What Is Dayvigo?

Dayvigo (lemborexant) is a prescription sleep medication used to treat insomnia in adults, manufactured by Eisai Inc. It was FDA-approved in December 2019 and is indicated for the treatment of insomnia characterized by difficulty with sleep onset and/or sleep maintenance.

Dayvigo belongs to a class of medications called dual orexin receptor antagonists (DORAs) — a newer approach to treating insomnia that works differently from older sleep medications like benzodiazepines or "Z-drugs" (zolpidem, eszopiclone). Instead of broadly sedating the brain, DORAs specifically block the wakefulness signals that keep you alert.

Dayvigo is a Schedule IV controlled substance, meaning it has some potential for dependence, though studies suggest lower abuse potential compared to benzodiazepines and Z-drugs.

Medfinder can help you find pharmacies with Dayvigo in stock.

How does Dayvigo work?

Dayvigo works by blocking orexin receptors in the brain. Orexins (also called hypocretins) are neuropeptides produced in the hypothalamus that play a central role in keeping you awake and alert. By blocking both the orexin-1 (OX1R) and orexin-2 (OX2R) receptors, Dayvigo essentially turns down your brain's wakefulness signals, allowing sleep to occur naturally.

This is fundamentally different from older sleep medications. Benzodiazepines and Z-drugs (like Ambien) work by enhancing GABA activity, which broadly sedates the central nervous system. Dayvigo's targeted approach — blocking only the wake-promoting orexin system — may result in a more natural sleep architecture with potentially fewer side effects like next-day grogginess.

Dayvigo reaches peak blood concentration in 1 to 3 hours and has an elimination half-life of approximately 17 to 19 hours. Despite the long half-life, clinical studies showed that next-day impairment was generally mild at the recommended 5 mg dose. Dayvigo has a stronger affinity for OX2R, which is more directly involved in sleep-wake regulation.

Notably, studies have shown no evidence of rebound insomnia or withdrawal symptoms when discontinuing Dayvigo after 30-day and 6-month trials, which is a meaningful advantage over some older insomnia medications.

What doses are available for Dayvigo?

Dayvigo is available as oral tablets in two strengths:

• 5 mg tablets — recommended starting dose for most adults
• 10 mg tablets — maximum recommended dose, for patients who tolerate 5 mg but need greater efficacy

Dosing Guidelines

• Starting dose: 5 mg once nightly, taken immediately before bedtime
• Maximum dose: 10 mg once nightly
• Patients over 65: Use caution at doses above 5 mg
• Moderate hepatic impairment: Do not exceed 5 mg nightly
• Patients on weak CYP3A inhibitors: Do not exceed 5 mg nightly

Important: Take Dayvigo immediately before going to bed with at least 7 hours remaining before planned waking. Do not take with or immediately after a meal — food may delay the onset of action. Do not take with alcohol.

How hard is it to find Dayvigo in stock?

Dayvigo (lemborexant) is a brand-name prescription sleep medication, and we've assigned a findability score of 72 out of 100. While Dayvigo is not currently on the FDA shortage list and is manufactured in adequate supply by Eisai, its brand-only status and relatively niche prescribing patterns mean not every pharmacy keeps it on the shelf.

Why It Can Sometimes Be Hard to Find

Dayvigo has no generic version — it's a brand-only medication with a list price of $294 for a 30-day supply. Some pharmacies, especially independents, may not stock it routinely due to lower demand compared to older sleep medications like zolpidem (Ambien) or trazodone. Pharmacies tend to stock what's most commonly prescribed, and Dayvigo is still building market share as a newer drug class.

Because it's a Schedule IV controlled substance, Dayvigo requires a prescription and may have ordering lead times at pharmacies that don't regularly carry it. However, most major chain pharmacies (CVS, Walgreens, Walmart) can order it within 1–2 business days.

What This Means for Patients

Unlike acute-need medications, insomnia treatment allows some planning time. If your pharmacy doesn't have Dayvigo in stock, request they order it or check nearby pharmacies. Medfinder can help you quickly locate pharmacies with Dayvigo in stock near you.

Who Can Prescribe Dayvigo?

Any licensed prescriber can prescribe Dayvigo, including:

• Primary care physicians — most commonly prescribe insomnia medications
• Sleep medicine specialists — for complex or treatment-resistant insomnia
• Psychiatrists — often prescribe when insomnia co-occurs with anxiety, depression, or other mental health conditions
• Neurologists — may prescribe for sleep disorders
• Nurse practitioners and physician assistants — can prescribe in all states

As a Schedule IV controlled substance, Dayvigo requires a prescription but does not have the same prescribing restrictions as Schedule II medications. Many telehealth platforms can also prescribe Dayvigo for insomnia after an appropriate evaluation.

Medfinder helps you find pharmacies with Dayvigo in stock.

Is Dayvigo a controlled substance?

Yes, Dayvigo is a Schedule IV controlled substance under the Controlled Substances Act. This is the same classification as other sleep medications like zolpidem (Ambien), eszopiclone (Lunesta), and the other DORA, suvorexant (Belsomra).

Schedule IV means the drug has a lower potential for abuse relative to Schedule III substances. Clinical studies of lemborexant showed low abuse potential, and there is no evidence of physical dependence or withdrawal symptoms at recommended doses. However, as with all controlled substances, prescriptions cannot be transferred between pharmacies in some states, and refill policies may vary.

Common Side Effects of Dayvigo

Most Common

• Somnolence/drowsiness — the most frequently reported side effect, more common at 10 mg than 5 mg
• Headache
• Fatigue
• Dizziness
• Abnormal dreams or nightmares

Side effects are generally dose-dependent — the 5 mg dose is better tolerated than 10 mg. Most side effects are mild and tend to improve with continued use.

Serious but Rare

• Sleep paralysis — temporary inability to move or speak while falling asleep or waking up
• Hypnagogic/hypnopompic hallucinations — vivid experiences when falling asleep or waking
• Cataplexy-like symptoms — brief episodes of muscle weakness
• Complex sleep behaviors — sleepwalking, sleep-driving, or other activities while not fully awake (rare but serious)
• Worsening depression or suicidal ideation — monitor closely in patients with depression

Next-Day Impairment

As a CNS depressant with a 17–19 hour half-life, Dayvigo can impair next-day driving and activities. This risk increases at the 10 mg dose. Patients should ensure at least 7 hours of sleep before activities requiring full alertness.

Alternative Medications to Dayvigo

Other Dual Orexin Receptor Antagonists (DORAs)

• Suvorexant (Belsomra) — The first FDA-approved DORA (2014). Same drug class as Dayvigo. Available in 5 mg, 10 mg, 15 mg, and 20 mg doses. Also brand-only with similar pricing.

Z-Drugs (Non-Benzodiazepine Hypnotics)

• Zolpidem (Ambien) — Generic available — The most commonly prescribed sleep medication. Available as immediate-release and extended-release (Ambien CR). Generic costs as low as $5–$15. Works on GABA receptors.
• Eszopiclone (Lunesta) — Generic available — Another GABA-based sleep medication. Generic available at lower cost.
• Zaleplon (Sonata) — Generic available — Very short-acting, best for sleep onset difficulty only.

Other Options

• Trazodone — Generic available — Antidepressant widely used off-label for insomnia. Very inexpensive ($4–$10). Sedating at low doses.
• Doxepin (Silenor) — Generic available — Low-dose tricyclic antidepressant FDA-approved for sleep maintenance insomnia.
• Ramelteon (Rozerem) — Generic available — Melatonin receptor agonist. Not a controlled substance. Good for sleep onset difficulty.

Zolpidem (generic Ambien) and trazodone are the most commonly prescribed and affordable alternatives. Dayvigo's advantage is its novel mechanism, lower dependence risk, and lack of rebound insomnia.

Medfinder helps find sleep medication availability near you.

Drug Interactions with Dayvigo

Avoid Concurrent Use

• Strong CYP3A inhibitors (itraconazole, clarithromycin, ketoconazole) — significantly increase Dayvigo levels, raising risk of adverse effects. Do not use together.
• Strong CYP3A inducers (rifampin, carbamazepine, St. John's wort) — significantly reduce Dayvigo effectiveness. Avoid combination.
• Alcohol — increases CNS depression and impairment. Do not consume alcohol with Dayvigo.

Use with Caution

• Moderate CYP3A inhibitors (fluconazole, verapamil, diltiazem, erythromycin) — may increase Dayvigo levels. Avoid concurrent use or monitor closely.
• Moderate CYP3A inducers (bosentan, efavirenz, modafinil) — may decrease Dayvigo effectiveness.
• Weak CYP3A inhibitors — limit Dayvigo dose to 5 mg nightly when co-administered.
• Other CNS depressants (benzodiazepines, opioids, other sleep aids, sedating antihistamines) — additive sedation risk. Use caution and consider dose reduction.

Food Interactions

• Food/meals — taking Dayvigo with or immediately after eating can delay onset of action. Take on an empty stomach at bedtime.

Final Thoughts on Dayvigo

Dayvigo represents a newer, targeted approach to treating insomnia that works fundamentally differently from the older sleep medications many patients and providers are familiar with. By blocking orexin-driven wakefulness rather than broadly sedating the brain, it offers a more physiologically natural path to sleep with a lower risk of dependence and no rebound insomnia.

The main barriers are cost (brand-only at $294+ retail, though GoodRx coupons bring it to ~$135 and the Eisai savings card can reduce copays to $0–$30) and pharmacy stocking (not every pharmacy carries it routinely). For patients whose insomnia hasn't responded well to generic options or who want to avoid the dependence concerns associated with benzodiazepines and Z-drugs, Dayvigo is worth discussing with a provider.

Medfinder can help you find pharmacies with Dayvigo in stock near you. Search for availability.