Formulary
Solriamfetol: Indications, Dosing, Side Effects and Interactions
Solriamfetol increases the levels of dopamine and noradrenaline in the brain by inhibiting re-uptake, thereby improving wakefulness.
MedNext Academy | 3 min read
Solriamfetol: Indications, Dosing, Side Effects and Interactions
Solriamfetol increases the levels of dopamine and noradrenaline in the brain by inhibiting re-uptake, thereby improving wakefulness.
Drug action
Solriamfetol increases the levels of dopamine and noradrenaline in the brain by inhibiting re-uptake, thereby improving wakefulness.
Indications and dose
**Excessive sleepiness associated with narcolepsy [with or without cataplexy] (initiated by a specialist)**
- **Adult** (By Mouth): 75 mg once daily, increased if necessary up to 150 mg once daily, dose to be taken upon awakening and not within 9 hours of bedtime, dose to be increased by doubling the dose after at least 3 days, according to response, in patients with severe symptoms, a starting dose of 150 mg once daily may be considered; maximum 150 mg per day.
**Excessive sleepiness associated with obstructive sleep apnoea (initiated by a specialist)**
- **Adult** (By Mouth): 37.5 mg once daily, increased if necessary up to 150 mg once daily, dose to be taken upon awakening and not within 9 hours of bedtime, dose to be increased by doubling the dose at intervals of at least 3 days, according to response; maximum 150 mg per day.
Cautions
Elderly (limited information available-consider lower doses and close monitoring); history of alcohol abuse; history of stimulant abuse; history of, or concurrent, psychosis or bipolar disorder (risk of exacerbation of psychiatric symptoms); increased intra-ocular pressure (risk of mydriasis); patients at risk of angle-closure glaucoma (risk of mydriasis); patients at risk of major cardiovascular events
Contraindications
Cardiac arrhythmias; hypertension (uncontrolled); myocardial infarction (within the past year); unstable angina pectoris
Side effects
Common or very common Abdominal pain; anxiety; appetite decreased; chest discomfort; constipation; cough; diarrhoea; dizziness; dry mouth; feeling jittery; headache; hyperhidrosis; insomnia; irritability; nausea; palpitations; teeth grinding; vomiting Uncommon Concentration impaired; dyspnoea; hypertension; tachycardia; thirst; tremor; weight decreased Frequency not known Mydriasis
Pregnancy
Manufacturer advises avoid-toxicity in animal studies.
Breast feeding
Specialist sources indicate use with caution-limited information available. Monitor breast-fed infants for adverse reactions such as agitation, insomnia, poor feeding, and reduced weight gain.
Renal impairment
Manufacturer advises caution in moderate to severe impairment-increased risk of elevations in blood pressure and heart rate; avoid in end-stage renal disease. Dose adjustments Manufacturer advises a starting dose of 37.5 mg once daily, increased if necessary after 5 days to a maximum of 75 mg once daily, in moderate impairment; a dose of 37.5 mg once daily should not be exceeded in severe impairment.
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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