Solriamfetol

Pronunciation: SOL-ri-AM-fe-tol
Brand name: Sunosi
Dosage form: tablet (75 mg, 150 mg)
Drug class: Miscellaneous central nervous system agents

Medically reviewed by Melisa Puckey, BPharm. Last updated on Oct 3, 2024.

What is Solriamfetol?

Solriamfetol is a prescription medicine used to treat adults with excessive daytime sleepiness (EDS) due to narcolepsy or sleep disruption by sleep apnea. Solriamfetol (brand Sunosi) helps you feel more awake during the day and increases the time spent awake. It does not treat sleep apnea, it helps with the symptoms of excessive sleepiness during the day. Keep using your CPAP machine or other device prescribed by your doctor.

Solriamfetol mechanism of action is a dopamine and norepinephrine reuptake inhibitor (DNRI), It is thought to improve wakefulness in patients with excessive daytime sleepiness by affecting dopamine and norepinephrine levels. Solriamfetol is not a stimulant medicine. 

Solriamfetol is a controlled substance Schedule 4. Solriamfetol is FDA approved to improve wakefulness in adult patients with excessive daytime sleepiness associated with narcolepsy or obstructive sleep apnea (OSA).

Solriamfetol side effects

Common side effects of solriamfetol

Common side effects of solriamfetol are trouble sleeping (insomnia), anxiety, nausea, loss of appetite, or headache.

Serious side effects of solriamfetol

Solriamfetol may cause serious side effects, call your doctor at once if you have:

• racing thoughts, increased energy, decreased need for sleep, feeling agitated or irritable;
• ongoing sleep problems;
• fast or pounding heartbeats; or
• severe headache, blurred vision, pounding in your neck or ears.

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What is the cost of solriamfetol?

The cost of solriamfetol varies depending on your insurance plan and which pharmacy you use. Refer to our Sunosi price guide page for more information about the cost.

You may also be eligible for a Sunosi savings card, Sunosi coupon, or Sunosi copay card. Ask your doctor or pharmacist if you qualify.

Warnings

Solriamfetol is a controlled substance Schedule 4

Solriamfetol is a controlled substance, which means it has a low potential for abuse relative to those in Schedule 3. It currently has an accepted medical use in treatment in the United States. Abuse may lead to limited physical dependence or psychological dependence relative to those in schedule 3.

This medicine can be a target for people who abuse prescription medicines or street drugs.

Keep solriamfetol in a safe place to protect it from theft. Never give your tablets to anyone else because it may cause death or harm them. Selling or giving away this medicine may harm others and is against the law. Tell your healthcare provider if you have ever abused or been dependent on alcohol, prescription medicines or street drugs.

Blood Pressure and Heart Rate Increases 

Heart rate and blood pressure will be monitored before treatment and throughout treatment. Hypertension should be controlled before and during therapy. Solriamfetol should not be used in patients with unstable cardiovascular disease, serious heart arrhythmias, or other serious heart problems. 

Psychiatric Symptoms

Solriamfetol should be used with caution in patients with a history of psychosis or bipolar disorders. If psychiatric symptoms develop, the dose should be decreased or discontinued.

Other medicines

 Do not use solriamfetol if you have used an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine.

Before taking this medicine

If you have sleep apnea, this condition should be treated for at least 1 month before you start taking solriamfetol .

Do not use solriamfetol if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

To make sure this medicine is safe for you, tell your doctor if you have ever had:

• heart problems;
• a heart attack or stroke;
• high blood pressure;
• diabetes;
• high cholesterol;
• kidney disease;
• mental illness, psychosis, bipolar disorder; or
• alcoholism or drug addiction (especially addiction to cocaine or other stimulant).

Pregnancy

Tell your healthcare provider if you are pregnant or planning to become pregnant, as it is not known if solriamfetol will harm your unborn baby. There is a pregnancy registry for women who take Sunosi (solriamfetol) during pregnancy. The purpose of this registry is to collect information about the health of you and your baby. Talk to your healthcare provider about how you can take part in this registry.

Breastfeeding

Tell your doctor if you are breastfeeding or planning to breastfeed as solriamfetol passes into your breast milk. Talk to your healthcare provider about the best way to feed your baby if you take this medicine. The developmental and health benefits of breastfeeding should be considered, along with the mother’s clinical need for solriamfetol and any potential adverse effects on the breastfed infant from solriamfetol or the underlying maternal condition.

How should I take solriamfetol?

Take solriamfetol exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.

Solriamfetol is usually taken once daily when you wake up. You should not take if within 9 hours of your planned bedtime, as it may make it harder to go to sleep.

You may take solriamfetol with or without food.

You may need to swallow a tablet whole or split it in half. Follow your doctor's instructions very carefully.

Carefully follow your doctor's instructions about when to increase your dose. Taking more solriamfetol than prescribed will not make it more effective and may result in serious side effects.

Your blood pressure and heart rate will need to be checked often.

Do not change your dose or stop taking solriamfetol without your doctor's advice.

Do not keep leftover solriamfetol. Ask your pharmacist where to locate a drug take-back disposal program. If there is no take-back program, follow disposal instructions in the Medication Guide provided with your medicine.

Solriamfetol Dosing information

Usual Adult Solriamfetol Dose for Narcolepsy

Initial dose: 75 mg orally once a day upon awakening, dose may be doubled after 3 days based on efficacy and tolerability.
Maintenance dose: 75 to 150 mg orally once a day
Maximum dose: 150 mg/day
Comments: Doses above 150 mg/day have not been shown to increase effectiveness enough to outweigh dose-related adverse reactions.

Usual Adult Solriamfetol Dose for Obstructive Sleep Apnea/Hypopnea Syndrome

Initial dose: 37.5 mg orally once a day upon awakening, dose may be doubled at intervals of 3 days based on efficacy and tolerability
Maintenance dose: 37.5 to 150 mg orally once a day
Maximum dose: 150 mg/day
Comments:

This drug does not treat the underlying airway obstruction in obstructive sleep apnea (OSA).
Prior to initiating therapy, patients should have their underlying airway obstruction treated (e.g. with continuous positive airway pressure) for at least 1 month and should continue treatment while taking this drug.
Doses above 150 mg/day have not been shown to increase effectiveness enough to outweigh dose-related adverse reactions.

Related/similar drugs

Provigil, Nuvigil, Wakix, Xywav, Adderall, methylphenidate, Ritalin, Concerta, modafinil, dextroamphetamine

What happens if I miss a dose?

Take the medicine as soon as you can, but only if you plan to be awake for at least 9 hours. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What to avoid

Avoid taking this medicine within 9 hours of when you plan to go to bed, or you may have trouble sleeping.

What other drugs will affect solriamfetol?

Other drugs may interact with solriamfetol, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

Use solriamfetol with caution with drugs that increase blood pressure and/or heart rate and dopaminergic drugs: 

Ingredients 

Sunosi Active Ingredient: solriamfetol 

Sunosi Inactive Ingredients: hydroxypropyl cellulose and magnesium stearate. In addition, the film coating contains: iron oxide yellow, polyethylene glycol, polyvinyl alcohol, titanium dioxide, and talc. 

Storage

• Store at room temperature between 68°F to 77°F (20°C to 25°C).
• Store tablets in a safe place, like a locked cabinet. 
• Keep the medication in a place where others cannot get to it. Selling or giving away this medicine is against the law.
• Keep track of your medicine. You should be aware if anyone is using it improperly or without a prescription.
• Dispose of remaining, unused, or expired tablets by a medication take-back program at authorized collection sites such as retail pharmacies, hospital or clinic pharmacies, and law enforcement locations. If no take-back program or authorized collector is available, mix tablets with an undesirable, nontoxic substance such as dirt, cat litter, or used coffee grounds to make it less appealing to children and pets. Place the mixture in a container such as a sealed plastic bag and throw away tablets in the household trash. 
• Keep solriamfetol and all medicines out of the reach of children. 
• Store at room temperature away from moisture and heat. Keep track of your medicine. You should be aware if anyone is using it improperly or without a prescription.

Company

Sunosi brand of solriamfetol is Distributed by: Axsome Therapeutics, Inc. New York, NY 10007.

Frequently asked questions

• Is Sunosi (solriamfetol) a controlled substance?

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer