Quviviq vs. Belsomra: Differences, similarities, and side effects

In this article:

• Quviviq vs. Belsomra: Key differences
• Quviviq vs. Belsomra: Conditions treated
• Is Belsomra better than Quviviq?
• Quviviq vs. Belsomra: Insurance coverage and cost comparison
• Quviviq vs. Belsomra side effects
• Quviviq and Belsomra drug interactions
• Quviviq and Belsomra Drug warnings
• Can you take Quviviq and Belsomra together?

In this article

• Quviviq vs. Belsomra: Key differences
• Quviviq vs. Belsomra: Conditions treated
• Is Belsomra better than Quviviq?
• Quviviq vs. Belsomra: Insurance coverage and cost comparison
• Quviviq vs. Belsomra side effects
• Quviviq and Belsomra drug interactions
• Quviviq and Belsomra Drug warnings
• Can you take Quviviq and Belsomra together?

For people who struggle with insomnia or trouble sleeping, various options are available to help promote a good night’s rest. Quviviq and Belsomra are two prescription medications that a healthcare provider may recommend. These brand-name medications belong to a class of drugs called dual orexin receptor antagonists (DORAs). They work by targeting specific receptors in the brain involved in wakefulness.

Both Quviviq and Belsomra belong to the same drug class, but they have several differences. The better option will depend on the person and what works for them. A prescribing healthcare provider can determine the most effective option based on an individual’s overall needs.

Quviviq vs. Belsomra: Key differences

The main difference between Quviviq and Belsomra is that they contain different active ingredients. Quviviq is a drug manufactured by Idorsia Pharmaceuticals that contains daridorexant. Belsomra is manufactured by Merck Sharp & Dohme and contains suvorexant.

Belsomra was the first DORA, approved by the Food and Drug Administration (FDA) in 2014. Quviviq is a newer drug, with its first approval in 2022. Quviviq comes as a 25 or 50 milligram (mg) tablet, while Belsomra is available as an oral tablet in strengths of 5 mg, 10 mg, 15 mg, and 20 mg. 

Quviviq may start working faster and has a shorter half-life than Belsomra. Quviviq has a half-life of around eight hours while Belsomra has a half-life of around 15 hours. This means that Quviviq may be cleared from the body more quickly, potentially reducing the risk of next-day drowsiness.

Compare Quviviq vs. Belsomra: Key differences
	Quviviq	Belsomra
Drug class	Orexin receptor antagonist	Orexin receptor antagonist
Brand/generic status	Brand	Brand
What is the generic name?	Daridorexant	Suvorexant
What form(s) does the drug come in?	Oral tablet	Oral tablet
What is the standard dosage?	25 to 50 mg once at night, taken 30 minutes before bedtime, with at least 7 hours allotted for sleep	10 to 20 mg once at night, taken 30 minutes before bedtime, with at least 7 hours allotted for sleep
How long is the typical treatment?	Short- or long-term	Short- or long-term
Who typically uses the medication?	Adults	Adults

Quviviq vs. Belsomra: Conditions treated

Quviviq and Belsomra are medications mainly prescribed for insomnia treatment. These drugs help individuals who have trouble falling asleep (sleep onset), staying asleep (sleep maintenance), or both. Both medications may be used for treating chronic insomnia. 

These drugs do not treat narcolepsy or other sleep disorders. Instead, they help manage symptoms of insomnia and improve sleep quality.

Compare Quviviq vs. Belsomra conditions treated
Condition	Quviviq	Belsomra
Insomnia	Yes	Yes

Is Belsomra better than Quviviq?

Belsomra and Quviviq have been shown to be more effective than placebo or using nothing at all. One study compared daridorexant and suvorexant and concluded that daridorexant has fewer side effects than suvorexant and can improve daytime function. However, the better medication will depend on an individual’s response to either drug regarding effectiveness and side effects. 

A network analysis compared the effectiveness of different doses of FDA-approved sleep medications, including suvorexant and daridorexant, by analyzing data from nine clinical trials with 7,257 total participants. Suvorexant at 20 mg and 40 mg and daridorexant at 10 mg and 50 mg were found to be the best at helping people fall asleep faster and stay asleep longer. Other drugs like lemborexant were also effective, especially at 5 mg and 10 mg doses, in reducing the time it takes to fall asleep and increasing total sleep time.

Consult a healthcare provider for the most appropriate insomnia drug. They can evaluate a person’s medical history, sleep problems, and current medications. Both drugs have shown efficacy in improving sleep quality and duration but may work differently for each individual.

RELATED: Quviviq vs. Ambien

Quviviq vs. Belsomra: Insurance coverage and cost comparison

Belsomra may have wider acceptance among insurance plans than Quviviq, as it’s an older, more established drug. Medicare plans rarely cover Quviviq, though specific coverage may vary. Individuals should check their plans to see if prior authorization is required.

RELATED: Is Quviviq covered by Medicare?

Without insurance, the retail costs of Quviviq and Belsomra can vary. A 30-day supply may be slightly higher for Quviviq than Belsomra, although both medications can run over $600 as brand-name medications. There are currently no generic versions available for Quviviq or Belsomra.

A SingleCare coupon may be able to help reduce the retail cost of Quviviq and Belsomra. Always compare prices to find the most cost-effective option. 

Compare Quviviq vs. Belsomra: Cost & coverage
	Quviviq	Belsomra
Typically covered by insurance?	Varies	Varies
Typically covered by Medicare Part D?	Varies	Varies
Quantity	30 tablets	30 tablets
SingleCare cost	$488	$389

RELATED: How to save on Quviviq

Quviviq vs. Belsomra side effects

Quviviq and Belsomra share similar side effects. Both drugs can cause daytime sleepiness and drowsiness due to their action on the brain to help with sleep. Both medications may also cause headaches, dizziness, and abnormal dreams.

However, Belsomra may cause more side effects in general than Quviviq. Unlike Quviviq, Belsomra can cause diarrhea, dry mouth, and cough. 

Serious side effects are possible with both drugs, such as worsened depression, complex sleep behaviors, and respiratory depression. Seek medical attention if serious side effects develop, persist, or worsen. 

Compare Quviviq vs. Belsomra: Side effects
	Quviviq		Belsomra
Side effect	Applicable?	Frequency	Applicable?	Frequency
Sleepiness	Yes	6%	Yes	7%
Headache	Yes	6%	Yes	7%
Diarrhea	No	–	Yes	2%
Dry mouth	No	–	Yes	2%
Dizziness	Yes	2%	Yes	3%
Abnormal dreams	Yes	N/A	Yes	2%
Cough	No	–	Yes	2%

Frequency is not based on data from a head-to-head trial. This may not be a complete list of adverse effects that can occur. Please refer to your doctor or healthcare provider to learn more.

Source: DailyMed (Quviviq), DailyMed (Belsomra)

Quviviq and Belsomra drug interactions

Quviviq and Belsomra are medications that can interact with other drugs that slow down the central nervous system (CNS), like benzodiazepines (used for anxiety), opioids (painkillers), and tricyclic antidepressants. Taking these medications together can increase the risk of feeling severe sleepiness or drowsiness during the day. Therefore, the doses of Quviviq, Belsomra, and other CNS depressants may need to be adjusted if used together.

Both Quviviq and Belsomra are processed by the liver using a specific pathway involving an enzyme. This means they can interact with other drugs that affect how this liver pathway works. For example:

• Some medications can block this liver enzyme pathway, leading to higher levels of Quviviq or Belsomra in the body and increasing the risk of side effects. Examples include certain antifungal medications like ketoconazole and antibiotics like clarithromycin. If these drugs are taken with Quviviq or Belsomra, a healthcare provider might need to lower the dose of Quviviq or Belsomra to avoid increased side effects.
• Other medications can make this liver pathway work faster, lowering the levels of Quviviq or Belsomra in the body and making them less effective. Examples include certain seizure medications like carbamazepine and the herbal supplement St. John’s wort. If these drugs are taken with Quviviq or Belsomra, a healthcare provider might need to increase the dose of Quviviq or Belsomra to ensure they work properly.

Always tell a healthcare provider about all the medications, including prescription drugs, over-the-counter medications, and herbal supplements. That way, doses can be adjusted and side effects can be monitored.

Compare Quviviq vs. Belsomra: Drug interactions
Drug	Drug class	Quviviq	Belsomra
Xanax (alprazolam)  Valium (diazepam)  Ativan (lorazepam)  Klonopin (clonazepam)	Benzodiazepine	Yes	Yes
OxyContin (oxycodone)  Vicodin (hydrocodone/acetaminophen)  Percocet (oxycodone/acetaminophen)  Dilaudid (hydromorphone)	Opioid	Yes	Yes
Elavil (amitriptyline)  Tofranil (imipramine)  Pamelor (nortriptyline)  Anafranil (clomipramine)	Tricyclic antidepressant	Yes	Yes
Biaxin (clarithromycin)  Ery-Tab (erythromycin)  Zithromax (azithromycin) Rifadin (rifampin)	Antibiotic	Yes	Yes
Sporanox (itraconazole)  Diflucan (fluconazole)  Nizoral (ketoconazole)	Antifungal	Yes	Yes
Norvir (ritonavir)  Reyataz (atazanavir)  Kaletra (lopinavir/ritonavir)	Antiviral	Yes	Yes
Tegretol (carbamazepine)  Dilantin (phenytoin)  Luminal (phenobarbital)	Antiepileptic	Yes	Yes
St. John’s wort	Herbal	Yes	Yes

Consult a healthcare professional for other possible drug interactions.

Quviviq and Belsomra Drug warnings

Quviviq and Belsomra both have important warnings to consider. Both Quviviq and Belsomra are CNS depressants that can affect daytime wakefulness even when used as prescribed. The effects may persist for several days after discontinuing either drug. 

Both medications can impair driving skills and increase the risk of falls, particularly in older adults. Avoid consuming alcohol while taking these medications, as alcohol can increase the risk of daytime impairment. 

Both drugs also share a risk of complex sleep behaviors, such as sleepwalking, sleep-driving, and other activities while not fully awake. These events can occur with or without alcohol and other CNS depressants, and patients usually do not remember them. 

Quviviq and Belsomra have additional warnings related to worsening depression and suicidal ideation. In patients with psychiatric disorders, including insomnia, there is an increased risk of suicide. Worsening of depression and suicidal thoughts and actions have been reported, requiring close monitoring and protective measures. 

Both drugs can also cause sleep paralysis, hypnagogic/hypnopompic hallucinations, and symptoms similar to mild cataplexy. These can include vivid and disturbing perceptions and periods of leg weakness, which may occur during sleep-wake transitions. 

Quviviq and Belsomra should be used with caution in patients with compromised respiratory function, as its effects on respiratory function have not been fully studied in patients with conditions like severe obstructive sleep apnea (OSA) or chronic obstructive pulmonary disease (COPD).

Quviviq and Belsomra are Schedule IV controlled substances. They carry a risk of abuse and dependence. However, neither drug has been shown to cause withdrawal symptoms when discontinuing them. 

It’s important to consult a healthcare provider to manage and reduce potential side effects. Tell a healthcare provider if any adverse effects occur while taking these medications.

Can you take Quviviq and Belsomra together?

Taking Quviviq and Belsomra together is not recommended. Both medications are part of the same drug class and work in the same way. Using them together can increase the risk of side effects such as excessive drowsiness, dizziness, and impaired coordination.