Solriamfetol Disease Interactions

Solriamfetol increases systolic blood pressure, diastolic blood pressure, and heart rate in a dose-dependent fashion. It is recommended to exercise caution when treating patients at higher risk of cardiovascular toxicities, particularly patients with known cardiovascular and cerebrovascular disease, preexisting hypertension, and patients with advanced age. Assess blood pressure and control hypertension before initiating treatment and monitor blood pressure regularly during treatment. Periodically reassess the need for continued therapy with solriamfetol and treat new-onset hypertension and exacerbations of preexisting hypertension according to clinical guidelines. If a patient experiences increases in blood pressure or heart rate that cannot be managed with dose reduction or other appropriate medical intervention, consider treatment discontinuation.

The use of solriamfetol may cause adverse psychiatric reactions, including anxiety, insomnia, and irritability. It is recommended to exercise caution when treating patients who have a history of psychosis or bipolar disorders. Observe patients treated with solriamfetol for the possible emergence or exacerbation of psychiatric symptoms and consider dose reduction or discontinuation of treatment.

The primary route of solriamfetol elimination is via urinary excretion. Dosage adjustment is not required for patients with mild renal impairment. Dosage adjustment is recommended for patients with moderate to severe renal impairment. Solriamfetol is not recommended for patients with end-stage renal disease. An average of 21% of solriamfetol is removed by hemodialysis. Patients with moderate or severe renal impairment may be at a higher risk of increases in cardiovascular adverse events and psychiatric symptoms because of the prolonged half-life.