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Lemborexant is a medication used in the management and treatment of insomnia. It is in the dual orexin antagonist class of medications. This activity outlines the indications, actions, and contraindications for lemborexant as a valuable agent in managing insomnia. This activity will highlight the mechanism of action, adverse event profile, and other key factors such as dosing, monitoring, and drug interactions pertinent for interprofessional team members in the care of patients with insomnia and related conditions. Objectives: Summarize the management considerations for patients with insomnia. Describe the mechanism of action of lemborexant. Identify the most common adverse effects of lemborexant therapy. Review the importance of collaboration and communication amongst the interprofessional team to enhance the delivery of care for patients receiving lemborexant. Access free multiple choice questions on this topic.

Clinical evidence to support toxic doses of lemborexant in humans is scarce. In at least one clinical study, 7.5 times the recommended dose of lemborexant was given to healthy human subjects resulting in dose-dependent increases of somnolence frequency, providing little information regarding toxicity. There is no specific antidote to lemborexant overdose. In the case of a suspected overdose, the protocol of any drug overdose should be followed, with close monitoring from a medical professional.

Managing insomnia with lemborexant requires communication between interprofessional healthcare team members, including clinicians, pharmacists, nurses, and other healthcare assistants. Patients should be aware of the possible risks of using lemborexant, especially those with pre-existing conditions such as drug abuse disorder or hepatic impairment. While lemborexant appears to be a safe option for treating insomnia in adults, it is a schedule IV-controlled substance and should be treated by patients and healthcare providers as such. Additionally, further randomized controlled trials are warranted due to the novelty and apparent advantages of lemborexant compared to current treatments. Lemborexant utilizes a novel mechanism of action, potentially presenting a superior safety profile for adults receiving pharmaceutical treatment for insomnia.[7][10][2] [Level 1] Patient education and post-prescribing monitoring with lemborexant are best accomplished with an interprofessional healthcare team exercising collaborative activity and open information sharing to drive optimal patient outcomes. [Level 5]