PharmaceuticalEugeroicWakefulness-promoting agentDNRI

Solriamfetol

Also known as Sunosi · JZP-110 · ADX-N05

Written by enwyReviewed 5 Aug 20262 sources0 comments

Solriamfetol (Sunosi) is a dual dopamine-norepinephrine reuptake inhibitor approved in 2019 to improve wakefulness in adults with excessive daytime sleepiness from narcolepsy or obstructive sleep apnoea. It is well studied in placebo-controlled trials and shows a dose-dependent wakefulness effect with a comparatively low abuse signal for a DNRI.

01 Overview

Solriamfetol was developed as a wakefulness-promoting agent and reached market approval on the strength of the TONES phase 3 programme, which demonstrated significant improvements on the Maintenance of Wakefulness Test and Epworth Sleepiness Scale across doses of 75-150 mg once daily.

Unlike amphetamines it does not appreciably release monoamines; it competitively blocks their reuptake. It is scheduled IV in the US, reflecting a real but modest reinforcing potential relative to classical stimulants. Blood pressure and heart rate increases are the main dose-limiting concern.

02 Mechanism

Selective dual reuptake inhibitor of dopamine and norepinephrine (DNRI) without meaningful monoamine-releasing or 5-HT activity, raising synaptic catecholamine tone in wake-regulating circuits.

03 Dosing

Tier	Dose	Route	Notes
Starting	37.5–75 mg/day	Oral	OSA patients may start at 37.5 mg; narcolepsy at 75 mg, taken on waking.
Common	75–150 mg/day	Oral	Titrate at intervals of ≥3 days; 150 mg is the labelled maximum.

04 Effects

Effect	Magnitude	Evidence
Improved wakefulnessDose-dependent increase in sleep latency on the Maintenance of Wakefulness Test sustained over 6-9 hours.	+9-13 min MWT vs placebo	Clinical
Reduced subjective sleepinessClinically meaningful reduction on the Epworth Sleepiness Scale in narcolepsy and OSA cohorts.	-3 to -5 ESS points	Clinical

05 Side effects

Effect	Severity	Frequency	Evidence
Elevated blood pressure and heart rateSmall mean increases in systolic/diastolic BP and pulse that scale with dose.	Moderate	Dose-dependent	Clinical
InsomniaDifficulty initiating sleep, especially with late dosing.	Mild	Common	Clinical
Headache and nauseaTransient headache, nausea and decreased appetite during initiation.	Mild	Common	Clinical

06 Legal status

United States

Schedule IV controlled

FDA-approved (Sunosi); prescription only. · as of Jan 2026

United Kingdom

POM

EMA-approved for narcolepsy and OSA. · as of Jan 2026

07 References

Solriamfetol for Excessive Sleepiness in Obstructive Sleep Apnea (TONES 3)Am J Respir Crit Care Med, 2019

Sunosi (solriamfetol) FDA prescribing informationUS FDA, 2019

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.