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solriamfetol

Adjunctive therapy

Brand: Sunosi

Published 2026-02-05 · Last reviewed 2026-02-12 · 5 references

Content sourced from FDA labeling (DailyMed) and peer-reviewed literature.

Print sheet Review evidence

At a glance

Class: Adjunctive therapy·Typical dose: Administer once daily upon awakening; avoid dosing within 9 hours of planned bedtime (label).·Half-life: Single-dose mean 7.1 h·LAI available: No

Class: Adjunctive therapy
Typical dose: Administer once daily upon awakening; avoid dosing within 9 hours of planned bedtime (label).
Half-life: Single-dose mean 7.1 h
LAI available: No

Quick answers

What is solriamfetol?: Solriamfetol (brand Sunosi) is a wakefulness-promoting medication indicated to improve wakefulness in adults with excessive sleepiness associated with narcolepsy or obstructive sleep apnea (OSA) (label).
What is Sunosi?: Sunosi is a brand name for solriamfetol.
What is Sunosi (solriamfetol) used for?: Label indications include: Improve wakefulness in adults with excessive sleepiness associated with narcolepsy or obstructive sleep apnea (label).
What drug class is Sunosi (solriamfetol)?: Wakefulness Agent.
What is the mechanism of action of Sunosi (solriamfetol)?: Wakefulness-promoting dopamine and norepinephrine reuptake inhibitor (solriamfetol) indicated to improve wakefulness in adults with excessive sleepiness associated with narcolepsy or obstructive sleep apnea; Schedule IV with dose-dependent blood pressure/heart rate effects and MAOI contraindication.
What strengths does Sunosi (solriamfetol) come in?: Tablets: 75 mg (functionally scored) and 150 mg (label).

General information

Solriamfetol (Sunosi) is a wakefulness-promoting medication indicated to improve wakefulness in adults with excessive sleepiness associated with narcolepsy or obstructive sleep apnea (OSA) (label).

It is a dopamine and norepinephrine reuptake inhibitor and is a Schedule IV controlled substance. Practical monitoring focuses on blood pressure/heart rate effects, anxiety/insomnia, and misuse risk in vulnerable populations (label/clinical).

Solriamfetol is not a substitute for primary OSA therapy; evaluation of PAP adherence, sleep restriction, sedating medications, and circadian factors remains clinically central when sleepiness persists (label/clinical).

Patients with moderate or severe renal impairment may be at higher risk for cardiovascular and psychiatric adverse reactions due to prolonged half-life; renal dosing is a routine prescribing checkpoint (label).

The solriamfetol compare view, evidence feed, and print page support review of activation and monitoring considerations.

U.S. approvals

Excessive sleepiness associated with narcolepsy (adults) (2019)
Excessive sleepiness associated with obstructive sleep apnea (adults) (2019)

Formulations & strengths

Tablets: 75 mg (functionally scored) and 150 mg (label).

Generic availability

Not available generically (brand-only).

Solriamfetol is a once-daily wake-promoting option with relatively low CYP-mediated interaction burden, but careful selection is important due to dose-dependent blood pressure/heart rate effects, insomnia/anxiety risk, and strict renal dose adjustments (label/clinical).

View labelExact

Mechanism of action

Refer to the Glossary entry on Neurotransmitters for background on receptor systems involved in serious mental illness.

Dopamine and norepinephrine reuptake inhibition is considered central to wake-promoting effects; the clinical phenotype often resembles other activating agents, with attention to insomnia and anxiety as practical tolerability constraints (label/clinical).

Because of noradrenergic effects, cardiovascular monitoring is emphasized, particularly in patients with uncontrolled hypertension or when combined with other pressor agents (label/clinical).

Dopamine and norepinephrine reuptake inhibition (wake-promoting mechanism).

Metabolism & pharmacokinetics

Oral bioavailability is ~95% and peak plasma concentration occurs at a median T_max of ~2 hours under fasted conditions; food has minimal effect on exposure but can delay T_max (label).
Solriamfetol is largely excreted unchanged in urine (~95% recovered as unchanged drug) with minimal metabolism; apparent mean elimination half-life is ~7.1 hours (label).
Renal impairment increases half-life and exposure in a graded manner; dose adjustments and avoidance in ESRD are safety-critical (label).

Dosing & administration

Administer once daily upon awakening; avoid dosing within 9 hours of planned bedtime (label).
Narcolepsy: initiate 75 mg once daily; may increase to 150 mg once daily based on efficacy/tolerability (label).
OSA: initiate 37.5 mg once daily; may titrate in stepwise fashion up to 150 mg once daily based on efficacy/tolerability (label).
Dose adjustments are required for renal impairment; clinicians often document renal function at initiation and reassess with clinical changes or when labs update (label/clinical).

Monitoring & labs

Blood pressure and heart rate monitoring at baseline and periodically (label/clinical).
Sleep disruption monitoring (insomnia, timing effects) (label/clinical).
Mood and psychiatric symptom monitoring (anxiety, irritability, mania/psychosis) (label/clinical).
Renal function review for dosing decisions and ongoing safety (label).
Misuse/diversion risk monitoring consistent with Schedule IV status (clinical).

Adverse effects

FDA boxed warnings

Common side effects (≥10%)

Headache: Common and often dose-related (label/clinical).
Nausea: Often improves over time; assess hydration and food intake (clinical).
Decreased appetite: Can occur; monitor weight in vulnerable patients (label/clinical).
Anxiety / irritability: Activating effects can worsen anxiety; monitor in anxiety and bipolar-spectrum illness (label/clinical).
Insomnia: Avoid late-day dosing; morning dosing is emphasized (label/clinical).

Other notable effects

Blood pressure and heart rate increases are dose-related; patients with cardiovascular disease or uncontrolled hypertension require careful selection and monitoring (label/clinical).
Psychiatric symptoms have been reported; renal impairment can increase exposure and risk, so dose adjustments and monitoring are central (label/clinical).
As a Schedule IV medication, misuse/diversion risk is addressed via clinical history, refill monitoring, and clear treatment goals (clinical).

Interactions

Monoamine oxidase inhibitors (MAOIs) are contraindicated and require a washout period due to risk of hypertensive reactions (label).
Concomitant use with other agents that raise blood pressure/heart rate may amplify cardiovascular effects; monitoring is common in combination regimens (label/clinical).
Because solriamfetol is largely excreted unchanged, CYP-based interaction burden is relatively low, but renal dosing and adherence to contraindications remain central safety steps (label/clinical).

Other useful information

Evidence syntheses and guidelines support wake-promoting agents for excessive daytime sleepiness in central hypersomnolence disorders, but medication choice is individualized based on comorbidities, adverse-effect profiles, and implementation constraints (AASM/clinical).
In serious mental illness, clinicians often monitor for activation, anxiety, and sleep disruption when adding wake-promoting agents, and may prioritize nonpharmacologic contributors to sleepiness first (clinical).

References

Related hubs:SMI toolkit·Support resources