Solriamfetol (Sunosi) for the treatment of narcolepsy

Introduction

Solriamfetol (trade name: Sunosi) has been approved in Germany since January 2020 for the treatment of narcolepsy in adults. It is supposed to improve alertness and reduce excessive sleepiness during the day.

Narcolepsy is a disorder that affects the sleep-wake cycle controlled by the brain. People who have narcolepsy are typically very tired during the day and have a strong urge to sleep. Sleeping “attacks” are also possible: These are sudden episodes of sleep that may even occur while the person is eating or speaking.

People with narcolepsy also commonly experience short episodes of muscle weakness (failure) during the day. This can result in falls. Doctors call this “cataplexy.” It most often occurs in emotional situations, such as when someone is scared, surprised or laughing.

Solriamfetol influences the metabolism of the chemical messengers dopamine and noradrenaline in the brain.

Application

Solriamfetol is used in tablet form, in the doses 75 mg and 150 mg. It is taken once a day in the morning after you wake up.

The recommended dose when starting treatment is 75 mg of solriamfetol. This dose can be increased after three days if necessary. The maximum daily dose of solriamfetol is 150 mg.

Other treatments

There are various other medications for the treatment of narcolepsy. The dose of these medications is adjusted on an individual basis. The medications modafinil and pitolisant are suitable for people who do not have cataplexy. People who have cataplexy can use sodium oxybate or pitolisant.

Assessment

In 2020, the Institute for Quality and Efficiency in Health Care (IQWiG, Germany) looked into whether solriamfetol has any advantages or disadvantages compared to the standard treatments for narcolepsy.

But the manufacturer didn’t provide any suitable data with which to do the assessment.

More information

This information summarizes the main results of a review produced by the Institute for Quality and Efficiency in Health Care (IQWiG, Germany). The review was commissioned by the German Federal Joint Committee (G-BA) as part of the “early benefit assessment of medications.” On the basis of the review and the hearings received, the G-BA passed a resolution on the added benefit of solriamfetol (Sunosi).

Institute for Quality and Efficiency in Health Care (IQWiG, Germany). Solriamfetol (Narcolepsy) – Benefit assessment according to § 35a Social Code Book V. Dossier assessment, Commission A20-47. August 13, 2020. (IQWiG reports; Volume 957).

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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Created on September 10, 2020
Next planned update: 2023

Authors/Publishers:

Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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