Dr. Ahmed Quviviq Vs Dayvigo is a comparison of the two medications approved for the treatment of Insomnia. Both these drugs act very differently than conventional sleep medicines.
General Comparison of Quviviq Vs Dayvigo:
Quviviq and Dayvigo are both used to treat Insomnia in people who have difficulty falling asleep, maintaining sound sleep during the night, or frequently waking up during the night.
Both these drugs are available as oral tablets administered at least 30 minutes before going to bed.
Quviviq is the latest FDA-approved drug among all the Orexin Inhibitors and is much costlier than Dayvigo and Belsomra.
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Here is a table comparing the general features of Quviviq Vs Dayvigo:
General Comparison | Quviviq | Dayvigo |
| Drug Name | Daridorexant | Lemborexant |
| Dosage form | Oral Tablets | Oral Tablets |
| Manufacturer Name | Idorsia Pharmaceuticals US Inc. | Eisai and Imbrium Therapeutics |
| FDA Approval Date | 7th January 2022 | 23rd Dec 2019 |
| Price per tablet | $17.6 | $11.5 |
Pharmacokinetic Differences Between Quviviq and Dayvigo:
Both Quviviq and Dayvigo belong to the same class of drugs, the Orexin blockers. When taken orally, their plasma levels reach the maximum in 1 – 3 hours.
The absorption is delayed when the drug is taken with food. Both drugs are metabolized by the hepatic enzyme CYP3A4 and primarily excreted via feces and urine.
However, the main difference in the pharmacokinetics of Quviviq Vs Dayvigo is the half-life elimination. Quviviq has a shorter half-life of 8 hours compared to 19 hours for Dayvigo.
Thus, it is likely that people taking Dayvigo for insomnia are more likely to develop daytime sleepiness, fatigue, and lethargy compared to Quviviq.
Pharmacokinetics | Quviviq | Dayvigo |
| MOA | Blocks both OX1R and OX2R | |
| Effect on QT Interval | None | |
| Peak Plasma levels after oral administration | 1 – 2 hours after taking it orally | 1 – 3 hours |
| Bioavailability | 62% | 87% |
| Effect of food | Absorption delayed by 1.3 hours | Absorption is delayed by 2 hours |
| Metabolism | CYP3A4 (89%) | CYP3A4 |
| Excretion | Feces 57%, Urine 28% | 57.4% feces, 29.1% urine |
| Half-life | 8 hours | 19 hours |
Quviviq Vs Dayvigo Dosing Considerations:
Both Quviviq and Dayvigo treatment should be initiated in a low dose to avoid potential side effects, especially serious and disturbing side effects such as sleep paralysis, sleepwalking, vivid dreams, and hallucinations.
Orexin inhibitors should not be used with drugs that are either inhibitors or inducers of CYP3A4 enzymes.
Lastly, like all sleeping pills, these medicines have the potential for drug abuse. It is recommended to use the smallest dose for a minimal time. To avoid tolerance and drug abuse, a drug-free holiday may be given.
Dosing/ Interactions | Quviviq | Dayvigo |
| Starting Dose | 25 mg | 5 mg |
| Maximum Dose | 50 mg | 10 mg |
| Drug Interactions | Not recommended with moderate or strong CYP3A Inhibitors or Inducers | |
| Pregnancy Risk Category | Not studied | Not studied |
| Abuse potential | Yes | Yes |
Side effects of Quviviq Vs Dayvigo:
The percentages of the common side effects of Dayvigo Vs Quviviq are mentioned in the table below:
Side effects | Quviviq [Ref] | Dayvigo [Ref] |
| Headache | 6 – 7% | 4.5 – 5.9% |
| Fatigue and daytime sleepiness | 5 – 6% | 6.9 – 9.6% |
| Dizziness | 2 – 3% | – |
| Nausea | 0 – 3% | – |
| Sleep paralysis | 0.3 – 0.5% | 1.3 – 1.6% |
| Hallucinations | 0.6% | 0.1 – 0.7% |
| Nightmares | – | 0.9 – 2.2% |
It is obvious from the table above that Dayvigo is associated with more daytime sleepiness, fatigue, and lethargy due to its longer half-life.
Headache, dizziness, and nausea are more common with Quviviq than with Dayvigo while Sleep paralysis, Hallucinations, and nightmares are common with Dayvigo.
Which Sleep Medicine is More effective: Quviviq or Dayvigo?
Both Quviviq and Dayvigo were found effective for treating insomnia compared to placebo medicine. Both drugs effectively reduced the time to sleep after going to bed and maintained sleep for a longer time than the placebo with minimal wake time and interruptions.
However, Dayvigo seems to maintain sleep better than Quviviq, probably because of its long half-life.
The table below compares the effect of Dayvigo and Quviviq on sleep onset, sleep maintenance, and the time awake after sleep onset:
Effect on Sleep | Dayvigo | Quviviq |
| Sleep onset | Reduced by 23 to 26 minutes from a baseline of 43 to 45 minutes | Reduced by 28 to 31 minutes from a baseline of 64 to 67 minutes |
| Sleep maintenance | 4.5 to 4.7 times better sleep | 2 times better sleep than placebo (Total sleep time improved by 34 to 44 minutes) |
| Time awake after sleep onset to wake time | Reduced by 45 minutes | Reduced by 21 to 30 minutes |
It is evident here that both Dayvigo and Quviviq reduced the time to fall asleep by about 25 to 30 minutes.
Sleep was maintained for a longer time with these medications, and the time awake after sleep onset was reduced up to 45 minutes with Dayvigo Vs 30 minutes with Quviviq.
In Conclusion:
Dayvigo and Quviviq are both potent sleep medicines that reduce the time to sleep onset, the time awake after asleep to wake time, and increase sleep maintenance time.
Some of the side effects of these drugs may include headaches, daytime sleepiness, hallucinations, sleep paralysis, and sleepwalking.
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