Products
Solriamfetol was approved in the United States in tablet form in 2019 (Sunosi).
Structure and properties
Solriamfetol (C10H14N2O2, Mr = 194.2 g/mol) is present in the drug as -solriamfetol hydrochloride, a white substance that is highly soluble in water. Solriamfetol is a carbamate and structurally related to amphetamines but pharmacologically distinct from them.
Effects
Solriamfetol promotes alertness. The effects are due to inhibition of norepinephrine and dopamine transporters in the central nervous system. This reduces reuptake into the presynaptic neuron and increases the concentration in the synaptic cleft. The half-life is in the range of 7.1 hours.
Indications
For improving wakefulness in adults with excessive sleepiness during the day, which is related to narcolepsy or obstructive sleep apnea.
Dosage
According to the SmPC. Tablets are taken once daily in the morning, independent of meals.
Abuse
Solriamfetol may be abused as a smart drug and stimulant. Appropriate precautions must be considered.
Contraindications
- Hypersensitivity
- Treatment with an MAO inhibitor (until 14 days after discontinuation).
For complete precautions, see the drug label.
Interactions
Drug-drug interactions have been described with MAO inhibitors (contraindicated), agents that increase blood pressure or heart rate, and dopaminergic drugs. Solriamfetol is poorly metabolized and excreted predominantly unchanged.
Adverse effects
The most common potential adverse effects include headache, nausea, poor appetite, insomnia, and anxiety. Solriamfetol increases blood pressure and heart rate in a dose-dependent manner.