Belsomra for Insomnia: Dosage and Side Effects

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The medications listed on this website are provided for informational purposes only. Their inclusion does not guarantee that they will be prescribed to any individual, as treatment decisions are ultimately at the discretion of healthcare providers. This list is not exhaustive, and healthcare providers may prescribe other medications, including non-stimulant options, based on the patient's unique health circumstances and needs.

Insomnia (trouble falling or staying asleep) is a widespread problem. Fortunately, there are many approaches used for its treatment. And while psychotherapy is the first-line help, in some cases, sleep medicine is required too.

One commonly prescribed medication for insomnia is Belsomra (Suvorexant). Assisting in sleep regulation, it contributes to improving the quality of life. However, this drug should be taken according to instructions, and the occurrence of side effects has to be monitored, so let’s learn more about these and other aspects of this medication.

Only a licensed doctor can choose and prescribe a suitable medication for insomnia.

Basic Instructions on Taking Belsomra

The Belsomra dosage for insomnia should be precise as set by a prescriber.

  • The standard adult dosage is 10 mg orally daily. The patient should take medicine 30 minutes before bed and reserve seven hours of sleep before becoming active again.
  • Where 10 mg is ineffective and well-tolerated, the patient can ask a doctor about increasing the dosage. The maximum daily dosage of Belsomra is 20 mg.

Patients should not take more Belsomra for insomnia than stated in the doctor’s recommendation. In addition, individuals should give special attention to the prescription label and other Belsomra guides.

It is also discouraged to take this drug beyond the recommended period, and when the urge to take more Belsomra grows, one must inform the doctor. This is because addiction, misuse [5*] , and overdose can lead to serious consequences, including death in severe cases.

You can take Belsomra with or without food. However, the person should avoid taking medicine shortly after a meal, or it will take longer to act. And since the medicine will cause sleep, make sure there are at least seven hours of sleep before becoming active again.

There have been cases of people taking Belsomra and engaging in activities they have no awareness or memory of later. If this happens, the individual should inform the doctor. Also, speak to a prescriber if the symptoms don’t improve.

Belsomra’s Mechanism of Action

Explanation of Belsomra’s mechanism of action perfectly answers the question ‘what is Belsomra.’ Typically, the brain contains orexin — a chemical that regulates the sleep and wake cycle. Belsomra blocks the orexin receptors in the brain, decreasing the rapid firing of neurons and leading to peaceful sleep.

Is Belsomra Effective as a Sleeping Pill?

Belsomra was the first approved newer class of drugs for treating insomnia. Studies show that Belsomra is more effective [6*]  than inactive tablets for decreasing the time it takes to fall asleep and the length of sleep. Participants fell asleep ten minutes faster, and the Belsomra sleep length was 30 minutes better than the placebo tablet and was, therefore, suitable for insomnia.

However, drowsiness the following day is more likely for people taking Belsomra. Because of the probability of side effects, Belsomra is a controlled substance included in schedule 4 drugs, and its use should be guided and monitored by a professional.

Belsomra and Anxiety

Belsomra is only FDA-approved for insomnia, not anxiety. A study [7*]  in Japan involving 40 psychiatric patients concluded that Belsomra only improved sleep quality and had no effect on anxiety, but more studies are necessary. Moreover, this medication can cause anxiety symptoms in some patients or worsen them.

Before Taking Belsomra for Insomnia

Anyone with narcolepsy [8*]  or allergic to suvorexant should not take Belsomra. Also, for safety, the individual should inform the doctor if they have:

  • Muscle weakness that appears suddenly
  • Mental illness, depression, or thoughts about suicide
  • Cases of falling asleep at unexpected time
  • Drug addiction or alcohol abuse
  • Excessive sleepiness
  • Liver disease
  • Pregnant or breastfeeding

Avoid anything that requires alertness, such as operating machinery and driving, 8 hours after taking Belsomra. People who took alcohol a few hours before bed should avoid Belsomra for the day.

Experiencing any side effects is a reason to ask your prescriber for help and get your treatment plan adjusted.

Belsomra Side Effects

Even though Belsomra is good for insomnia, it has several side effects. A patient should seek immediate medical help in case of allergic reaction to Belsomra, which may result in difficulty breathing, hives, and throat, tongue, face, or lips swelling.

Common Belsomra side effects may include drowsiness during the day, strange dreams, and the following:

  • Leg weakness
  • Suicide thoughts
  • Depression, agitation, or anxiety
  • Hallucinations or confusions
  • Memory problems

Also, those taking Belsomra for insomnia may experience various difficulties such as:

  • Moving or speaking when in the process of falling asleep.
  • It may take longer to speak or move around after waking up.

Will It Cause Weight Loss?

Weight loss or weight gain is not on the list of side effects of Belsomra, and anyone taking the medication should not expect a change.

While clinical studies (Diabetes Research and Clinical Practice, Volume 169, November 2020) did not report any weight changes, people with type 2 diabetes reported experiencing Belsomra weight loss. They had a slight reduction in waist size.

Any cases of weight loss may be due to better sleep cycles that reduce the time the individuals have to take calories. They are not waking up at night to take snacks.

Drugs with Possible Interactions with Belsomra

Some drugs that typically cause drowsiness will worsen it after taking Belsomra. These medications may include:

  • Anxiety meds
  • Muscle relaxers
  • Sleeping pills
  • Opioid medications

The dosage of Belsomra may be reduced for those taking moderate CYP3A inhibitors such as fosamprenavir, diltiazem, verapamil, miconazole, erythromycin, fluconazole. However, people taking strong CYP3A inhibitors are recommended to avoid Belsomra entirely. These drugs include ketoconazole, clarithromycin, darunavir, nefazodone, itraconazole, and saquinavir.

Tell the prescriber if you take, have stopped, or are starting to take any of the above drugs, herbal products, vitamins, and over-the-counter medicine since they may interact with Belsomra too.


Belsomra may be an effective medication for people that have trouble falling and staying asleep. Studies show that it’s more effective than the placebo in inducing sleep and prolonging its length. However, individuals must inform their doctor of other drugs to avoid interactions that increase or reduce Belsomra’s effectiveness.


+8 sources
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  2. Suvorexant: a promising, novel treatment for insomnia. (2016)
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  3. Neuroendocrine, Autonomic, and Metabolic Responses to an Orexin Antagonist, Suvorexant, in Psychiatric Patients with Insomnia. (2017)
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  4. An Update on Dual Orexin Receptor Antagonists and Their Potential Role in Insomnia Therapeutics. (2018)
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  5. Mental Health By the Numbers
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  6. Suvorexant: a promising, novel treatment for insomnia. (2016)
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  7. Neuroendocrine, Autonomic, and Metabolic Responses to an Orexin Antagonist, Suvorexant, in Psychiatric Patients with Insomnia. (2017)
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  8. An Update on Dual Orexin Receptor Antagonists and Their Potential Role in Insomnia Therapeutics. (2018)
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