Quviviq Vs Belsomra (Daridorexant Vs Suvorexant)

Quviviq Vs Belsomra

This post about “Quviviq Vs Belsomra” is to compare the two hypnotic medications which have been approved by the FDA for the treatment of Insomnia.

These drugs belong to the class of medicines called “Orexin inhibitors” and are especially indicated for adults who have a poor response to other drugs like Zolpidem (Ambien) and Eszopiclone (Lunesta).

General Comparison of Quviviq Vs Belsomra:

Quviviq and Belsomra are both FDA-approved drugs for treating insomnia in adults. These drugs are used by people who have disturbed sleep such as difficulty falling asleep, maintaining a night of good sleep, and getting up frequently during the night.

Belsomra (Suvorexant) was the first FDA-approved Orexin inhibitor. Quviviq, on the other hand, is the latest FDA-approved drug among all the Orexin Inhibitors.

It is much costlier than Belsomra (Suvorexant) and even Dayvigo (Lemborexant).

Here is a table comparing the general features of Quviviq Vs Belsomra:

General Comparison



Drug NameDaridorexantSuvorexant
Dosage formOral TabletsOral Tablets
Manufacturer NameIdorsia Pharmaceuticals US Inc.Merck and Co
FDA Approval Date7th January 202213th August 2014
Price per tablet$17.6$15.17

Belsomra is a time-tested medicine but some people find Quviviq more effective than Belsomra. The monthly cost of Quviviq Vs Belsomra is $514.78 vs $455.23 respectively.

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Pharmacokinetic Differences Between Quviviq and Belsomra:

Both Quviviq (Daridorexant) and Belsomra (Suvorexant) belong to the same class of hypnotic drugs, the Orexin inhibitors. These drugs have a totally different mechanism of action compared to most sedatives and sleep medicines.

These drugs are well absorbed when taken orally, especially on an empty stomach. The maximum plasma levels of these drugs are achieved within 1 – 2 hours, however, if taken with fatty or high-caloric meals, their absorption is delayed.

Both Quviviq and Belsomra are primarily metabolized by the liver enzyme CYP3A4 and primarily excreted via feces and urine.

Quviviq has a relatively short half-life of 8 hours compared to Belsomra which may reduce the chances of next-day sedation to a great extent.

The following table summarizes the pharmacokinetics of Quviviq Vs Belsomra:




MOABlocks both OX1R and OX2R
Effect on QT IntervalNone
Peak Plasma levels after oral administration1 – 2 hours after taking it orally2 hours
Effect of foodAbsorption delayed by 1.3 hoursAbsorption is delayed by 1.5 hours
MetabolismCYP3A4 (89%)CYP3A4
ExcretionFeces 57%, Urine 28%66% feces, 33% urine
Half-life8 hours12 hours

Both drugs should not be used in combination with hypnotics, alcohol, and other medicines that are strong inhibitors or inducers of the hepatic enzymes, CYP3A4.

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Quviviq Vs Belsomra Dosing Considerations:

Like all sleep medicines, both Quviviq and Belsomra are recommended in low doses initially. The dose is then up-titrated if an inadequate response is observed.

Starting directly in higher doses may result in serious side effects such as sleep paralysis, sleepwalking, hallucinations that are described as very real, and nightmares.

Both these drugs are not intended for use in children, those with advanced liver disease, in combination with other hypnotics or alcohol, and in pregnant women.

Lastly, these medicines have the potential to be taken in doses exceeding the recommended doses, and individuals may get addicted.

The prescription should be limited to a small period of time. The smallest effective dose should be prescribed.

Dosing/ Interactions



Starting Dose25 mg10 mg
Maximum Dose50 mg20 mg
Drug InteractionsNot recommended with moderate or strong CYP3A Inhibitors or Inducers
Pregnancy Risk CategoryNot studiedNot studied
Abuse potentialYesYes
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Side effects of Quviviq Vs Belsomra:

The percentages of the common side effects of Belsomra (Suvorexant) Vs Quviviq (Daridorexant) are mentioned in the table below:

Side effects

Quviviq [Ref]

Belsomra [Ref]

Headache6 – 7%7%
Fatigue and daytime sleepiness5 – 6%7%
Dizziness2 – 3%3%
Nausea0 – 3%
Sleep paralysis0.3 – 0.5%Frequency not mentioned
Hallucinations0.6%Frequency not mentioned

In addition, diarrhea, cough, and upper respiratory tract infections were observed in 2% of the individuals taking Belsomra.

The side effects of both Quviviq and Belsomra are comparable, however, next-day sleepiness may be more prominent in patients taking Belsomra because it has a relatively longer half-life (12 hours compared to 8 hours of Quviviq)

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Which Sleep Medicine is More effective: Quviviq or Belsomra?

Both Quviviq and Belsomra are effective sleep medicines. They reduce the time between going to bed and falling asleep, increasing the total time a person is asleep, and reducing the chances the person wakes up at night while asleep.

However, Belsomra seems to maintain sleep better than Quviviq, probably because of its long half-life.

The table below compares the effect of Belsomra and Quviviq on sleep onset, sleep maintenance, and the time awake after sleep onset:

Effect on Sleep

Belsomra [Ref]


Sleep onsetReduced by 34 minutes from a baseline of 69 minutesReduced by 28 to 31 minutes from a baseline of 64 to 67 minutes
Sleep maintenanceTotal sleep time increased by 39 to 60 minutes (1.2 to 1.9 times better sleep than a placebo)2 times better sleep than placebo (Total sleep time improved by 34 to 44 minutes)
Time awake after sleep onset to wake timeReduced by 42 to 56 minutesReduced by 21 to 30 minutes

It is evident here that both Belsomra and Quviviq are effective sleep medicines. Their efficacies in inducing sleep, maintaining sleep, and reducing the frequency of waking up are comparable.

In real-life data from social media, most people who switched from Belsomra to Quiviq reported better results in terms of sleep onset, sleep maintenance, and fewer side effects. We will publish the results in the coming posts.

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In Conclusion:

Belsomra and Quviviq are effective sleep medicines working on the final pathway of brain awake signals.

Common side effects of these drugs may include headaches, somnolence, nightmares, sleep paralysis, and sleepwalking.

What do you think?

Written by Dr. Ahmed

I am Dr. Ahmed (MBBS; FCPS Medicine), an Internist and a practicing physician. I am in the medical field for over fifteen years working in one of the busiest hospitals and writing medical posts for over 5 years.

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