Belsomra Interactions: Alcohol, Medications, and Others

When should I avoid Belsomra?

Certain health conditions or other factors could raise your risk of harm if you take Belsomra. In such cases, your doctor may not prescribe Belsomra for you. These are known as contraindications. The list below includes Belsomra contraindications.

If you have narcolepsy. Narcolepsy is a kind of sleep disorder. If you have narcolepsy, your doctor likely won’t prescribe Belsomra. It could make your narcolepsy symptoms worse. You can ask your doctor about other treatments that may be better options for you.

If you’ve had an allergic reaction. If you’ve had an allergic reaction to Belsomra or any of its ingredients, your doctor likely won’t prescribe Belsomra. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better options for you.

Before you start taking Belsomra, talk with your doctor if any of the factors above apply to you. Your doctor can determine whether Belsomra is safe for you to take.

Does Belsomra interact with alcohol?

Belsomra interacts with alcohol. Both Belsomra and alcohol slow the activity in your brain and nervous system. Combining them could cause excessive sleepiness, coordination problems (clumsiness), and an increased risk of falls.

If your doctor prescribes Belsomra, it’s important to avoid drinking alcohol. If you’ve had any alcohol to drink, you shouldn’t take Belsomra that evening. If you’re concerned about avoiding alcohol, talk with your doctor.

Does Belsomra interact with other drugs?

Before you start taking Belsomra, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions. (To learn whether Belsomra interacts with supplements, herbs, and vitamins, see the “Are there other interactions with Belsomra?” section below.)

If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.

The table below lists drugs that may interact with Belsomra. Keep in mind that this table doesn’t include all drugs that may interact with Belsomra.

* To learn more about Belsomra’s side effects, see this article.
† For more information about these interactions, see the “Drug interactions explained” section below.

Drug interactions explained

Keep reading to learn more about certain drug interactions that can occur with Belsomra.

Interaction with gabapentin

Gabapentin (Neurontin, Gralise) is an antiepileptic medication that’s also used to treat nerve pain.

Gabapentin and Belsomra are both central nervous system depressants. This means they slow activity in your brain and nervous system.

What could happen

Taking Belsomra with gabapentin could cause excessive sleepiness, slow and shallow breathing, coordination problems (clumsiness), and an increased risk of falls. These effects may continue the day after taking Belsomra.

What you can do

If your doctor prescribes Belsomra with gabapentin, tell your doctor if you experience any of the side effects mentioned above. If needed, your doctor may lower your dosage of Belsomra or gabapentin.

If you feel sleepy, groggy, or less alert while taking Belsomra with gabapentin, you shouldn’t drive or do other potentially dangerous activities. These effects may continue the day after taking Belsomra.

Interaction with opioids

Opioids are strong prescription pain relievers. Doctors might sometimes prescribe Belsomra with an opioid.

Opioids and Belsomra are both central nervous system depressants. This means they slow activity in your brain and nervous system.

Examples of opioid medications:

• codeine
• hydrocodone (Hysingla ER)
• oxycodone (Oxycontin)
• tramadol (Qdolo, Conzip)

What could happen

If you take Belsomra with an opioid, you may have excessive sleepiness, slow and shallow breathing, coordination problems (clumsiness), and an increased risk of falls. These effects may continue the day after taking Belsomra.

What you can do

If your doctor prescribes Belsomra with an opioid, they may recommend keeping a supply of naloxone (Narcan). Narcan is a nasal spray that can reverse the effects of opioids in an emergency.

While taking Belsomra with an opioid, tell your doctor if you have any of the side effects mentioned above. Your doctor may lower your dosage of Belsomra or the opioid.

If you feel sleepy, groggy, or less alert while taking Belsomra with an opioid, you shouldn’t drive or do other potentially dangerous activities. These effects may continue the day after taking Belsomra.

Interaction with certain antibiotics

Antibiotics are used to treat bacterial infections. If you have an infection, your doctor may prescribe an antibiotic.

Certain antibiotics can stop your body from breaking down Belsomra as well as usual. This can make Belsomra build up in your body.

Examples of antibiotic medications that can interact with Belsomra include:

• clarithromycin
• erythromycin (Ery-Tab, EryPed)
• ciprofloxacin (Cipro)

What could happen

Taking Belsomra with one of the antibiotics listed above could raise your risk of Belsomra side effects.

What you can do

Be sure to tell your doctor about all medications you’re currently taking. Before prescribing a new medication, your doctor will check whether interactions are possible.

Due to the risk of side effects, your doctor may not prescribe certain antibiotics with Belsomra. Or your doctor may recommend that you take a lower dosage of Belsomra while taking certain antibiotics.

Are there other interactions with Belsomra?

Belsomra may have other interactions. They could occur with supplements, foods, vaccines, or even lab tests. See below for details. Note that the information below does not include all other possible interactions with Belsomra.

Does Belsomra interact with supplements?

Before you start taking Belsomra, talk with your doctor and pharmacist about any supplements, herbs, and vitamins you take. Sharing this information with them may help you avoid possible interactions.

Belsomra interactions with supplements

Melatonin. You should avoid taking Belsomra with melatonin. Taking both drugs could cause excessive sleepiness. It may also raise your risk of certain side effects. These side effects include problems with coordination (clumsiness) or memory problems. They can also include unusual sleep behaviors such as sleepwalking or sleep-driving.

If you have questions about other interactions that may affect you, talk with your doctor or pharmacist.

Belsomra interactions with herbs

St. John’s wort. Taking Belsomra with St. John’s wort can make your liver breakdown Belsomra faster than usual. This could make Belsomra less effective. You should avoid taking Belsomra with St. John’s wort.

Valerian. You should avoid taking Belsomra with valerian. Taking Belsomra with valerian could cause excessive sleepiness.

If you have questions about any other herbs you take and possible interactions with Belsomra, talk with your doctor or pharmacist.

Belsomra and vitamins

There are currently no reports of Belsomra interacting with vitamins. But this doesn’t mean that vitamin interactions won’t be recognized in the future.

For this reason, it’s still important to check with your doctor or pharmacist before taking any of these products while taking Belsomra.

Does Belsomra interact with food?

Grapefruit. Consuming grapefruit or grapefruit juice with Belsomra can increase the amount of Belsomra in your body. This can raise your risk of its side effects.

You should avoid consuming grapefruit or grapefruit juice with Belsomra. If you’re unable to avoid grapefruit, tell your doctor. They’ll likely prescribe a Belsomra dosage that’s lower than usual.

Caffeine. Caffeine is a stimulant that can interfere with sleep. Consuming caffeine-containing foods or drinks with Belsomra could make Belsomra less effective.

While taking Belsomra to help you sleep, you should avoid consuming caffeine-containing foods or drinks in the afternoon and evening. Examples include:

• coffee
• tea
• certain sodas
• green tea
• energy drinks
• chocolate

If you have questions about consuming any other foods or drinks with Belsomra, talk with your doctor.

Does Belsomra interact with vaccines?

There are currently no reports of Belsomra interacting with vaccines. If you have questions about receiving certain vaccines during your treatment with Belsomra, talk with your doctor.

Does Belsomra interact with lab tests?

There are currently no reports of Belsomra interacting with lab tests. If you have questions about having lab tests during your treatment with Belsomra, talk with your doctor.

Does Belsomra interact with cannabis or CBD?

There are currently no reports of Belsomra interacting with cannabis (commonly called marijuana) or cannabis products such as cannabidiol (CBD). But both Belsomra and cannabis slow activity in your brain and nervous system. So, taking Belsomra with cannabis or cannabis products could cause excessive sleepiness or slowed reactions.

As with any drug or supplement, talk with your doctor before using cannabis with Belsomra.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Does my health history affect whether I should take Belsomra?

Certain medical conditions or other health factors may raise the risk of interactions with Belsomra. Before taking Belsomra, talk with your doctor about your health history. They’ll determine whether Belsomra is right for you.

Health conditions or other factors that might interact with Belsomra include:

Narcolepsy. Belsomra may worsen narcolepsy. If you have narcolepsy, your doctor will likely not prescribe Belsomra. See “When should I avoid Belsomra” above for more details.

Mental health conditions such as depression. If you have a mental health condition such as depression, Belsomra may increase your risk of suicidal thoughts or behaviors. Talk with your doctor about whether Belsomra is right for you. If you do take Belsomra and have any changes in your mood, thoughts, or behavior, tell your doctor right away.

Drug or alcohol misuse. Belsomra is a Schedule IV controlled substance, which means it has a low risk of misuse and dependence.With misuse, a drug is taken in a way other than how a doctor prescribes it. With dependence, your body needs the drug to function as usual. If there has been drug misuse in the past, talk with your doctor about whether Belsomra is right for you.

Cataplexy. Belsomra can sometimes cause temporary muscle weakness. Cataplexy causes a similar symptom. If you have cataplexy, talk with your doctor about whether Belsomra is right for you.

Breathing problems. Belsomra could worsen breathing problems such as sleep apnea and chronic obstructive pulmonary disease (COPD). If you have a lung or breathing problem, talk with your doctor about whether Belsomra is right for you.

Older age. Belsomra can cause sleepiness and coordination problems (clumsiness) that may continue the day after taking it. It may also make you feel dizzy. If you’re 65 years or older, these side effects may increase your risk of a fall.

Liver problems. Your liver helps to clear Belsomra from your body. If you have severe liver problems, Belsomra could build up in your body. This could raise your risk of side effects. Due to this risk, your doctor will likely not prescribe Belsomra if you have severe liver problems. You can ask them about other treatments that may be better choices for you.

Pregnancy. It’s not known whether it’s safe to take Belsomra during pregnancy. If you’re pregnant or plan to become pregnant, your doctor will likely recommend that you don’t take Belsomra. You can ask your doctor about other possible treatment options.

Breastfeeding. It’s not known whether Belsomra can pass into breast milk or affect a child who’s breastfed. If you’re breastfeeding or plan to breastfeed, your doctor will likely recommend that you don’t take Belsomra. You can ask your doctor about other possible treatment options.

Allergic reaction. If you’ve had an allergic reaction to Belsomra or any of its ingredients, your doctor will likely not prescribe Belsomra. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better choices for you.

How can I prevent interactions?

Taking certain steps can help you avoid interactions with Belsomra. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:

• Whether you drink alcohol or use cannabis.
• Other medications you take, as well as any vitamins, supplements, and herbs. Your doctor or pharmacist can help you fill out a medication list.
• What to do if you start taking a new drug during your Belsomra treatment.

It’s also important to understand Belsomra’s label and other paperwork that may come with the drug. Colored stickers that describe interactions may be on the label. And the paperwork (sometimes called the patient package insert or medication guide) may have other details about interactions. (If you did not get paperwork with Belsomra, ask your pharmacist to print a copy for you.)

If you have trouble reading or understanding this information, your doctor or pharmacist can help.

Taking Belsomra exactly as prescribed can also help prevent interactions.

What should I ask my doctor?

If you still have questions about Belsomra and its possible interactions, talk with your doctor.

Questions you may want to ask your doctor include:

• Is it safe to take Belsomra with over-the-counter pain relievers?
• Does my risk of interactions depend on my dosage of Belsomra?
• Can I still take Belsomra if I’m over 65 years old?
• Do other insomnia treatments have similar interactions?

To learn more about Belsomra, see these articles:

• All About Belsomra
• Side Effects of Belsomra: What You Need to Know
• Belsomra and Cost: What You Need to Know

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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.