226 lines
41 KiB
Text
226 lines
41 KiB
Text
<!DOCTYPE html>
|
|
<html xmlns="http://www.w3.org/1999/xhtml" xml:lang="en" class="no-js no-jr">
|
|
<head>
|
|
<!-- For pinger, set start time and add meta elements. -->
|
|
<script type="text/javascript">var ncbi_startTime = new Date();</script>
|
|
|
|
<!-- Logger begin -->
|
|
<meta name="ncbi_db" content="books">
|
|
<meta name="ncbi_pdid" content="book-part">
|
|
<meta name="ncbi_acc" content="NBK547900">
|
|
<meta name="ncbi_domain" content="livertox">
|
|
<meta name="ncbi_report" content="reader">
|
|
<meta name="ncbi_type" content="fulltext">
|
|
<meta name="ncbi_objectid" content="">
|
|
<meta name="ncbi_pcid" content="/NBK547900/?report=reader">
|
|
<meta name="ncbi_pagename" content="Suvorexant - LiverTox - NCBI Bookshelf">
|
|
<meta name="ncbi_bookparttype" content="chapter">
|
|
<meta name="ncbi_app" content="bookshelf">
|
|
<!-- Logger end -->
|
|
|
|
<!--component id="Page" label="meta"/-->
|
|
<script type="text/javascript" src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.boots.min.js"> </script><title>Suvorexant - LiverTox - NCBI Bookshelf</title>
|
|
<meta charset="utf-8">
|
|
<meta name="apple-mobile-web-app-capable" content="no">
|
|
<meta name="viewport" content="initial-scale=1,minimum-scale=1,maximum-scale=1,user-scalable=no">
|
|
<meta name="jr-col-layout" content="auto">
|
|
<meta name="jr-prev-unit" content="/books/n/livertox/Sunitinib/?report=reader">
|
|
<meta name="jr-next-unit" content="/books/n/livertox/Tacrine/?report=reader">
|
|
<meta name="bk-toc-url" content="/books/n/livertox/?report=toc">
|
|
<meta name="robots" content="INDEX,FOLLOW,NOARCHIVE">
|
|
<meta name="citation_inbook_title" content="LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]">
|
|
<meta name="citation_title" content="Suvorexant">
|
|
<meta name="citation_publisher" content="National Institute of Diabetes and Digestive and Kidney Diseases">
|
|
<meta name="citation_date" content="2025/02/05">
|
|
<meta name="citation_pmid" content="31643236">
|
|
<meta name="citation_fulltext_html_url" content="https://www.ncbi.nlm.nih.gov/books/NBK547900/">
|
|
<link rel="schema.DC" href="http://purl.org/DC/elements/1.0/">
|
|
<meta name="DC.Title" content="Suvorexant">
|
|
<meta name="DC.Type" content="Text">
|
|
<meta name="DC.Publisher" content="National Institute of Diabetes and Digestive and Kidney Diseases">
|
|
<meta name="DC.Date" content="2025/02/05">
|
|
<meta name="DC.Identifier" content="https://www.ncbi.nlm.nih.gov/books/NBK547900/">
|
|
<meta name="description" content="Suvorexant is an orexin receptor antagonist used for the treatment of insomnia and sleep disorders. Suvorexant therapy is associated with rare occurrence of transient serum enzyme elevations but has not been implicated in cases of clinically apparent liver injury.">
|
|
<meta name="og:title" content="Suvorexant">
|
|
<meta name="og:type" content="book">
|
|
<meta name="og:description" content="Suvorexant is an orexin receptor antagonist used for the treatment of insomnia and sleep disorders. Suvorexant therapy is associated with rare occurrence of transient serum enzyme elevations but has not been implicated in cases of clinically apparent liver injury.">
|
|
<meta name="og:url" content="https://www.ncbi.nlm.nih.gov/books/NBK547900/">
|
|
<meta name="og:site_name" content="NCBI Bookshelf">
|
|
<meta name="og:image" content="https://www.ncbi.nlm.nih.gov/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-livertox-lrg.png">
|
|
<meta name="twitter:card" content="summary">
|
|
<meta name="twitter:site" content="@ncbibooks">
|
|
<meta name="bk-non-canon-loc" content="/books/n/livertox/Suvorexant/?report=reader">
|
|
<link rel="canonical" href="https://www.ncbi.nlm.nih.gov/books/NBK547900/">
|
|
<link href="https://fonts.googleapis.com/css?family=Archivo+Narrow:400,700,400italic,700italic&subset=latin" rel="stylesheet" type="text/css">
|
|
<link rel="stylesheet" href="/corehtml/pmc/jatsreader/ptpmc_3.22/css/libs.min.css">
|
|
<link rel="stylesheet" href="/corehtml/pmc/jatsreader/ptpmc_3.22/css/jr.min.css">
|
|
<meta name="format-detection" content="telephone=no">
|
|
<link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books.min.css" type="text/css">
|
|
<link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css//books_print.min.css" type="text/css" media="print">
|
|
<link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books_reader.min.css" type="text/css">
|
|
<style type="text/css">p a.figpopup{display:inline !important} .bk_tt {font-family: monospace} .first-line-outdent .bk_ref {display: inline} .body-content h2, .body-content .h2 {border-bottom: 1px solid #97B0C8} .body-content h2.inline {border-bottom: none} a.page-toc-label , .jig-ncbismoothscroll a {text-decoration:none;border:0 !important} .temp-labeled-list .graphic {display:inline-block !important} .temp-labeled-list img{width:100%}</style>
|
|
|
|
<link rel="shortcut icon" href="//www.ncbi.nlm.nih.gov/favicon.ico">
|
|
<meta name="ncbi_phid" content="CE8E44597D7F767100000000004B003D.m_5">
|
|
<meta name='referrer' content='origin-when-cross-origin'/><link type="text/css" rel="stylesheet" href="//static.pubmed.gov/portal/portal3rc.fcgi/4216699/css/3852956/3849091.css"></head>
|
|
<body>
|
|
<!-- Book content! -->
|
|
|
|
|
|
<div id="jr" data-jr-path="/corehtml/pmc/jatsreader/ptpmc_3.22/"><div class="jr-unsupported"><table class="modal"><tr><td><span class="attn inline-block"></span><br />Your browser does not support the NLM PubReader view.<br />Go to <a href="/pmc/about/pr-browsers/">this page</a> to see a list of supported browsers<br />or return to the <br /><a href="/books/NBK547900/?report=classic">regular view</a>.</td></tr></table></div><div id="jr-ui" class="hidden"><nav id="jr-head"><div class="flexh tb"><div id="jr-tb1"><a id="jr-links-sw" class="hidden" title="Links"><svg xmlns="http://www.w3.org/2000/svg" version="1.1" x="0px" y="0px" viewBox="0 0 70.6 85.3" style="enable-background:new 0 0 70.6 85.3;vertical-align:middle" xml:space="preserve" width="24" height="24">
|
|
<style type="text/css">.st0{fill:#939598;}</style>
|
|
<g>
|
|
<path class="st0" d="M36,0C12.8,2.2-22.4,14.6,19.6,32.5C40.7,41.4-30.6,14,35.9,9.8"></path>
|
|
<path class="st0" d="M34.5,85.3c23.2-2.2,58.4-14.6,16.4-32.5c-21.1-8.9,50.2,18.5-16.3,22.7"></path>
|
|
<path class="st0" d="M34.7,37.1c66.5-4.2-4.8-31.6,16.3-22.7c42.1,17.9,6.9,30.3-16.4,32.5h1.7c-66.2,4.4,4.8,31.6-16.3,22.7 c-42.1-17.9-6.9-30.3,16.4-32.5"></path>
|
|
</g>
|
|
</svg> Books</a></div><div class="jr-rhead f1 flexh"><div class="head"><a href="/books/n/livertox/Sunitinib/?report=reader"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M75,30 c-80,60 -80,0 0,60 c-30,-60 -30,0 0,-60"></path><text x="20" y="28" textLength="60" style="font-size:25px">Prev</text></svg></a></div><div class="body"><div class="t">Suvorexant</div><div class="j">LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]</div></div><div class="tail"><a href="/books/n/livertox/Tacrine/?report=reader"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M25,30c80,60 80,0 0,60 c30,-60 30,0 0,-60"></path><text x="20" y="28" textLength="60" style="font-size:25px">Next</text></svg></a></div></div><div id="jr-tb2"><a id="jr-bkhelp-sw" class="btn wsprkl hidden" title="Help with NLM PubReader">?</a><a id="jr-help-sw" class="btn wsprkl hidden" title="Settings and typography in NLM PubReader"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 512 512" preserveAspectRatio="none"><path d="M462,283.742v-55.485l-29.981-10.662c-11.431-4.065-20.628-12.794-25.274-24.001 c-0.002-0.004-0.004-0.009-0.006-0.013c-4.659-11.235-4.333-23.918,0.889-34.903l13.653-28.724l-39.234-39.234l-28.72,13.652 c-10.979,5.219-23.68,5.546-34.908,0.889c-0.005-0.002-0.01-0.003-0.014-0.005c-11.215-4.65-19.933-13.834-24-25.273L283.741,50 h-55.484l-10.662,29.981c-4.065,11.431-12.794,20.627-24.001,25.274c-0.005,0.002-0.009,0.004-0.014,0.005 c-11.235,4.66-23.919,4.333-34.905-0.889l-28.723-13.653l-39.234,39.234l13.653,28.721c5.219,10.979,5.545,23.681,0.889,34.91 c-0.002,0.004-0.004,0.009-0.006,0.013c-4.649,11.214-13.834,19.931-25.271,23.998L50,228.257v55.485l29.98,10.661 c11.431,4.065,20.627,12.794,25.274,24c0.002,0.005,0.003,0.01,0.005,0.014c4.66,11.236,4.334,23.921-0.888,34.906l-13.654,28.723 l39.234,39.234l28.721-13.652c10.979-5.219,23.681-5.546,34.909-0.889c0.005,0.002,0.01,0.004,0.014,0.006 c11.214,4.649,19.93,13.833,23.998,25.271L228.257,462h55.484l10.595-29.79c4.103-11.538,12.908-20.824,24.216-25.525 c0.005-0.002,0.009-0.004,0.014-0.006c11.127-4.628,23.694-4.311,34.578,0.863l28.902,13.738l39.234-39.234l-13.66-28.737 c-5.214-10.969-5.539-23.659-0.886-34.877c0.002-0.005,0.004-0.009,0.006-0.014c4.654-11.225,13.848-19.949,25.297-24.021 L462,283.742z M256,331.546c-41.724,0-75.548-33.823-75.548-75.546s33.824-75.547,75.548-75.547 c41.723,0,75.546,33.824,75.546,75.547S297.723,331.546,256,331.546z"></path></svg></a><a id="jr-fip-sw" class="btn wsprkl hidden" title="Find"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 550 600" preserveAspectRatio="none"><path fill="none" stroke="#000" stroke-width="36" stroke-linecap="round" style="fill:#FFF" d="m320,350a153,153 0 1,0-2,2l170,170m-91-117 110,110-26,26-110-110"></path></svg></a><a id="jr-rtoc-sw" class="btn wsprkl hidden" title="Table of Contents"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M20,20h10v8H20V20zM36,20h44v8H36V20zM20,37.33h10v8H20V37.33zM36,37.33h44v8H36V37.33zM20,54.66h10v8H20V54.66zM36,54.66h44v8H36V54.66zM20,72h10v8 H20V72zM36,72h44v8H36V72z"></path></svg></a></div></div></nav><nav id="jr-dash" class="noselect"><nav id="jr-dash" class="noselect"><div id="jr-pi" class="hidden"><a id="jr-pi-prev" class="hidden" title="Previous page"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M75,30 c-80,60 -80,0 0,60 c-30,-60 -30,0 0,-60"></path><text x="20" y="28" textLength="60" style="font-size:25px">Prev</text></svg></a><div class="pginfo">Page <i class="jr-pg-pn">0</i> of <i class="jr-pg-lp">0</i></div><a id="jr-pi-next" class="hidden" title="Next page"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M25,30c80,60 80,0 0,60 c30,-60 30,0 0,-60"></path><text x="20" y="28" textLength="60" style="font-size:25px">Next</text></svg></a></div><div id="jr-is-tb"><a id="jr-is-sw" class="btn wsprkl hidden" title="Switch between Figures/Tables strip and Progress bar"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><rect x="10" y="40" width="20" height="20"></rect><rect x="40" y="40" width="20" height="20"></rect><rect x="70" y="40" width="20" height="20"></rect></svg></a></div><nav id="jr-istrip" class="istrip hidden"><a id="jr-is-prev" href="#" class="hidden" title="Previous"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M80,40 60,65 80,90 70,90 50,65 70,40z M50,40 30,65 50,90 40,90 20,65 40,40z"></path><text x="35" y="25" textLength="60" style="font-size:25px">Prev</text></svg></a><a id="jr-is-next" href="#" class="hidden" title="Next"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M20,40 40,65 20,90 30,90 50,65 30,40z M50,40 70,65 50,90 60,90 80,65 60,40z"></path><text x="15" y="25" textLength="60" style="font-size:25px">Next</text></svg></a></nav><nav id="jr-progress"></nav></nav></nav><aside id="jr-links-p" class="hidden flexv"><div class="tb sk-htbar flexh"><div><a class="jr-p-close btn wsprkl">Done</a></div><div class="title-text f1">NCBI Bookshelf</div></div><div class="cnt lol f1"><a href="/books/">Home</a><a href="/books/browse/">Browse All Titles</a><a class="btn share" target="_blank" rel="noopener noreferrer" href="https://www.facebook.com/sharer/sharer.php?u=https://www.ncbi.nlm.nih.gov/books/NBK547900/"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 33 33" style="vertical-align:middle" width="24" height="24" preserveAspectRatio="none"><g><path d="M 17.996,32L 12,32 L 12,16 l-4,0 l0-5.514 l 4-0.002l-0.006-3.248C 11.993,2.737, 13.213,0, 18.512,0l 4.412,0 l0,5.515 l-2.757,0 c-2.063,0-2.163,0.77-2.163,2.209l-0.008,2.76l 4.959,0 l-0.585,5.514L 18,16L 17.996,32z"></path></g></svg> Share on Facebook</a><a class="btn share" target="_blank" rel="noopener noreferrer" href="https://twitter.com/intent/tweet?url=https://www.ncbi.nlm.nih.gov/books/NBK547900/&text=Suvorexant"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 33 33" style="vertical-align:middle" width="24" height="24"><g><path d="M 32,6.076c-1.177,0.522-2.443,0.875-3.771,1.034c 1.355-0.813, 2.396-2.099, 2.887-3.632 c-1.269,0.752-2.674,1.299-4.169,1.593c-1.198-1.276-2.904-2.073-4.792-2.073c-3.626,0-6.565,2.939-6.565,6.565 c0,0.515, 0.058,1.016, 0.17,1.496c-5.456-0.274-10.294-2.888-13.532-6.86c-0.565,0.97-0.889,2.097-0.889,3.301 c0,2.278, 1.159,4.287, 2.921,5.465c-1.076-0.034-2.088-0.329-2.974-0.821c-0.001,0.027-0.001,0.055-0.001,0.083 c0,3.181, 2.263,5.834, 5.266,6.438c-0.551,0.15-1.131,0.23-1.73,0.23c-0.423,0-0.834-0.041-1.235-0.118 c 0.836,2.608, 3.26,4.506, 6.133,4.559c-2.247,1.761-5.078,2.81-8.154,2.81c-0.53,0-1.052-0.031-1.566-0.092 c 2.905,1.863, 6.356,2.95, 10.064,2.95c 12.076,0, 18.679-10.004, 18.679-18.68c0-0.285-0.006-0.568-0.019-0.849 C 30.007,8.548, 31.12,7.392, 32,6.076z"></path></g></svg> Share on Twitter</a></div></aside><aside id="jr-rtoc-p" class="hidden flexv"><div class="tb sk-htbar flexh"><div><a class="jr-p-close btn wsprkl">Done</a></div><div class="title-text f1">Table of Content</div></div><div class="cnt lol f1"><a href="/books/n/livertox/?report=reader">Title Information</a><a href="/books/n/livertox/toc/?report=reader">Table of Contents Page</a></div></aside><aside id="jr-help-p" class="hidden flexv"><div class="tb sk-htbar flexh"><div><a class="jr-p-close btn wsprkl">Done</a></div><div class="title-text f1">Settings</div></div><div class="cnt f1"><div id="jr-typo-p" class="typo"><div><a class="sf btn wsprkl">A-</a><a class="lf btn wsprkl">A+</a></div><div><a class="bcol-auto btn wsprkl"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 200 100" preserveAspectRatio="none"><text x="10" y="70" style="font-size:60px;font-family: Trebuchet MS, ArialMT, Arial, sans-serif" textLength="180">AUTO</text></svg></a><a class="bcol-1 btn wsprkl"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M15,25 85,25zM15,40 85,40zM15,55 85,55zM15,70 85,70z"></path></svg></a><a class="bcol-2 btn wsprkl"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M5,25 45,25z M55,25 95,25zM5,40 45,40z M55,40 95,40zM5,55 45,55z M55,55 95,55zM5,70 45,70z M55,70 95,70z"></path></svg></a></div></div><div class="lol"><a class="" href="/books/NBK547900/?report=classic">Switch to classic view</a><a href="/books/NBK547900/pdf/Bookshelf_NBK547900.pdf">PDF (106K)</a><a href="/books/NBK547900/?report=printable">Print View</a></div></div></aside><aside id="jr-bkhelp-p" class="hidden flexv"><div class="tb sk-htbar flexh"><div><a class="jr-p-close btn wsprkl">Done</a></div><div class="title-text f1">Help</div></div><div class="cnt f1 lol"><a id="jr-helpobj-sw" data-path="/corehtml/pmc/jatsreader/ptpmc_3.22/" data-href="/corehtml/pmc/jatsreader/ptpmc_3.22/img/bookshelf/help.xml" href="">Help</a><a href="mailto:info@ncbi.nlm.nih.gov?subject=PubReader%20feedback%20%2F%20NBK547900%20%2F%20sid%3ACE8B5AF87C7FFCB1_0191SID%20%2F%20phid%3ACE8E44597D7F767100000000004B003D.4">Send us feedback</a><a id="jr-about-sw" data-path="/corehtml/pmc/jatsreader/ptpmc_3.22/" data-href="/corehtml/pmc/jatsreader/ptpmc_3.22/img/bookshelf/about.xml" href="">About PubReader</a></div></aside><aside id="jr-objectbox" class="thidden hidden"><div class="jr-objectbox-close wsprkl">✘</div><div class="jr-objectbox-inner cnt"><div class="jr-objectbox-drawer"></div></div></aside><nav id="jr-pm-left" class="hidden"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 40 800" preserveAspectRatio="none"><text font-stretch="ultra-condensed" x="800" y="-15" text-anchor="end" transform="rotate(90)" font-size="18" letter-spacing=".1em">Previous Page</text></svg></nav><nav id="jr-pm-right" class="hidden"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 40 800" preserveAspectRatio="none"><text font-stretch="ultra-condensed" x="800" y="-15" text-anchor="end" transform="rotate(90)" font-size="18" letter-spacing=".1em">Next Page</text></svg></nav><nav id="jr-fip" class="hidden"><nav id="jr-fip-term-p"><input type="search" placeholder="search this page" id="jr-fip-term" autocorrect="off" autocomplete="off" /><a id="jr-fip-mg" class="wsprkl btn" title="Find"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 550 600" preserveAspectRatio="none"><path fill="none" stroke="#000" stroke-width="36" stroke-linecap="round" style="fill:#FFF" d="m320,350a153,153 0 1,0-2,2l170,170m-91-117 110,110-26,26-110-110"></path></svg></a><a id="jr-fip-done" class="wsprkl btn" title="Dismiss find">✘</a></nav><nav id="jr-fip-info-p"><a id="jr-fip-prev" class="wsprkl btn" title="Jump to previuos match">◀</a><button id="jr-fip-matches">no matches yet</button><a id="jr-fip-next" class="wsprkl btn" title="Jump to next match">▶</a></nav></nav></div><div id="jr-epub-interstitial" class="hidden"></div><div id="jr-content"><article data-type="main"><div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><div class="fm-sec"><h1 id="_NBK547900_"><span class="title" itemprop="name">Suvorexant</span></h1><p class="fm-aai"><a href="#_NBK547900_pubdet_">Publication Details</a></p></div></div><div class="body-content whole_rhythm" itemprop="text"><div id="Suvorexant.OVERVIEW"><h2 id="_Suvorexant_OVERVIEW_">OVERVIEW</h2><div id="Suvorexant.Introduction"><h3>Introduction</h3><p>Suvorexant is an orexin receptor antagonist used for the treatment of insomnia and sleep disorders. Suvorexant therapy is associated with rare occurrence of transient serum enzyme elevations but has not been implicated in cases of clinically apparent liver injury.</p></div><div id="Suvorexant.Background"><h3>Background</h3><p>Suvorexant (soo" voe rex' ant) is an orexin receptor antagonist which is used to treat insomnia. Central nervous system neurons with orexin receptors are involved in wakefulness and are inactive during sleep. Engagement of the orexin receptor results in wakefulness, and loss of the receptor can result in excessive daytime sleepiness and narcolepsy. Inhibition of orexin receptor signaling using suvorexant has been shown to shorten the time to falling asleep and to prolong sleep in patients with sleep-onset and sleep-maintenance insomnia. Suvorexant was approved for use in the United States in 2014, the first such orexin based drug approved for insomnia. Suvorexant is available in 5, 10, 15 and 20 mg tablets under the brand name Belsomra. The recommended dose is 10 mg taken orally within 30 minutes of bedtime. The dose can be increased to 20 mg. Side effects are few, but may include daytime somnolence, fatigue, dizziness, headache and vivid or abnormal dreams. Rare but potentially severe side effects include sleep paralysis, cataplexy, nightmares, excessive daytime sleepiness, worsening of depression and suicidal ideation and behaviors. Suvorexant can also decrease respiratory function and should be used with caution in persons with respiratory illnesses. Suvorexant is classified as a Schedule 4 controlled substance, meaning that it has a low potential for abuse or dependence and has an approved medical use.</p></div><div id="Suvorexant.Hepatotoxicity"><h3>Hepatotoxicity</h3><p>In several clinical trials, suvorexant was found to be well tolerated, with serum ALT elevations in 0 to 5% of patients, usually with higher doses, and resolving spontaneously without dose modification. In the registration trials of suvorexant, there were no reports of clinically apparent liver injury. Suvorexant has been available for more than a decade but has not been implicated in causing clinically apparent liver injury even with an overdose.</p><p>Likelihood score: E (unlikely cause of clinically apparent liver injury).</p></div><div id="Suvorexant.Mechanism_of_Injury"><h3>Mechanism of Injury</h3><p>The mechanism by which suvorexant might cause liver injury is unknown. Suvorexant is metabolized by the cytochrome P450 system (predominantly CYP3A4), and the dose may need to be altered in patients taking strong inhibitors (decreasing dose) or inducers (increasing dose) of the enzymes. The relative lack of serious liver related adverse events is probably due to the low doses used and its uncommon, intermittent use.</p><p>Drug Class: <a href="/books/n/livertox/Sedatives_Hypnotics/?report=reader">Sedatives and Hypnotics</a>; Drugs for Insomnia</p><p>Other Orexin Receptor Antagonists: <a href="/books/n/livertox/Daridorexant/?report=reader">Daridorexant</a>, <a href="/books/n/livertox/Lemborexant/?report=reader">Lemborexant</a></p></div></div><div id="Suvorexant.PRODUCT_INFORMATION"><h2 id="_Suvorexant_PRODUCT_INFORMATION_">PRODUCT INFORMATION</h2><p>
|
|
<b>REPRESENTATIVE TRADE NAMES</b>
|
|
</p><p>Suvorexant – Belsomra®</p><p>
|
|
<b>DRUG CLASS</b>
|
|
</p><p>Sedatives and Hypnotics</p><p>
|
|
<a href="https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=suvorexant" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">COMPLETE LABELING</a>
|
|
</p><p>Product labeling at DailyMed, National Library of Medicine, NIH</p></div><div id="Suvorexant.CHEMICAL_FORMULA_AND_STRUCTUR"><h2 id="_Suvorexant_CHEMICAL_FORMULA_AND_STRUCTUR_">CHEMICAL FORMULA AND STRUCTURE</h2><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figSuvorexantTc"><a href="/books/NBK547900/table/Suvorexant.Tc/?report=objectonly" target="object" title="Table" class="img_link icnblk_img" rid-ob="figobSuvorexantTc"><img class="small-thumb" src="/corehtml/pmc/css/bookshelf/2.26/img/table-icon.gif" alt="Table Icon" /></a><div class="icnblk_cntnt"><h4 id="Suvorexant.Tc"><a href="/books/NBK547900/table/Suvorexant.Tc/?report=objectonly" target="object" rid-ob="figobSuvorexantTc">Table</a></h4></div></div></div><div id="Suvorexant.ANNOTATED_BIBLIOGRAPHY"><h2 id="_Suvorexant_ANNOTATED_BIBLIOGRAPHY_">ANNOTATED BIBLIOGRAPHY</h2><p>References updated: 05 February 2025</p><ul class="first-line-outdent"><li><div class="bk_ref" id="Suvorexant.REF.zimmerman.1999">Zimmerman HJ. Unconventional drugs. Miscellaneous drugs and diagnostic chemicals. In, Zimmerman HJ. Hepatotoxicity: the adverse effects of drugs and other chemicals on the liver. 2nd ed. Philadelphia: Lippincott, 1999, pp. 731-4.<div><i>(Expert review of hepatotoxicity published in 1999; suvorexant and the orexin receptor antagonists are not discussed).</i></div></div></li><li><div class="bk_ref" id="Suvorexant.REF.larrey.2013">Larrey D, Ripault MP. Anxiolytic agents. Hepatotoxicity of psychotropic drugs and drugs of abuse. In, Kaplowitz N, DeLeve LD, eds. Drug-induced liver disease. 3rd ed. Amsterdam: Elsevier, 2013, p. 455-6.<div><i>(Review of hepatotoxicity of hypnotics and sedatives discusses benzodiazepines, buspirone and valerian, all of which have been linked to rare cases of liver injury; suvorexant and orexin receptor antagonists are not discussed).</i></div></div></li><li><div class="bk_ref" id="Suvorexant.REF.mihic.2018">Mihic SJ, Mayfield J, Harris RA. Hypnotics and sedatives. In, Brunton LL, Hilal-Dandan R, Knollman BC, eds. Goodman & Gilman's the pharmacological basis of therapeutics. 13th ed. New York: McGraw-Hill, 2018, pp. 339-354.<div><i>(Textbook of and therapeutics, discusses suvorexant).</i></div></div></li><li><div class="bk_ref" id="Suvorexant.REF.crossdiscipline_review">FDA.
|
|
Cross-Discipline Review. <a href="https://www.accessdata.fda.gov/drugsatfda_docs/nda/2014/204569Orig1s000MedR.pdf" ref="pagearea=cite-ref&targetsite=external&targetcat=link&targettype=uri">https://www<wbr style="display:inline-block"></wbr>​.accessdata<wbr style="display:inline-block"></wbr>​.fda.gov/drugsatfda_docs<wbr style="display:inline-block"></wbr>​/nda/2014/204569Orig1s000MedR.pdf</a><div><i>(FDA website with product labels and multiple disciplinary review that supported approval of suvorexant in the US, mentions that there were no hepatic serious adverse events, no discontinuations for hepatic events, and no significant shift or change in serum ALT or AST levels during therapy, no instance of ALT elevation with jaundice, and in registration trials enrolling more than 2,500 subjects, ALT elevations of more than 3 times ULN arose in 0.5% of suvorexant and 0.3% of placebo recipients).</i></div></div></li><li><div class="bk_ref" id="Suvorexant.REF.herring.2012.2265">Herring
|
|
WJ, Snyder
|
|
E, Budd
|
|
K, Hutzelmann
|
|
J, Snavely
|
|
D, Liu
|
|
K, Lines
|
|
C, et al.
|
|
Orexin receptor antagonism for treatment of insomnia: a randomized clinical trial of suvorexant.
|
|
Neurology
|
|
2012; 79: 2265-74.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/23197752" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23197752</span></a>]<div><i>(Among 254 patients treated with one of 4 doses of suvorexant or placebo in a cross over design, adverse events were more common with higher doses and consisted mainly of somnolence [2-12%], headache [0-5%], dizziness [0-5%] and abnormal dreams [0-5%], with rare instances of ALT elevations [1.6-3.4% with higher doses vs 0.4% with placebo], all of which resolved spontaneously without dose modification).</i></div></div></li><li><div class="bk_ref" id="Suvorexant.REF.herring.2016.136">Herring
|
|
WJ, Connor
|
|
KM, Ivgy-May
|
|
N, Snyder
|
|
E, Liu
|
|
K, Snavely
|
|
DB, Krystal
|
|
AD, et al.
|
|
Suvorexant in patients with insomnia: results from two 3-month randomized controlled clinical trials.
|
|
Biol Psychiatry.
|
|
2016; 79(2): 136-48.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/25526970" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25526970</span></a>]<div><i>(In two 3-month controlled trials of suvorexant versus placebo for primary insomnia in 2040 patients, “No clinically relevant changes in laboratory … measures were observed” and no serious hepatic adverse events were reported).</i></div></div></li><li><div class="bk_ref" id="Suvorexant.REF.michelson.2014.461">Michelson
|
|
D, Snyder
|
|
E, Paradis
|
|
E, Chengan-Liu
|
|
M, Snavely
|
|
DB, Hutzelmann
|
|
J, Walsh
|
|
JK, et al.
|
|
Safety and efficacy of suvorexant during 1-year treatment of insomnia with subsequent abrupt treatment discontinuation: a phase 3 randomised, double-blind, placebo-controlled trial.
|
|
Lancet Neurol
|
|
2014; 13: 461-71.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/24680372" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24680372</span></a>]<div><i>(Among 522 patients with insomnia treated with suvorexant or placebo for one year, rates of adverse events with similar in the two groups and “there were no clinically meaningful differences between groups in vital signs or laboratory values”).</i></div></div></li><li><div class="bk_ref" id="Suvorexant.REF.yin.2015.247">Yin
|
|
J, Mobarec
|
|
JC, Kolb
|
|
P, Rosenbaum
|
|
DM. Crystal structure of the human OX (2) orexin receptor bound to the insomnia drug suvorexant.
|
|
Nature
|
|
2015;519(7542):247-50.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/25533960" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25533960</span></a>]<div><i>(Resolution of the crystal structure of the human orexin receptor bound to suvorexant).</i></div></div></li><li><div class="bk_ref" id="Suvorexant.REF9">Suvorexant (Belsomra) for insomnia.
|
|
Med Lett Drugs Ther
|
|
2015; 57: 29-31.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/25719996" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25719996</span></a>]<div><i>(Concise review of the efficacy, safety and costs of suvorexant as therapy of insomnia shortly after its approval in the US, mentions the most common side effect as being next day somnolence [in 7-13% of recipients]; no mention of hepatotoxicity or ALT elevations).</i></div></div></li><li><div class="bk_ref" id="Suvorexant.REF.patel.2015.477">Patel
|
|
KV, Aspesi
|
|
AV, Evoy
|
|
KE. Suvorexant: A dual orexin receptor antagonist for the treatment of sleep onset and sleep maintenance insomnia.
|
|
Ann Pharmacother
|
|
2015;49(4):477-83.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/25667197" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25667197</span></a>]<div><i>(Review of 3 randomized, controlled trials of suvorexant as therapy of insomnia mentions that somnolence, fatigue and headache were more common with drug than placebo; no mention of ALT elevations or hepatotoxicity).</i></div></div></li><li><div class="bk_ref" id="Suvorexant.REF.chalasani.2015.1340">Chalasani
|
|
N, Bonkovsky
|
|
HL, Fontana
|
|
R, Lee
|
|
W, Stolz
|
|
A, Talwalkar
|
|
J, Reddy
|
|
KR, et al.; United States Drug Induced Liver Injury Network. Features and outcomes of 899 patients with drug-induced liver injury: The DILIN Prospective Study.
|
|
Gastroenterology
|
|
2015; 148: 1340-52.e7.
|
|
[<a href="/pmc/articles/PMC4446235/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4446235</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/25754159" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25754159</span></a>]<div><i>(Among 899 cases of drug induced liver injury enrolled in a US prospective study between 2004 and 2013, 82 [9%] were attributed to agents active in the central nervous system, but none were sedatives or sleeping aids).</i></div></div></li><li><div class="bk_ref" id="Suvorexant.REF12">Drugs for insomnia.
|
|
Med Lett Drugs Ther
|
|
2015; 57 (1472): 95-8.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/26147892" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26147892</span></a>]<div><i>(Concise review of the mechanism of action, efficacy, safety and costs of drugs for insomnia including benzodiazepine receptor agonists, benzodiazepines, melatonin receptor agonists, orexin receptor antagonists such as suvorexant and other agents including nonprescription and herbal products; no mention of ALT elevations or hepatotoxicity).</i></div></div></li><li><div class="bk_ref" id="Suvorexant.REF.schroeck.2016.2340">Schroeck
|
|
JL, Ford
|
|
J, Conway
|
|
EL, Kurtzhalts
|
|
KE, Gee
|
|
ME, Vollmer
|
|
KA, Mergenhagen
|
|
KA. Review of safety and efficacy of sleep medicines in older adults.
|
|
Clin Ther
|
|
2016; 38: 2340-72.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/27751669" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27751669</span></a>]<div><i>(Systematic review of the literature on the safety and efficacy of sleep aids in the elderly focuses upon common adverse events such as somnolence, fatigue, headache and dry mouth with special emphasis on dementia, forgetfulness, daytime somnolence, falls and fractures; no mention of ALT elevations or hepatotoxicity).</i></div></div></li><li><div class="bk_ref" id="Suvorexant.REF.kuriyama.2017.1">Kuriyama
|
|
A, Tabata
|
|
H. Suvorexant for the treatment of primary insomnia: A systematic review and meta-analysis.
|
|
Sleep Med Rev
|
|
2017; 35: 1-7.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/28365447" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28365447</span></a>]<div><i>(Systematic review of the safety and efficacy of suvorexant does not mention effects on ALT levels or hepatotoxicity).</i></div></div></li><li><div class="bk_ref" id="Suvorexant.REF15">Drugs for chronic insomnia.
|
|
Med Lett Drugs Ther.
|
|
2018;60:201-205.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/30625122" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30625122</span></a>]<div><i>(Concise review of the mechanisms of action, relative clinical efficacy, safety and costs of medications used to treat chronic insomnia mentions that suvorexant’s most common adverse events are somnolence, fatigue and nightmares and that it may cause impairment of next day driving performance and rarely has been linked to complex-sleep related disorders such as cataplexy and leg weakness; no mention of ALT elevations or hepatotoxicity).</i></div></div></li><li><div class="bk_ref" id="Suvorexant.REF.borchert.2019.e13371">Borchert
|
|
JS, Wang
|
|
B, Ramzanali
|
|
M, Stein
|
|
AB, Malaiyandi
|
|
LM, Dineley
|
|
KE. Adverse events due to insomnia drugs reported in a regulatory database and online patient reviews: comparative study.
|
|
J Med Internet Res.
|
|
2019;21:e13371.
|
|
[<a href="/pmc/articles/PMC6874799/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6874799</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/31702558" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31702558</span></a>]<div><i>(Search of regulatory databases of adverse event reports attributed to drugs for insomnia discusses suvorexant, the main reported side effects being nightmares, headache, somnolence, sleep paralysis, abnormal dreams, feeling abnormal, insomnia, and hangover; no mention of liver test abnormalities or hepatotoxicity).</i></div></div></li><li><div class="bk_ref" id="Suvorexant.REF.muehlan.2020.1063">Muehlan
|
|
C, Vaillant
|
|
C, Zenklusen
|
|
I, Kraehenbuehl
|
|
S, Dingemanse
|
|
J. Clinical pharmacology, efficacy, and safety of orexin receptor antagonists for the treatment of insomnia disorders.
|
|
Expert Opin Drug Metab Toxicol.
|
|
2020;16:1063-1078.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/32901578" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32901578</span></a>]<div><i>(Review of the role of orexin in sleep and wakefulness, and the mechanism of action, pharmacology, clinical efficacy and safety of orexin receptor antagonists including suvo-, lembo-, darido- and seltorexant, all of which have similar side effects but are generally “well tolerated”).</i></div></div></li><li><div class="bk_ref" id="Suvorexant.REF.ito.2021.e14329">Ito
|
|
H, Ogawa
|
|
Y, Shimojo
|
|
N, Kawano
|
|
S. Suvorexant poisoning in a patient with cirrhosis and renal failure.
|
|
Cureus.
|
|
2021;13:e14329.
|
|
[<a href="/pmc/articles/PMC8101530/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC8101530</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/33968537" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33968537</span></a>]<div><i>(83 year old man with nonalcoholic steatohepatitis and cirrhosis, hepatocellular carcinoma and renal failure took 270 mg of suvorexant [18 of his 15 mg tablets] in a suicide attempt and slept for 10 hours but then presented with normal cognition, no sedation, no asterixis and normal ALT, AST, alkaline phosphatase, bilirubin and INR, with no worsening of his renal failure).</i></div></div></li><li><div class="bk_ref" id="Suvorexant.REF.preskorn.2023.38">Preskorn
|
|
SH. Comparative pharmacology of the 3 marketed dual orexin antagonists-daridorexant, lemborexant, and suvorexant-part 2. principal drug metabolizing enzyme, drug-drug interactions, and effects of liver and renal impairment on metabolism.
|
|
J Psychiatr Pract.
|
|
2023;29:38-41.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/36649550" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 36649550</span></a>]<div><i>(Review of the pharmacokinetics of the 3 orexin antagonists in clinical use, including suvo-, lembo-, and daridorexant, mentions that they have similar chemical structures and similar metabolism by CYP 3A4, with only minor differences in susceptibility to inducers and inhibitors of CYP 3A4).</i></div></div></li><li><div class="bk_ref" id="Suvorexant.REF20">Drugs for chronic insomnia.
|
|
Med Lett Drugs Ther.
|
|
2023;65:1-6.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/36630579" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 36630579</span></a>]<div><i>(Concise description of drugs approved for use in chronic insomnia including relative efficacy, safety and costs, mentions that orexin receptor inhibitors improve latency to falling asleep by 5-10 minutes and duration of sleep to waking by 15-25 minutes compared to placebo and that the most common adverse events are somnolence, fatigue, headache, and abnormal dreams; no mention of ALT elevations or hepatotoxicity).</i></div></div></li><li><div class="bk_ref" id="Suvorexant.REF.pan.2023.587">Pan
|
|
B, Ge
|
|
L, Lai
|
|
H, Hou
|
|
L, Tian
|
|
C, Wang
|
|
Q, Yang
|
|
K, et al.
|
|
The comparative effectiveness and safety of insomnia drugs: a systematic review and network meta-analysis of 153 randomized trials.
|
|
Drugs.
|
|
2023;83:587-619.
|
|
[<a href="https://pubmed.ncbi.nlm.nih.gov/36947394" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 36947394</span></a>]<div><i>(Systematic review of the literature on the safety of drugs for insomnia identified 61 trials with 25,093 patients, and while the frequency of common adverse events varied, “with respect to serious and drug related adverse events, there were no differences among the drugs’; no mention of liver related adverse events).</i></div></div></li></ul></div><div id="bk_toc_contnr"></div></div></div><div class="fm-sec"><h2 id="_NBK547900_pubdet_">Publication Details</h2><h3>Publication History</h3><p class="small">Last Update: <span itemprop="dateModified">February 5, 2025</span>.</p><h3>Copyright</h3><div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright Notice</a></div></div><h3>Publisher</h3><p><a href="https://www.niddk.nih.gov/" ref="pagearea=page-banner&targetsite=external&targetcat=link&targettype=publisher">National Institute of Diabetes and Digestive and Kidney Diseases</a>, Bethesda (MD)</p><h3>NLM Citation</h3><p>LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012-. Suvorexant. [Updated 2025 Feb 5].<span class="bk_cite_avail"></span></p></div><div class="small-screen-prev"><a href="/books/n/livertox/Sunitinib/?report=reader"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M75,30 c-80,60 -80,0 0,60 c-30,-60 -30,0 0,-60"></path><text x="20" y="28" textLength="60" style="font-size:25px">Prev</text></svg></a></div><div class="small-screen-next"><a href="/books/n/livertox/Tacrine/?report=reader"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M25,30c80,60 80,0 0,60 c30,-60 30,0 0,-60"></path><text x="20" y="28" textLength="60" style="font-size:25px">Next</text></svg></a></div></article><article data-type="table-wrap" id="figobSuvorexantTc"><div id="Suvorexant.Tc" class="table"><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK547900/table/Suvorexant.Tc/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__Suvorexant.Tc_lrgtbl__"><table><thead><tr><th id="hd_h_Suvorexant.Tc_1_1_1_1" scope="col" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">DRUG</th><th id="hd_h_Suvorexant.Tc_1_1_1_2" scope="col" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">CAS REGISTRY NO</th><th id="hd_h_Suvorexant.Tc_1_1_1_3" scope="col" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">MOLECULAR FORMULA</th><th id="hd_h_Suvorexant.Tc_1_1_1_4" scope="col" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">STRUCTURE</th></tr></thead><tbody><tr><td headers="hd_h_Suvorexant.Tc_1_1_1_1" scope="row" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Suvorexant</td><td headers="hd_h_Suvorexant.Tc_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<a href="https://pubchem.ncbi.nlm.nih.gov/substance/135267387" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubchem">1030377-33-3</a>
|
|
</td><td headers="hd_h_Suvorexant.Tc_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<b>C23-H23-Cl-N6-O2</b>
|
|
</td><td headers="hd_h_Suvorexant.Tc_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
|
|
<a href="https://pubchem.ncbi.nlm.nih.gov/substance/135267387" title="View this structure in PubChem" class="img_link" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubchem"><img src="https://pubchem.ncbi.nlm.nih.gov/image/imgsrv.fcgi?t=l&sid=135267387" alt="image 135267387 in the ncbi pubchem database" /></a>
|
|
</td></tr></tbody></table></div></div></article></div><div id="jr-scripts"><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/libs.min.js"> </script><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.min.js"> </script></div></div>
|
|
|
|
|
|
|
|
|
|
<!-- Book content -->
|
|
|
|
<script type="text/javascript" src="/portal/portal3rc.fcgi/rlib/js/InstrumentNCBIBaseJS/InstrumentPageStarterJS.js"> </script>
|
|
|
|
|
|
<!-- CE8B5AF87C7FFCB1_0191SID /projects/books/PBooks@9.11 portal107 v4.1.r689238 Tue, Oct 22 2024 16:10:51 -->
|
|
<span id="portal-csrf-token" style="display:none" data-token="CE8B5AF87C7FFCB1_0191SID"></span>
|
|
|
|
<script type="text/javascript" src="//static.pubmed.gov/portal/portal3rc.fcgi/4216699/js/3968615.js" snapshot="books"></script></body>
|
|
</html>
|