QUVIVIQ™ mechanism of action
QUVIVIQ™ reduces overactive wake signalling1,5,6
QUVIVIQ™ reduces overactive wake-signalling by blocking orexin, allowing restorative sleep to occur without altering the proportion of sleep stages.1-7
QUVIVIQ™ mechanism of action
Dual orexin receptor antagonists (DORAs) block the action of orexins:1,5,8
- preventing orexin stimulation of the ascending reticular activating system (ARAS)
- without widespread inhibition of neuronal pathways associated with gamma-aminobutyric acid (GABA) modulators in the central nervous system (CNS) and without altering the proportion of sleep stages
- QUVIVIQ™ blocks the wake-promoting action of orexin A and B by targeting orexin type 1 and type 2 receptors
- subsequently, this may reduce the overactive wake‑signalling characteristic of insomnia1,5,6
Orexin is a neuropeptide that promotes wakefulness and provides a specific target for therapeutic intervention.5
QUVIVIQ™ is different from other hypnotics*
Benozodiazapines and Z-drugs
Benozodiazapines and Z-drugs are commonly prescribed insomnia treatments:2,5
- Act by targeting and inhibiting GABA-A receptors
- Cause broad inhibition of CNS activity to induce sleep
-
May cause unwelcome side effects:2
- daytime drowsiness
- motor function impairment
- falls
- memory/ cognitive impairment
- dependency
- tolerance
- abuse
QUVIVIQ™
QUVIVIQ™ is a dual orexin receptor antagonist:1,2
- Acts by targeting orexin receptors 1 and 21
- Causes targeted inhibition of orexin stimulation of the ARAS1
-
In clinical trials up to 12 months, improvements versus placebo were seen in:1,2
- all aspects of daytime functioning (including cognition)
- number of falls (ie fewer) -
In clinical trials up to 12 months versus placebo, QUVIVIQ™ did not show:1,2
- residual daytime sleepiness
- dependency/ withdrawal symptoms
- abuse
- rebound insomnia
*This is not a direct comparison.
With QUVIVIQ™ 50 mg, patients can expect an experience different from that with other hypnotics†
Works differently
- Unlike other hypnotics, QUVIVIQ™ targets and blocks the action of orexin, reducing overactive wake-signalling and enabling restorative sleep without altering the proportion of sleep stages1-7
Taken differently
- The standard dose is 50 mg every night for adults with chronic insomnia, assessed within 3 months.1†
- 25 mg is recommended for patients with moderate hepatic impairment or taking moderate CYP3A4 inhibitors1
- Maintaining good sleep habits is important with QUVIVIQ™ 50 mg12,13
Experienced differently
- No evidence of physical dependence was observed on discontinuation of QUVIVIQ™ in clinical trials with up to 12 months of continuous treatment1,2,4‡
- Night and day efficacy continuously improves versus placebo over the first 3 months of treatment and is maintained with up to 12 months of nightly use2,4
†The recommended daily dose of QUVIVIQ™ for adults is 50 mg once per night. Please refer to the QUVIVIQ™ SPC for full details.1
‡Treatment duration should be as short as possible and should be reassessed periodically.1
CYP3A4: cytochrome P450 3A4
Safety profile summary
The most frequently reported adverse reactions observed with QUVIVIQ™ treatment were headache and somnolence.1
The majority of adverse reactions were mild to moderate in intensity. No evidence of a dose-response relationship for the frequency or severity of adverse reactions was observed. The adverse reaction profile in elderly subjects was consistent with that observed in younger subjects.1
This medicine is subject to additional monitoring.
Adverse events should be reported. Reporting forms and information can be found at https://yellowcard.mhra.gov.uk/. Adverse events should also be reported to Idorsia at ds.safety.uk@idorsia.com.
This information is intended for UK healthcare professionals.
References
- QUVIVIQ™ (daridorexant) Summary of Product Characteristics
- Mignot E, Mayleben D et al. Safety and efficacy of daridorexant in patients with insomnia disorder: results from two multicentre, randomised, double-blind, placebo-controlled, phase 3 trials. Lancet Neurol 2022;21:125-139
- Robbins R, Quan S F et al. A nationally representative survey assessing restorative sleep in US adults. Front Sleep 2022;1:935228
- Kunz D, Dauvilliers Y et al. Long-term safety and tolerability of daridorexant in patients with insomnia disorder. CNS Drugs 2023;37:93-106
- Roch C, Bergamini G et al. Nonclinical pharmacology of daridorexant: a new dual orexin receptor antagonist for the treatment of insomnia. Psychopharmacology (Berl) 2021;238:2693-2708
- Di Marco T, Djonlagic I et al. Effect of daridorexant on sleep architecture in patients with chronic insomnia disorder: a pooled post hoc analysis of two randomized Phase 3 clinical studies. Sleep 2024:zsae098
- Chaput J P, Dutil C, Sampasa-Kanyinga H. Sleeping hours: what is the ideal number and how does age impact this? Nat Sci Sleep 2018;10:421-430
- Janto K, Prichard J R, Pusalavidyasagar S. An update on dual orexin receptor antagonists and their potential role in insomnia therapeutics. J Clin Sleep Med 2018;14:1399-1408
- Oh D Y, Park S M, Choi S W. Daytime neurophysiological hyperarousal in chronic insomnia: a study of qEEG. J Clin Med 2020;9:3425
- Shwartz J R, Roth T. Neurophysiology of sleep and wakefulness: basic science and clinical implications. Curr Neuropharmacol 2008;6:367‑378
- della Monica C, Dijk D J. What makes a good night’s sleep? The external and internal factors that influence a good night’s sleep. Physiol News 2018:36‑39
- Sleep Foundation. Mastering sleep hygiene: your path to quality sleep. Available at: sleepfoundation.org. Accessed July 2025
- National Institute for Health and Care Excellence (NICE). Technology appraisal guidance 922. Daridorexant for treating long-term insomnia, 18 October 2023. Available at: nice.org.uk. Accessed July 2025
© NICE 2023. Daridorexant for treating long-term insomnia. Available from www.nice.org.uk/guidance/TA922. All rights reserved. Subject to Notice of rights.
NICE guidance is prepared for the National Health Service in England. All NICE guidance is subject to regular review and may be updated or withdrawn. NICE accepts no responsibility for the use of its content in this product/ publication.
UK-DA-00917 | Last updated: July 2025
QUV-Pro.idorsia QUVIVIQ MoA_June 2025
