[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Other hypnotics (melatonin agonists and orexin antagonists)](https://durgical.com/en/pharmacology/classes/other-hypnotics/) › Lemborexant

# Lemborexant

## Other hypnotics (melatonin agonists and orexin antagonists)?

Other hypnotics (melatonin agonists and orexin antagonists)

A dual orexin receptor antagonist for insomnia. It switches off the brain's wake signal; next-day drowsiness and sleep paralysis can occur.

Updated Nov 1, 2026

## Quick facts

**Group**
[Other hypnotics (melatonin agonists and orexin antagonists)](https://durgical.com/en/pharmacology/classes/other-hypnotics/)

**Target**
Orexin receptors OX1 and OX2

**Used for**
Insomnia with trouble falling

**Key effects**
Somnolence and tiredness · Headache

**Monitor**
Next-day alertness

**ATC**
N05CJ02

No doses: the clinician sets them by the current guideline.

On this page

- The basics Mechanism of action
- Indications
- Adverse effects
- Pharmacokinetics
- Memory aid

- Safety Contraindications
- Key interactions
- What is monitored
- Administration and safety
- Nursing care

- Study Test yourself

- Connections Connections

## Mechanism of action

◎**Orexin receptors OX1 and OX2**Lemborexant

ⓘ The figure shows lemborexant itself bound to the human OX2 orexin receptor; it also blocks OX1.

**Target in 3D:** Orexin receptors OX1 and OX2. PDB structure 7XRR (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/7XRR) · Drag to rotate · pinch to zoom

Lemborexant blocks orexin 1 and orexin 2 receptors, so the orexin neuropeptides that keep the brain awake cannot act. Unlike benzodiazepines and Z-drugs it does not act on GABA-A receptors and does not cause anterograde amnesia.

- Blocks OX1 and OX2 orexin receptors
- The orexin wake signal is switched off
- Sleep begins and is maintained

## Indications

- Insomnia with trouble falling or staying asleep [Insomnia disorder →](https://durgical.com/en/conditions/insomnia-disorder/)

## Adverse effects

### Common

- Somnolence and tiredness
- Headache
- Vivid dreams or nightmares

### Serious (rare, important)

- Sleep paralysis and sudden leg weakness (cataplexy-like)
- Complex sleep behaviours without later memory
- New or worse depression and suicidal thoughts
- Next-day impairment of driving and falls

## Contraindications

- Narcolepsy

## Key interactions

**Alcohol**
Worse side effects

**Other sleep medicines and sedatives**
Added sedation and next-day impairment

**St John's wort**
May change how well it works

## What is monitored

- Next-day alertness, driving and falls
- Mood and unusual night-time behaviour

## Administration and safety

- Given by mouth right before bedtime, at most once a night
- Controlled medicine (Schedule IV in the United States)

## Nursing care

- Ask about narcolepsy, sleep apnoea, lung disease, liver disease and depression
- Teach to avoid alcohol and other sedatives
- Teach to report sleep paralysis, leg weakness or actions done while asleep

## Pharmacokinetics

**Half-life**
Long, about 17 to 19 hours

## Memory aid

Lemborexant: «-orexant blocks orexin» – lose the wake signal, and in narcolepsy you lose more.

## Test yourself

Think of the answer, then tap the question to see it.

## Which receptors does lemborexant block?

Orexin 1 and orexin 2 receptors.

## Why is it avoided in narcolepsy?

Narcolepsy is caused by loss of orexin; blocking orexin further makes sense to avoid.

## Does lemborexant cause anterograde amnesia like benzodiazepines?

No; it does not act on GABA-A receptors.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/lemborexant/)

[More Pharmacology questions →](https://durgical.com/en/practice/?f=pharmacology)

## Connections

## Related drugs 4

- [Suvorexant](https://durgical.com/en/pharmacology/suvorexant/)
- [Daridorexant](https://durgical.com/en/pharmacology/daridorexant/)
- [Zolpidem](https://durgical.com/en/pharmacology/zolpidem/)
- [Ramelteon](https://durgical.com/en/pharmacology/ramelteon/)

## Related conditions 1

- [Insomnia disorder](https://durgical.com/en/conditions/insomnia-disorder/)

[← Back to the class: Other hypnotics (melatonin agonists and orexin antagonists)](https://durgical.com/en/pharmacology/classes/other-hypnotics/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [Lemborexant: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a620039.html) (MedlinePlus (U.S. National Library of Medicine), 2026); [7XRR: Crystal structure of the human OX2R bound to the insomnia drug lemborexant.](https://www.rcsb.org/structure/7XRR) (RCSB Protein Data Bank, 2022); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=N05CJ02) (WHO Collaborating Centre for Drug Statistics Methodology, 2026).

## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake

Representative model, for educational purposes only.

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Source: https://durgical.com/en/pharmacology/lemborexant/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/lemborexant/