Lemborexant and Perampanel interaction

Lemborexant and Perampanel: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.

Major

Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.

What the FDA labels say

From the Lemborexant (DAYVIGO) label · effective 2025-02-24

Major

Strong or moderate CYP3A inhibitors: Avoid concomitant use.

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Major

Intervention: Avoid concomitant use of DAYVIGO with strong or moderate CYP3A inhibitors [see Dosage and Administration ( 2.2 )].

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Moderate

Risk increases with dose and use with other central nervous system (CNS) depressants.

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Moderate

Co-administration with other CNS depressants (e.g., benzodiazepines, opioids, tricyclic antidepressants, alcohol) increases the risk of CNS depression, which can cause daytime impairment.

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Moderate

Weak CYP3A inhibitors: The maximum recommended dose is 5 mg.

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From the Perampanel (Fycompa) label · effective 2024-01-05

Moderate

Patients should be carefully observed for signs of central nervous system (CNS) depression, such as somnolence and sedation, when FYCOMPA is used with other drugs with sedative properties because of potential additive effects.

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Moderate

Alcohol and Other CNS Depressants The concomitant use of FYCOMPA and CNS depressants including alcohol may increase CNS depression.

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Minor

These effects may also be seen when FYCOMPA is used in combination with other CNS depressants.

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Minor

Patients should limit activity until they have experience with concomitant use of CNS depressants (e.g., benzodiazepines, narcotics, barbiturates, sedating antihistamines).

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Not medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.