PharmaceuticalHypnoticDual orexin receptor antagonistSchedule IV

Lemborexant

Also known as Dayvigo · E2006

Written by enwyReviewed 5 Aug 20262 sources0 comments

Dual orexin receptor antagonist approved for insomnia in 2019. Similar mechanism to suvorexant with a somewhat shorter effective duration, improving both sleep onset and maintenance; Schedule IV with dose-dependent next-day somnolence.

01 Overview

Lemborexant (brand Dayvigo) is a dual orexin receptor antagonist approved by the FDA in 2019 for insomnia with problems of sleep onset and/or maintenance. Like suvorexant it works by blocking orexin-mediated wakefulness rather than by broad CNS depression.

It showed benefit on both sleep onset and maintenance in head-to-head and placebo-controlled trials, and comparative data suggested it was non-inferior to zolpidem extended-release on some maintenance measures. It is a Schedule IV controlled substance and, like all DORAs, carries dose-dependent next-day sleepiness and the class warning for complex sleep behaviours.

02 Mechanism

Reversible competitive antagonist at orexin OX1 and OX2 receptors, suppressing the wake-promoting orexin system to enable sleep.

03 Dosing

Tier	Dose	Route	Notes
Starting	5 mg/day	Oral	5 mg immediately before bed with >=7 h remaining.
Maximum	10 mg/day	Oral	May increase to 10 mg; higher next-day somnolence risk.

04 Effects

Effect	Magnitude	Evidence
Reduced sleep onset latencyShortens latency to persistent sleep versus placebo.	~7-22 min faster to sleep	Clinical
Improved sleep maintenanceReduces wake after sleep onset and increases sleep efficiency.		Clinical

05 Side effects

Effect	Severity	Frequency	Evidence
Next-day somnolenceResidual sleepiness and possible impaired driving, more likely at 10 mg.	Moderate	Common, dose-dependent	Clinical
Sleep paralysis / hypnagogic hallucinationsTransient inability to move and vivid hallucinations at sleep transitions.	Moderate	Uncommon	Clinical
Complex sleep behavioursSleep-driving and other parasomnias without recollection.	Severe	Rare	Clinical

06 Legal status

Marketed for insomnia. · as of Jan 2026

United States

Schedule IV

FDA-approved 2019; DEA Schedule IV. · as of Jan 2026

07 References

Lemborexant vs Placebo and Zolpidem ER in Insomnia (SUNRISE-1)JAMA Network Open, 2019

Dayvigo (lemborexant) FDA prescribing informationUS FDA

08 Discussion0 comments

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This page is reference information, not medical advice. Doses and protocols are documented as they appear in the clinical literature and in practice — describing them is not a recommendation to use them. Countermeasures listed here are not a substitute for a physician. Legal status varies by jurisdiction and changes.