Investigation of a simple suspension method for orexin receptor antagonist tablets

A simple suspension method is used in medical practice to administer several orexin receptor antagonists for patients with dysphagia; however, detailed suspension and passage through catheter evaluations have not been performed. Therefore, to safely administer orexin receptor antagonists using the simple suspension method in patients with dysphagia, this study evaluated the disintegration, suspension, passage through the catheter, and drug recovery after passage of Belsomra® 20 mg (suvorexant), Dayvigo® 10 mg (lemborexant), and Quviviq® 50 mg (daridorexant) tablets through a catheter. Disintegration and suspension of Belsomra® 20 mg, Dayvigo® 10 mg, and Quviviq® 50 mg tablets, and passage through the catheter were visually confirmed. Drug recovery after passage through the catheter was quantified using liquid chromatography-mass spectrometry. In this study, there was no disintegration and suspension of Belsomra® 20 mg tablets. However, Dayvigo® 10 mg and Quviviq® 50 mg tablets demonstrated disintegration and suspension, including passage through the catheter after rapid and complete disintegration. Drug recovery after catheter passage was >80% for Dayvigo® 10 mg without flushing and for Quviviq® 50 mg after two flushes. As the disintegration and suspension properties of Belsomra® 20 mg tablet could not be confirmed, the conventional simple suspension method is not suitable for this product. However, Dayvigo® 10 mg and Quviviq® 50 mg tablets showed potential suitability for the simple suspension method.