently FDA-approved drugs for insomnia. This means they're brand-name drugs with no currently available generic versions. Ambien and Lunesta are relatively older drugs. They're available as brand and generic drugs. Generic drugs tend to cost less than brand-name drugs.

For more information about how these medications compare, talk with your doctor or pharmacist.

Is Belsomra used to treat anxiety?

Belsomra isn't used to treat anxiety. In fact, anxiety has been reported as a side effect of Belsomra since the drug was approved.

One small study showed that suvorexant (the active ingredient in Belsomra) helped reduce the severity of anxiety in hospitalized people with mental illness and anxiety. The drug was also found to help improve sleep quality in this study. More studies are needed to assess Belsomra for anxiety.

Talk with your doctor if you have questions about Belsomra's uses or treatments for anxiety.

Does Belsomra cause weight loss or weight gain?

Belsomra shouldn't cause weight gain or weight loss. Weight changes weren't reported in the drug's clinical studies.

If you're concerned about changes in your weight, talk with your doctor. They may help you identify the cause or recommend ways to manage your weight.

Is Belsomra addictive? And will I experience withdrawal if I stop taking it?

There was no evidence of physical addiction in people who took Belsomra in clinical studies. Also in these studies, no withdrawal symptoms were reported after people stopped taking the drug.

Belsomra is a Schedule IV controlled substance, which means it carries a low risk of misuse or dependence.

It's possible that taking Belsomra may lead to psychological (mental or emotional) addiction. For example, it's possible that someone taking Belsomra may feel that they can't fall asleep without it. To help prevent this, your doctor will likely advise you not to take Belsomra every night. It's a medication that's meant to be taken only as needed.

Is Belsomra a narcotic? Will it make me feel 'high'?

No, Belsomra isn't a narcotic. And in the drug's studies, there were no reports of people feeling high.

Narcotics are opioids, such as oxycodone. Opioids are prescribed to treat severe pain.

Belsomra is prescribed to treat insomnia. It belongs to a group of drugs called dual orexin receptor antagonists.

If you have questions about what to expect with Belsomra treatment, talk with your doctor.

What is Belsomra's mechanism of action (how does it work)?

Belsomra is used to help adults with insomnia get more sleep. It's thought to work by blocking the effects of brain chemicals called orexins. Orexins are involved in telling your brain to stay awake or wake up.

To learn more about how Belsomra works to treat insomnia, talk with your doctor.

What is Belsomra's dosage?

Your doctor will recommend the dosage of Belsomra that's right for you. Below are commonly used dosages, but always take the dosage your doctor prescribes.

Form and strengths

Belsomra is a tablet that you'll swallow. It's available in four strengths: 5 milligrams (mg), 10 mg, 15 mg, and 20 mg.

Recommended dosages

The usual starting dose of Belsomra is 10 mg. You'll take a dose up to 30 minutes before you go to bed. Only take Belsomra if you'll be able to sleep at least 7 hours.

Your doctor will likely advise you not to take Belsomra every night. It's usually taken only as needed.

If you don't feel that you're sleeping better after taking Belsomra, talk with your doctor. They may increase your dose. The maximum dose of Belsomra is 20 mg. But you should not change your dose unless your doctor recommends it.

Your doctor may prescribe a lower starting and maximum dosage if you take certain medications or if you're age 65 years or older.

Questions about Belsomra's dosage

Below are some common questions about Belsomra's dosage.

What if I miss a dose of Belsomra? Belsomra should be taken at least 30 minutes before going to bed. If you forget to take it at least 30 minutes before your bedtime, you can still take it later, as long as you'll still have at least 7 hours before you need to wake up.
Will I need to use Belsomra long term? It's possible that your doctor may prescribe Belsomra for you long term. But they may advise you not to take it every night. This drug is usually taken only as needed.
How long does Belsomra take to work? Belsomra starts working within 30 minutes after you take a dose. But if you take your dose with food or right after a meal, it may take an hour or so longer than this to start working.

What is Belsomra used for?

Belsomra is used to treat insomnia in adults who have trouble falling asleep, staying asleep, or both.

Symptoms of insomnia may include:

lying awake for a long time before falling asleep
waking up during the night or waking up too early
tiredness

Not getting enough sleep can lead to other symptoms. Examples include feeling irritable and having trouble with memory or focus.

Belsomra may not be effective for insomnia caused by other medical conditions or drugs.

If you don't feel like Belsomra is helping you sleep after taking it for 7 to 10 nights, talk with your doctor. They may adjust your dosage or treatment plan. They may also check if other factors or illnesses may be causing your insomnia.

To learn more about taking Belsomra for sleep, talk with your doctor or pharmacist.

What does Belsomra cost?

Costs of prescription drugs can vary depending on many factors. These factors include what your insurance plan covers and which pharmacy you use.

If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. A savings coupon may also be available for Belsomra.

You can also check out this article to learn more about saving money on prescriptions.

What should be considered before taking Belsomra?

This section describes what to consider before starting Belsomra treatment.

Interactions

Taking a medication with certain vaccines, foods, and other things can affect how the medication works. These effects are called interactions.

Before taking Belsomra, be sure to tell your doctor about all medications you take, including prescription and over-the-counter types. Also describe any vitamins, herbs, or supplements you use. Your doctor or pharmacist can tell you about any interactions these items may cause with Belsomra.

For information about drug-condition interactions, see the "Warnings" section below.

Interactions with drugs or supplements

Belsomra can interact with several types of drugs or supplements. Some examples include:

other central nervous system (CNS) depressants, such as opioids or other types of drugs that can cause drowsiness
certain blood pressure medications, such as diltiazem (Cardizem) and verapamil (Calan)
digoxin, a heart medication
certain drugs used to treat seizures
protease inhibitors, a group of HIV drugs
certain drugs used to treat infections
the herb St. John's wort

Warnings

Belsomra may not be right for you if you have certain medical conditions. These are known as drug-condition interactions. Other factors may also affect whether Belsomra is a good treatment option for you.

Talk with your doctor about your health history before you take Belsomra. Factors to consider include those in the list below.

Depression or other mental health condition. In rare cases, Belsomra may increase suicidal thoughts and behaviors or worsened depression. If you have depression, talk with your doctor about your condition before starting Belsomra. They may monitor you more closely during treatment, or they may recommend another treatment for your condition.
Drug or substance misuse. Belsomra is a controlled substance and carries the risk of misuse (also called abuse). If you have a problem with drug, alcohol, or substance misuse (or have had one of these issues in the past), tell your doctor. They may suggest a different treatment option for your insomnia.
Cataplexy. Belsomra may cause temporary weakness in your muscles. This side effect is similar to the main symptom of cataplexy. If you have cataplexy, talk with your doctor before taking Belsomra. They can determine if this drug is safe for you.
Liver problems. It isn't known if Belsomra use is safe for people with severe liver problems. If you have liver problems or have had them in the past, talk with your doctor before taking Belsomra. Your doctor may check your liver health to determine if it's safe for you to take Belsomra.
Breathing problems. Belsomra can cause cough and upper respiratory infection, which could irritate your lungs. If you already have breathing problems such as obstructive sleep apnea or chronic obstructive pulmonary disease, taking Belsomra could worsen your symptoms. Talk with your doctor to find out if it's safe for you to take Belsomra.
Narcolepsy. If you have narcolepsy, taking Belsomra could worsen your condition. Due to this risk, doctors will likely not prescribe Belsomra to people with narcolepsy. If you have this condition, talk with your doctor about other insomnia treatments.
Allergic reaction. If you've had an allergic reaction to Belsomra or any of its ingredients, your doctor will likely not prescribe Belsomra. Ask them what other medications are better options for you.
Older age. People ages 65 years and older may have a higher risk of certain side effects of Belsomra, such as dizziness. This can lead to falls and related injuries. Due to this risk, doctors may prescribe a lower dose of Belsomra if you're age 65 years or older. They'll also monitor you closely for side effects during your treatment.

Belsomra and alcohol

You should not combine Belsomra with alcohol. If you drink alcohol while you're prescribed Belsomra, do not take Belsomra that evening before you go to bed.

Belsomra and alcohol are both central nervous system (CNS) depressants. This means they can slow your brain's activity. Drinking alcohol with Belsomra can raise your risk of excessive drowsiness and falls.

If you have questions about drinking alcohol during your Belsomra treatment, talk with your doctor.

Pregnancy and breastfeeding

It isn't known if it's safe to take Belsomra while pregnant.

If you're pregnant or planning a pregnancy, tell your doctor. They'll likely recommend other treatment options besides Belsomra during your pregnancy.

It also isn't known if it's safe to take Belsomra while breastfeeding. It's possible that a breastfed child may become excessively sleepy if they're exposed to Belsomra through breast milk.

If you're breastfeeding or planning to breastfeed, talk with your doctor. They may recommend other treatment options for insomnia.

What should be done in case of overdose?

Do not take more Belsomra than your doctor prescribes. Using more than this can lead to serious side effects.

What to do in case you take too much Belsomra

Call your doctor if you think you've taken too much Belsomra. You can also call 800-222-1222 to reach the American Association of Poison Control Centers or use its online resource. But if you have severe symptoms, immediately call 911 or your local emergency number. Or go to the nearest emergency room.

How is Belsomra taken?

Your doctor will explain how you should take Belsomra. They'll also explain how much to take and how often. Be sure to follow your doctor's instructions.

Taking Belsomra

Belsomra is a tablet that you'll swallow. You'll take Belsomra up to 30 minutes before going to bed. Only take Belsomra if you'll be able to get at least 7 hours of sleep.

Your doctor will likely advise you not to take Belsomra every night. It's typically taken only as needed.

Accessible medication containers and labels

If it's hard for you to read the label on your prescription, tell your doctor or pharmacist. Certain pharmacies may provide medication labels that:

have large print
use braille
contain a code you can scan with a smartphone to change the text into audio

Your doctor or pharmacist may be able to recommend a pharmacy that offers these options if your current pharmacy doesn't.

Questions about taking Belsomra

Below are some common questions about Belsomra.

Can Belsomra be chewed, crushed, or split? No, Belsomra tablets should be swallowed whole. If you have trouble swallowing pills, check out this article for tips. Or talk with your doctor about other treatment options.
Should I take Belsomra with food? Belsomra may be taken with or without food. But Belsomra may take longer to start working if you take it with food or right after you've eaten.
Is there a best time of day to take Belsomra? Yes. You should take Belsomra up to 30 minutes before going to bed. Only take Belsomra if you'll be able to get at least 7 hours of sleep.

Questions for your doctor
You may have questions about Belsomra and your treatment plan. It's important to discuss all your concerns with your doctor.
Here are a few tips that might help guide your discussion:
Before your appointment, write down questions such as:
How will Belsomra affect my body, mood, or lifestyle?
Bring someone with you to your appointment if doing so will help you feel more comfortable.
If you don't understand something related to your condition or treatment, ask your doctor to explain it to you.
Remember, your doctor and other healthcare professionals are available to help you. And they want you to get the best care possible. So don't be afraid to ask questions or offer feedback on your treatment.

Can Belsomra be misused

Belsomra is a controlled substance. The government regulates how controlled substances are prescribed and dispensed because of their potential for misuse or dependence. ("Misuse" means using a drug in a way other than how it was prescribed. With dependence, you rely on a drug to function or feel a certain way.)

Belsomra is a Schedule IV controlled substance, which means it carries a low risk of misuse or dependence.

If you have concerns about your risk for misuse or dependence with Belsomra, talk with your doctor before starting treatment.

What to ask your doctor

If you have questions about taking Belsomra or other treatment options for insomnia, talk with your doctor.

Here are some example questions to help start your conversation:

Does Belsomra show up on a drug test?
What are my options if Belsomra isn't working for me?
Should I continue taking my other medications with Belsomra?
How can I tell if I'm becoming dependent or addicted to Belsomra?

You can read more about the warning signs of sleep disorders, including insomnia, here.

Ask a pharmacist

Q:

If I wake up at night after taking Belsomra at bedtime, can I take an over-the-counter drug that causes drowsiness, such as Benadryl?

Anonymous

A:

It's not recommended. Belsomra and diphenhydramine (Benadryl) are central nervous system (CNS) depressants. This means they can slow your brain's activity and cause symptoms such as drowsiness.

Benadryl contains the active drug diphenhydramine. This drug is also found in other over-the-counter (OTC) sleep aids, such as Sominex and ZzzQuil. It's also found in certain OTC cold and allergy medications.

Taking these drugs with or after taking Belsomra may cause excessive drowsiness. You may have trouble getting up, feel sleepy the next day, or have trouble staying alert. This can make certain activities dangerous, such as driving.

You should not take more than your prescribed dose of Belsomra. If you feel that the drug isn't working, talk with your doctor. They may change your dose or recommend a different treatment option for your insomnia.

The Healthline Pharmacist TeamAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.