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This safety and warning information outlines important risks and precautions associated with the use of Belsomra (suvorexant). Please read carefully and consult your healthcare provider if you have any concerns:

• Next-Day Drowsiness: Belsomra can impair focus, thinking, and reaction times, possibly extending into the next morning. Those over 65 are at increased risk of falls due to drowsiness. Avoid activities requiring alertness, such as driving or operating machinery, until the medication’s effects are known. This risk is heightened by alcohol, other sedative medications, or insufficient sleep (less than 7 hours).

• Interactions with CNS Depressants: Belsomra may cause abnormal behaviors, such as agitation or hallucinations, as it slows brain activity. It can interact with other central nervous system depressants like antihistamines, opiates, and alcohol, worsening side effects. Avoid such combinations and inform your healthcare provider and pharmacist about all medications you take. Be vigilant for unusual behavioral changes, especially if you have undiagnosed psychiatric conditions.

• Sleep-related Behaviors: There is an increased risk of performing activities while asleep, such as sleepwalking, eating, or driving. If these occur, consult your healthcare provider immediately about discontinuing Belsomra. This risk increases with the use of alcohol or other sedatives.

• Potential for Dependence: As a controlled medication, Belsomra can lead to abuse or dependence. If insomnia persists after 10 days, it may indicate an underlying mental health issue. Those with a history of substance abuse should exercise caution. Discuss non-pharmacological sleep improvement techniques with your healthcare provider.

• Depression Risks: Insomnia may signal depression, a condition Belsomra does not treat. Report sudden mood changes or lack of improvement in insomnia after 10 days to your healthcare provider. The risk increases with higher doses and a history of depression.

• Breathing Difficulties: If you have conditions like COPD or sleep apnea, consult your healthcare provider before starting Belsomra. They may require further testing or an alternative treatment.

• Sleep Paralysis and Muscle Weakness: Belsomra may cause sleep paralysis or sudden muscle weakness (cataplexy), sometimes accompanied by vivid and disturbing hallucinations. These symptoms necessitate a prompt discussion with your healthcare provider, as a medication change may be required.

There are no specific contraindications available for Belsomra. However, all potential risks should be discussed with your healthcare provider to ensure safe usage of the medication.

When taking suvorexant, some individuals may experience certain side effects. Commonly, users might feel drowsy the next day or have unusual dreams, which are generally mild but should be discussed with a healthcare provider if they persist. There are also reports of memory problems and sleep paralysis, where individuals temporarily struggle to move or speak while falling asleep or waking up. Some may experience vivid dreams or even hallucinations. In rare cases, people have engaged in activities such as sleepwalking, driving, or eating while not fully awake, which can be dangerous. It's important to inform a healthcare provider if any of these activities occur.

More serious side effects, although uncommon, include mental or mood changes like worsening depression or suicidal thoughts. An immediate medical evaluation is crucial if such symptoms arise. Additionally, a severe allergic reaction is rare but requires urgent attention if symptoms like rash, swelling, severe dizziness, or difficulty breathing appear. While most people do not experience serious side effects, monitoring for these reactions and consulting with a healthcare provider as needed can help manage them effectively.