Short answer: Solriamfetol (Sunosi) is a prescription medicine that improves wakefulness in adults with narcolepsy or obstructive sleep apnea. It is a Schedule IV controlled substance approved in 2019. It blocks dopamine and norepinephrine reuptake and can raise blood pressure and heart rate.
Key takeaways
- What it is: Solriamfetol is a dopamine and norepinephrine reuptake inhibitor and a Schedule IV controlled substance in the US.
- Main uses: Narcolepsy and sleep apnea sleepiness.
- Timing: effects start in about 2 hours and last up to 9 hours or more.
- Most dangerous mix: MAO inhibitors (within 14 days), which can cause hypertensive reaction.
- Naloxone: it does not reverse this drug, but give it whenever opioids could be involved.
- Dependence risk: Low.
- Legal route: only with a prescription from a DEA-registered clinician, filled by a licensed pharmacy.
What is solriamfetol?
Solriamfetol improves wakefulness in narcolepsy and in sleep apnea with persistent sleepiness. It does not treat the airway obstruction, so CPAP or other treatment should continue.
Unlike amphetamines, it does not release dopamine; it blocks its reuptake, and its misuse potential is considered low.
Quick facts
| Fact | Solriamfetol |
|---|---|
| Generic name | Solriamfetol |
| Brand names | Sunosi |
| Drug class | Dopamine and norepinephrine reuptake inhibitor (DNRI) |
| US legal status | Schedule IV, prescription only |
| Approved uses | Excessive daytime sleepiness in adults with narcolepsy or obstructive sleep apnea |
| Forms | Tablets (75, 150 mg) |
| Half-life | About 7 hours |
| Cleared by | The kidneys, mostly unchanged |
How long does solriamfetol last?
- Starts working: About 2 hours
- Effects last: Up to 9 hours or more
- Half-life: About 7 hours
Timing varies with the dose, the form, how it is taken, liver and kidney function, age, and other drugs taken at the same time.
What are the biggest risks of solriamfetol?
Common side effects include headache, nausea, decreased appetite, anxiety, and insomnia.
Blood pressure and heart rate: it raises both; blood pressure should be controlled before starting and monitored.
Psychiatric symptoms: anxiety, irritability, and agitation; use caution with a history of psychosis or bipolar disorder.
What should you never mix with solriamfetol?
| Combined with | What happens | Label guidance |
|---|---|---|
| MAO inhibitors (within 14 days) | Hypertensive reaction | Contraindicated |
| Other drugs that raise blood pressure or dopamine (stimulants, decongestants) | Higher blood pressure and heart rate | Use caution |
| Alcohol | Masked tiredness | Avoid |
Check any combination with the DoseUses combination checker or ask a pharmacist.
What are the signs of a solriamfetol overdose, and what should you do?
Overdose may cause agitation, abnormal movements, fast heartbeat, and high blood pressure.
If someone may be overdosing
- Call 911 for chest pain, a seizure, trouble breathing, signs of a stroke (face drooping, weakness on one side, slurred speech), a very high body temperature, or if the person collapses.
- Move them somewhere cool and calm, loosen tight clothing, and cool the skin with water. Do not try to hold them down.
- If they become unresponsive or their breathing slows, give naloxone. Street stimulants are often contaminated with fentanyl.
- For advice when the person is awake and stable, call Poison Help at 1-800-222-1222.
Does solriamfetol cause withdrawal?
In clinical trials, stopping solriamfetol did not cause withdrawal symptoms; sleepiness returned to pre-treatment levels.
- Days 1 to 3Sleepiness returnsDaytime sleepiness returns to its earlier level.
- Week 1No withdrawal expectedTrials found no withdrawal syndrome.
- OngoingReassessDiscuss alternatives with the prescriber.
See the withdrawal timelines and the full solriamfetol withdrawal guide.
Is solriamfetol legal?
In the United States, solriamfetol is a Schedule IV controlled substance. The only legal way to get it is with a prescription from a clinician registered with the Drug Enforcement Administration (DEA), filled by a licensed pharmacy. Depending on state law, that can be a physician, nurse practitioner, or physician assistant.
- Refills: a Schedule IV prescription can be refilled up to five times within six months of the date it was written. After that, a new prescription is needed.
- Telehealth: federal flexibilities let DEA-registered clinicians prescribe Schedule II to V medicines after a telemedicine visit, without a prior in-person exam, through December 31, 2026. A permanent DEA rule was under final review in late 2026. State rules can be stricter.
- Monitoring: prescribers and pharmacists in most states check a prescription drug monitoring program, a database of controlled-substance prescriptions, before prescribing or dispensing.
Outside the United States
| Country | Status |
|---|---|
| European Union | Approved in 2020; prescription only |
| International | Not under UN control |
Frequently asked questions about solriamfetol
Is Sunosi a stimulant?
It is a wakefulness-promoting agent that blocks dopamine and norepinephrine reuptake. It is grouped with stimulants but works differently from amphetamines.
Can solriamfetol replace CPAP?
No. It treats sleepiness, not the airway obstruction.
Does solriamfetol raise blood pressure?
Yes, modestly. Blood pressure should be checked before and during treatment.
Is Sunosi a controlled substance?
Yes, Schedule IV.
When should I take Sunosi?
On waking, and not within 9 hours of bedtime.
Sources
- Sunosi (solriamfetol) prescription information, DailyMed, US National Library of Medicine.
- Controlled Substance Schedules, DEA Diversion Control Division.
- 21 CFR 1306.22, Refilling of prescriptions (Schedules III and IV), Electronic Code of Federal Regulations.
- Prescribing controlled substances via telehealth, US Department of Health and Human Services.
- BeSafeRx: Your Source for Online Pharmacy Information, US Food and Drug Administration.
- Safe Pharmacy, National Association of Boards of Pharmacy.
- One Pill Can Kill, US Drug Enforcement Administration.
- International drug control conventions, United Nations Office on Drugs and Crime.
This guide summarizes the sourced DoseUses Solriamfetol profile, written from FDA labels, DEA rules, and federal health agencies. It is educational and is not medical advice. Last updated October 5, 2026.
