Indications for WAKIX:
Excessive daytime sleepiness (EDS) in adults with narcolepsy.
Take in the AM upon awakening. Week 1: initially 8.9mg once daily; Week 2: increase to 17.8mg once daily; Week 3: may increase to max 35.6mg once daily. Adjust dose based on tolerability. Moderate hepatic impairment: initially 8.9mg once daily, may increase to max 17.8mg once daily after 14 days. Moderate to severe renal impairment: initially 8.9mg once daily, may increase to max 17.8mg once daily after 7 days. ESRD: not recommended. Concomitant strong CYP2D6 inhibitors: initially 8.9mg once daily, may increase to max 17.8mg once daily after 7 days; patients already stabilized on Wakix: reduce Wakix dose by ½. CYP2D6 poor metabolizers: initially 8.9mg once daily, may increase to max 17.8mg once daily after 7 days. Concomitant strong CYP3A4 inducers: double the original Wakix daily dose over 7 days; see full labeling.
Severe hepatic impairment.
Avoid in known QT prolongation, history of cardiac arrhythmias. Conditions that may increase risk of torsade de pointes or sudden death (eg, symptomatic bradycardia, hypokalemia, hypomagnesemia, congenital QT prolongation). Hepatic or renal impairment; monitor (See Adults). Elderly. Advise females of reproductive potential to use effective non-hormonal contraceptive during and for ≥21 days after the last dose. Pregnancy. Nursing mothers.
H3 receptor antagonist/inverse agonist.
Avoid concomitant other drugs known to prolong QT interval (eg, Class 1A & 3 antiarrhythmics, ziprasidone, chlorpromazine, thioridazine, moxifloxacin), centrally acting H1 receptor antagonists (eg, pheniramine maleate, diphenhydramine, promethazine, imipramine, clomipramine, mirtazapine). Potentiated by strong CYP2D6 inhibitors (eg, paroxetine, fluoxetine, bupropion); see Adults. Antagonized by strong CYP3A4 inducers (eg, rifampin, carbamazepine, phenytoin); see Adults. Antagonizes sensitive CYP3A4 substrates (eg, midazolam, cyclosporine, hormonal contraceptives).
Insomnia, nausea, anxiety; QT prolongation.