solriamfetol

Adjunctive therapy

Brands: Sunosi

Last reviewed 2026-02-12

Reviewed by PsychMed Editorial Team.

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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-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).

Snapshot

Class: Adjunctive therapy
Common US brands: Sunosi
Therapeutic drug monitoring not routinely recommended.
Last reviewed: 2026-02-12

Label indications

Improve wakefulness in adults with excessive sleepiness associated with narcolepsy or obstructive sleep apnea (label).

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Clinical Highlights

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). It is a dopamine and norepinephrine reuptake inhibitor and is a Schedule IV controlled substance; practical monitoring often 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; persistent sleepiness should also prompt reassessment for PAP adherence, sleep restriction, sedating medications, and circadian misalignment (label/clinical).
Psychiatric symptoms (anxiety, irritability, insomnia) can occur and may be more likely with higher exposure (e.g., renal impairment); careful monitoring is important in bipolar-spectrum illness, psychosis, or baseline anxiety (label/clinical).
The compare view, solriamfetol evidence feed, and solriamfetol print page help contextualize activation and cardiovascular monitoring topics across wake-promoting options.

Dosing & Formulations

Tablets: 75 mg (functionally scored) and 150 mg (label). Administer once daily upon awakening; avoid dosing within 9 hours of planned bedtime because of potential sleep interference (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).
Renal impairment requires dose adjustment, and severe renal impairment or ESRD markedly increases exposure; renal status is a routine prescribing checkpoint (label).

Monitoring & Risks

Blood pressure and heart rate increases are dose-related; baseline and periodic monitoring is emphasized, especially in patients with cardiovascular disease or poorly controlled hypertension (label/clinical). Sleep disruption can occur; morning dosing and avoiding late-day dosing are core tolerability strategies (label/clinical).

Psychiatric monitoring (anxiety, irritability, mania/psychosis) is important in serious mental illness, particularly with polypharmacy or renal impairment (label/clinical).
Schedule IV status and stimulant-like effects warrant attention to misuse/diversion risk; documentation of goals and reassessment is a common practice pattern (clinical).

Drug Interactions

Monoamine oxidase inhibitors (MAOIs) are contraindicated and require a washout period due to risk of hypertensive reactions (label). Other agents that increase blood pressure/heart rate (stimulants, some SNRIs, decongestants) may amplify cardiovascular effects; careful monitoring is common in combination regimens (label/clinical).

Because solriamfetol is largely excreted unchanged in urine, CYP-based interaction burden is lower than with modafinil/armodafinil, but renal dosing remains central (label/clinical).

Practice Notes

In psychiatry, wake-promoting therapy discussions often distinguish excessive sleepiness from fatigue, assess sleep quantity and medications, and set a time-bounded reassessment plan (clinical). In patients with OSA, documenting ongoing PAP use and addressing sleep restriction or sedating co-medications can improve outcomes more than escalating wake-promoting dose alone (clinical).

If anxiety or insomnia worsens, dose timing, dose reduction, or switching agents is often considered rather than layering additional activating medications (clinical).

References

SUNOSI (solriamfetol) tablets prescribing information — DailyMed (2026)
Treatment of central disorders of hypersomnolence: an American Academy of Sleep Medicine clinical practice guideline — Journal of Clinical Sleep Medicine (2021)
Treatment OF Central Disorders OF Hypersomnolence: AN American Academy OF Sleep Medicine Systematic Review, Meta Analysis, AND Grade Assessment — Journal of Clinical Sleep Medicine (2021)
A randomized study of solriamfetol for excessive sleepiness in narcolepsy — Annals of Neurology (2019)
Solriamfetol for Excessive Sleepiness in Obstructive Sleep Apnea (TONES 3). A Randomized Controlled Trial — American Journal of Respiratory and Critical Care Medicine (2019)