Given the rarity of Non-24, most cardiology practitioners are unlikely to encounter this drug.
4 Cardiovascular side effects were not reported in tasimelteon clinical trials, and there are no documented significant drug interactions with common cardiology drugs. Tasimelteon is an orphan drug with a wholesale acquisition cost (WAC) of $270/capsule. Tasimelteon is dosed 20 mg prior to bedtime at the same time each night. 2,3 Non-24 is most common in totally blind patients, with an estimated US prevalence of 65-95 thousand patients. Tasimelteon is a melatonin (MT 1/MT 2) receptor agonist that is indicated for Non-24-Hour Sleep-Wake Syndrome (Non-24), a disorder in which circadian rhythm becomes unsynchronized with the 24-hour day-night cycle. Since the publication of the AASM guideline in 2008, two new drugs have been approved by the FDA for sleep disorders: tasimelteon in January 2014 and suvorexant in August 2014. 1 Over-the-counter antihistamines and herbal supplements are not recommended due to relative lack of efficacy and safety data. The American Academy of Sleep Medicine (AASM) guidelines for chronic insomnia recommend the use of short-intermediate acting benzodiazepine-receptor agonists, the melatonin receptor agonist ramelteon, sedating antidepressants if comorbid depression/anxiety, and other sedating agents when also needed for the medication's primary indication.
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