Rozerem vs Belsomra

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Introduction

For patients struggling with insomnia or other types of sleep disorders, certain drugs that modulate the activity of specific receptors in the brain can help in promoting restful sleep and managing symptoms. Rozerem and Belsomra are two such medications that are prescribed for these conditions. These drugs influence different receptors in the brain but both have effects aimed at enhancing sleep quality. Rozerem is a melatonin receptor agonist, it works by mimicking the action of melatonin, a hormone naturally produced by your body to regulate your sleep-wake cycle. On the other hand, Belsomra acts as an orexin receptor antagonist which blocks orexin, a neurotransmitter involved in wakefulness and arousal - this results in decreased wakefulness and helps individuals fall asleep more easily.

What is Rozerem?

Ramelteon (the generic name for Rozerem) was the first drug of the melatonin receptor agonist class of sleep aids, which marked a significant development on previous classes of sleep aid drugs such as benzodiazepines. Ramelteon was first approved by the FDA in 2005. Rozerem works by mimicking the effects of melatonin, a hormone that regulates your body's internal clock and helps control your natural cycle of sleeping and waking hours. It is prescribed for insomnia characterized particularly by difficulty falling asleep.

Belsomra, with its generic name Suvorexant, belongs to a newer class known as orexin receptor antagonists approved in 2014. Belsomra acts differently compared to other hypnotics; it blocks the action of orexin, a neurotransmitter that influences wakefulness.

While both medications are designed to help you fall asleep faster, they have different mechanisms and potential side effects. Rozerem has little-to-no risk of dependence or withdrawal symptoms due to its targeted influence on melatonin receptors but might not be as effective at maintaining sleep throughout the night like Belsomra can.

What conditions is Rozerem approved to treat?

Rozerem is approved for the treatment of sleep disorders, including:

Insomnia characterized by difficulty with sleep onset
Sleep maintenance issues (in off-label use)

Belsomra, on the other hand, has been approved to treat:

Insomnia characterized by difficulties with sleep onset and/or sleep maintenance

How does Rozerem help with these illnesses?

Rozerem helps to manage insomnia by mimicking the action of melatonin, a hormone that is produced in response to darkness and plays a crucial role in regulating sleep-wake cycles. Rozerem does this by binding to melatonin receptors in the brain, thereby promoting sleep onset. Melatonin is intimately involved in maintaining our circadian rhythm – the internal biological clock that regulates various physiological processes including sleep-wake patterns.

On the other hand, Belsomra works somewhat differently: it inhibits orexin, a neurotransmitter known for promoting wakefulness. By blocking orexin's alerting signals, Belsomra allows natural sleep processes to occur more smoothly.

Both drugs are designed to help those with difficulty falling asleep or staying asleep throughout the night without causing dependency issues often associated with other types of sleeping aids.

What is Belsomra?

Belsomra is a brand name for suvorexant, which is an orexin receptor antagonist. This means it works by blocking the action of a neurotransmitter called orexin in the brain that regulates wakefulness. By inhibiting these receptors, Belsomra can help promote sleepiness and maintain sleep throughout the night.

Suvorexant was first approved by the FDA in 2014 as a new class of drug to treat insomnia. Unlike other common sleeping aids, it does not work on GABA receptors in the brain, which are targeted by benzodiazepines and non-benzodiazepines alike. As such, its side-effect profile differs from those drugs; namely it doesn't induce muscle relaxation or cause withdrawal symptoms upon discontinuation.

The unique mode-of-action makes Belsomra particularly useful for patients who have not responded well to traditional hypnotic medications or experienced unpleasant side effects from them.

What conditions is Belsomra approved to treat?

Belsomra, also known as suvorexant, is an FDA-approved medication for the treatment of:

Insomnia characterized by difficulties with sleep onset and/or sleep maintenance It's a unique class of drug called orexin receptor antagonist which works differently than other insomnia medications by targeting the brain's wakefulness promoting actions. This makes it especially helpful for those who have trouble falling asleep or staying asleep throughout the night.

How does Belsomra help with these illnesses?

Orexin is a neurotransmitter that plays significant roles in wakefulness and staying alert. Low levels of orexin can cause narcolepsy, which leads to excessive daytime sleepiness and sudden bouts of sleep. Belsomra works by inhibiting the action of orexin in the brain, thereby helping patients fall asleep more quickly and stay asleep longer. Its unique mechanism among other insomnia medications has made it a preferred treatment for some people with chronic insomnia issues. Unlike Rozerem, which acts on melatonin receptors to promote sleep, Belsomra directly targets the wake-promoting effects of orexin for a different approach to treating insomnia symptoms. It may be prescribed when patients do not respond well to other types of sleep aids or if they experience unwanted side effects.

How effective are both Rozerem and Belsomra?

Both ramelteon (Rozerem) and suvorexant (Belsomra) are approved by the FDA for treating insomnia, with Rozerem gaining approval in 2005 and Belsomra following nearly a decade later in 2014. Both medications act on different receptors associated with sleep; Rozerem targets melatonin receptors, while Belsomra inhibits orexin neurotransmitters. The effectiveness of each was verified through separate trials: one published study from 2007 compared ramelteon to placebo in patients with chronic insomnia, demonstrating its efficacy in decreasing sleep latency; similarly, a 2014 trial found that suvorexant significantly improved both sleep onset and maintenance.

A review of studies evaluating ramelteon's effects showed it can help individuals fall asleep faster, particularly those experiencing difficulty due to delayed sleep phase syndrome or jet lag-related issues. Its side effect profile is considered tolerable for most adults including elderly populations.

On the other hand, suvorexant gained attention as the first drug developed to antagonize orexin neurons — key regulators of wakefulness — making it effective against insomnia where excessive wakefulness is an issue. Though effective at doses starting from 10 mg/day upwards, it comes with potential safety concerns such as next-day drowsiness which led the FDA recommending lower initial doses than originally proposed by its manufacturer.

Overall comparison suggests both drugs provide benefits in managing sleeping difficulties but they're typically not first-line treatment options due to their unique mechanisms requiring consideration of specific patient factors like underlying causes of insomnia or concurrent medications affecting CNS depression.

abstract image of a researcher studying a bottle of drug.

At what dose is Rozerem typically prescribed?

Oral dosages of Rozerem range from 4-8 mg/day, typically taken around bedtime to aid sleep. However, for most people, a dosage of 8 mg/day is sufficient for treating insomnia. It's not recommended for use in children and adolescents under the age of 18 years old due to lack of safety studies in this population. On the other hand, Belsomra has a varying daily dose ranging from 5–20 mg/day depending on individual tolerance and effectivity. In either case, it should be noted that these medications are meant to be short-term solutions for sleep disorders and their usage should not extend over long periods without doctor supervision.

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At what dose is Belsomra typically prescribed?

Belsomra therapy typically begins at a dosage of 10 mg/day, taken orally immediately before bedtime or after the individual has attempted but failed to fall asleep. To ensure that you have adequate time for sleep, Belsomra should not be administered unless you can dedicate at least 7 hours to sleeping. The dose may then be increased by your doctor up to a maximum of 20 mg/day if necessary and as tolerated by the patient, depending on effectiveness and tolerance. Always consult with your healthcare provider about any changes in dosages or treatment plans.

What are the most common side effects for Rozerem?

Common side effects when using Rozerem can include:

Dizziness
Somnolence (sleepiness/drowsiness)
Fatigue, lethargy, and reduced alertness
Unusual or abnormal thoughts
Changes in mood or behavior
Hallucinations
Memory loss or forgetfulness

On the other hand, Belsomra may cause:

Sleepiness during the day
Difficulty with attention, memory and driving skills after waking up
Abnormal dreams
Headache
Dizziness
Diarrhea
Dry mouth
Cough

It's important to note that these are only potential side effects. Not everyone experiences them and they typically subside as your body adjusts to medication. Always consult with a healthcare provider for personalized advice.

abstract image of a patient experiencing side effect

Are there any potential serious side effects for Rozerem?

Serious side effects of Rozerem are rare, but can include:

Unusual thoughts or behavior
Worsening insomnia symptoms
Signs of an allergic reaction: hives; difficulty breathing; swelling in your face, lips, tongue, or throat
Abnormal thinking and behavioral changes such as aggression, agitation or hallucinations.

On the other hand, Belsomra may cause:

Complex sleep behaviors like sleep-walking that could lead to self-injury
Unexpected reactions such as aggressive behavior and confusion upon waking up
Temporary leg weakness (cataplexy)
Shortness of breath with slow heart rate

In some cases both medications might cause temporary memory loss. If you experience any of these side effects while taking either medication, consult a healthcare professional immediately.

What are the most common side effects for Belsomra?

Belsomra, another medication used to treat insomnia, may cause the following side effects:

Dry mouth and sore throat
Altered taste sensation
Nausea or vomiting
Unusual dreams or nightmares
Feeling drowsy or fatigued during the day
Headache, dizziness
Sleep problems (parasomnia)
Anxiety feelings -Fast heartbeat in some cases.

It's also important to note that Belsomra can sometimes lead to complex sleep behaviors such as sleep-walking. Please remember these are potential side effects and not everyone taking Belsomra will experience them. Always discuss any concerns with your healthcare provider before starting new medications.

Are there any potential serious side effects for Belsomra?

While Belsomra is generally well-tolerated, certain side effects might occur. Though rare, these may include:

An allergic reaction that includes symptoms such as itching, hives, breathing difficulty or swelling in the face and throat
Unusual behavior or mood changes including depression and suicidal thoughts
Sleep-walking activities like eating, driving a car, leaving the house which you cannot remember upon waking up
Temporary leg weakness
Hallucinations or feeling detached from reality If any of these side effects occur while taking Belsomra it's crucial to stop its usage immediately and consult with your healthcare provider as soon as possible.

Contraindications for Rozerem and Belsomra?

Both Rozerem and Belsomra, along with most other sleep medications, may worsen symptoms of insomnia in some people. If you notice your sleeping problems worsening or an increase in unusual thoughts or behaviors during the night, such as sleep-walking or doing activities while not fully awake, please seek immediate medical attention.

Neither Rozerem nor Belsomra can be taken if you have been consuming alcohol that evening or before bed. Always inform your doctor about any substances you are taking; combining alcohol with these sleep aids can intensify their effects and potentially cause dangerous interactions.

Additionally, it is important to tell your healthcare provider all the medications you are currently taking since several drugs may interfere with the way Rozerem and Belsomra work. These include certain antibiotics and antifungal medications, among others; they might require a period to be cleared from your system to prevent harmful interactions with both Rozerem and Belsomra.

How much do Rozerem and Belsomra cost?

For the brand name versions of these drugs:

The price of 30 tablets of Rozerem (8 mg) averages around $400, which works out to about $13/day.
The price for 30 tablets of Belsomra (10 mg) is approximately $330, working out to roughly $11/day.

This implies that if you are taking a standard dose, then brand-name Belsomra tends to be less expensive on a per-day treatment basis than Rozerem. As always though, cost should not be your primary consideration in determining which medication is right for you.

The generic versions of these sleep aids can provide significant savings:

Ramelteon (the generic form of Rozerem) costs between $1 and $3 per tablet or about $30-$90/month depending on the frequency prescribed.
Suvorexant (generic Belsomra), however, isn't currently available in the market as its patent has not yet expired. When it becomes available, it's expected to be more affordable as is typically the case with generics compared to their branded counterparts.

Popularity of Rozerem and Belsomra

Ramelteon, in generic form as well as brand names such as Rozerem, was estimated to have been prescribed to about 1.2 million people in the US in 2020. Ramelteon accounted for just under 5% of insomnia medication prescriptions in the US. However, it appears to be the most-common melatonin receptor agonist used for sleep disorders and has seen a steady rise since its introduction.

Suvorexant, including brand versions such as Belsomra, was prescribed to approximately 500 thousand people in the USA in 2020. In terms of prescriptions for treatment of insomnia, suvorexant accounts for just over 2%. Suvorexant is classified as an orexin receptor antagonist and represents a newer class of sleep medications which work by blocking chemicals that keep you awake. The prevalence of suvorexant has been generally increasing since its launch due to its unique mechanism and favorable side effect profile compared with other hypnotics.

Conclusion

Both Rozerem (ramelteon) and Belsomra (suvorexant) are widely used in the management of insomnia, with numerous clinical trials demonstrating their efficacy over placebo treatments. In certain instances, these two drugs may be combined under careful physician supervision given that they have different mechanisms of action: Rozerem works by mimicking melatonin to help regulate your sleep-wake cycle, while Belsomra inhibits orexin neurotransmitters to decrease wakefulness. Consequently, they tend to be prescribed based on individual patient needs.

Rozerem is often considered a first-line treatment option for individuals having trouble falling asleep due to its quick onset of action. In contrast, Belsomra might usually be recommended as an adjunct therapy in combination with other sleep aids or for patients who have difficulty staying asleep throughout the night.

Both medications come in generic forms which can offer significant cost savings especially for those paying out-of-pocket. Both Rozerem and Belsomra may require a period of adjustment; therefore immediate effects may not always be apparent.

The side effect profiles are similar between the two medications and both are generally well-tolerated. However, there could be differences such as Belsomra being more associated with next-day drowsiness compared to Rozerem. With either medication it's important that patients closely monitor their symptoms particularly when initiating treatment and seek medical aid immediately if any unusual or severe side effects occur.