No drug-related findings in immune function assessments (immunophenotyping, NK activity, granulocyte function, cytokine release)
“There were no significant drug-related findings in any immune function assessments: Immunophenotyping, natural killer cell activity, peripheral blood granulocytes functions, cytokine release.”
✓ VerifiedFDA multi-discipline review, p. 64Source ↗
Biodistribution & persistence
Rapid wide distribution, highest in liver; no melanin accumulation; crosses BBB with CSF above plasma
“Lemborexant is rapidly and extensively distributed to tissues in rats and monkeys with the highest levels found in liver and no accumulation in melanin-containing tissues in rats. Lemborexant and its metabolites readily cross the blood brain barrier and drug concentrations in cerebral spinal fluid are higher than that of plasma.”
✓ VerifiedFDA multi-discipline review, p. 47Source ↗
Modality-specific risk
Bone and teeth toxicity in rats from fluoride released by metabolism (fluorosis); low human relevance
“The observed bone and teeth toxicity in rats may be the result of fluorosis caused by the release of fluoride during the metabolism of lemborexant; an increase in fluoride levels was observed in bones of rats following daily administration of lemborexant.”
✓ VerifiedFDA multi-discipline review, p. 48Source ↗