Solriamfetol (Sunosi): Uses, Safety and Drug Interactions

What solriamfetol is used for

Solriamfetol is an oral medicine that promotes wakefulness through dopamine and noradrenaline signalling. The European Sunosi information covers adults with narcolepsy, with or without cataplexy, and adults whose excessive daytime sleepiness from obstructive sleep apnoea has not responded satisfactorily to primary treatment. The US indication also concerns sleepiness associated with these conditions. It does not remove an airway obstruction or replace prescribed continuous positive airway pressure or other primary apnoea treatment.

Kidney function matters because solriamfetol is mainly eliminated through the kidneys. Product instructions place administration early in the waking day because taking it near bedtime can disturb sleep. Persistent sleepiness can still make driving unsafe even while receiving treatment.

Cardiovascular and mental-health precautions

Blood pressure and pulse can rise. The clinician should assess these before treatment and monitor them during use; pre-existing hypertension needs control. The European label excludes certain serious cardiovascular conditions, and the US label advises avoiding unstable cardiovascular disease, serious arrhythmias or other serious heart problems. New chest discomfort or a rapid, irregular heartbeat warrants prompt medical assessment.

Headache, nausea, reduced appetite, anxiety and insomnia are commonly reported. Irritability or agitation can also occur. A history of bipolar disorder or psychosis needs particular attention, and new mental-health symptoms should be discussed promptly rather than managed by changing the medicine independently.

Interactions, pregnancy and breastfeeding

Monoamine oxidase inhibitors must not be combined with solriamfetol, including within the label-specified fourteen days after an MAOI is stopped, because a dangerous blood-pressure reaction can occur. Other medicines that raise blood pressure or pulse, and medicines that act on dopamine, require a specific interaction review. Include nonprescription and herbal products in that review.

Pregnancy information remains limited. The current US label reports passage into human milk but insufficient evidence about effects on infants or milk production. Breastfeeding therefore requires an individual benefit-risk discussion; measurable transfer does not establish infant safety.

Sources

• Sunosi tablets — EMA product information — European product information accessed 30 October 2026
• SUNOSI oral tablets — Axsome US prescribing information — US prescribing information revised May 2026

Sources checked on 30 October 2026. This date records a source check, not a clinical review by a doctor or pharmacist. Follow the leaflet supplied with your product and consult a qualified healthcare professional about personal treatment.