Wakix Dosages: Your GoodRx Guide

If you or a loved one is living with narcolepsy, you know how challenging it can be. Excessive daytime sleepiness can make it more difficult to get things done. And symptoms can come at any time, when you're least expecting them.

Wakix (pitolisant) is a prescription medication that's FDA approved for narcolepsy symptoms in adults and children ages 6 years and older. It's the only approved narcolepsy treatment that isn't a controlled substance.

Wakix comes in either 4.45 mg or 17.8 mg oral tablets.

Here, we'll review the recommended Wakix dosages and what to do if you miss a dose.

What's the typical Wakix dosage for adults?

Wakix is approved for excessive daytime sleepiness or cataplexy in adults. Cataplexy is a sudden loss of muscle tone that can result in falls for some people.

The recommended Wakix dosage for adults is 17.8 mg to 35.6 mg once daily in the morning.

You'll typically start with a lower dosage and increase it based on the following schedule:

• Week 1: Two 4.45 mg tablets (8.9 mg) once daily in the morning.

• Week 2: One 17.8 mg tablet once daily in the morning.

• Week 3: If needed, increase to two 17.8 mg tablets (35.6 mg) once daily in the morning. Doses over 35.6 mg daily aren't recommended.
  It can take up to 8 weeks to get the full benefits of Wakix. So stick with it, even if you don't notice a change in your symptoms right away.

Good to know: Wakix can make birth control pills less effective. If you're taking birth control pills to prevent pregnancy, be sure to use a nonhormonal backup method (such as condoms) while taking Wakix and for 21 days after stopping the medication.

What's the typical Wakix dosage for children?

The recommended Wakix dosage for children ages 6 and older with excessive daytime sleepiness starts at 4.45 mg once daily in the morning. As in adults, the dose can be increased as needed according to the following schedule:

• Week 1: One 4.45 mg tablet once daily in the morning.

• Week 2: Two 4.45 mg tablets (8.9 mg) once daily in the morning.

• Week 3: One 17.8 mg tablet by mouth once daily in the morning. This is the maximum recommended dose for children who weigh less than 40 kg (88 lbs).

• Week 4: For kids weighing 40 kg or more, the dosage can be increased to two 17.8 mg tablets (35.6 mg) once daily if needed. Doses over 35.6 mg aren't recommended.

Are there any dosage adjustments for medical conditions?

People with certain health conditions may need to take a different Wakix dosage. These include people with liver problems, kidney problems, and genetic differences.

Dosage for people with liver problems

Wakix is broken down in the liver so your body can get rid of the medication. If you have liver problems, Wakix can build up in your body more quickly. That can increase your risk for side effects.

You won't need a different dosage if you have mild liver problems. But moderate liver problems require a lower dosage. Wakix dosages over 17.8 mg daily (8.9 mg for children who weigh under 40 kg) aren't recommended. And you'll likely need to wait 2 weeks between dosage changes, instead of just 1 week. If you have severe liver problems, Wakix isn't recommended.

Your prescriber will let you know what Wakix dosage is appropriate for you.

Dosage for people with kidney problems

If you have mild kidney problems, you should be able to take the usual Wakix dosage. But more serious kidney problems can affect how your body clears Wakix. So doses over 17.8 mg per day (8.9 mg in children who weigh less than 40 kg) aren't recommended. If you have severe kidney problems, Wakix may not be the best medication for you.

Your prescriber will determine the best Wakix dosage based on your kidney function.

Dosage for CYP2D6 poor metabolizers

CYP2D6 is a liver enzyme that breaks down some medications, including Wakix. Some people have a CYP2D6 enzyme that doesn't work as well as usual. They're known as poor metabolizers, because they have difficulty breaking down (metabolizing) certain medications. As with liver and kidney problems, this can cause Wakix levels to build up, which can lead to side effects.

If genetic tests show that you're a CYP2D6 poor metabolizer, Wakix dosages over 17.8 mg per day (8.9 mg in children who weigh less than 40 kg) aren't recommended. Your prescriber will let you know if this applies to you.

Good to know: Certain medications can raise or lower Wakix levels due to a drug interaction. You may need a different Wakix dosage than usual if you're taking one of these medications. Be sure to show your full medication list to your prescriber before starting Wakix. This will ensure they're aware of any potential interactions, so they can adjust your Wakix dosage accordingly.

What happens if you miss a dose of Wakix?

If you miss a dose of Wakix, skip the missed dose. Take your regular dose the following morning when you wake up. Don't take Wakix later in the day, because it could keep you up at night. And don't take two doses the next day to make up for the missed dose.

Narcolepsy may make it harder for you to remember to take your medication every day. So it may be helpful to use a pillbox or medication reminder app. You can also try setting an alert on your phone for the time you usually wake up. Talk to your prescriber if you miss more than one dose of Wakix in a row or consistently have trouble remembering to take it.

What should you do if you take too much Wakix?

If you accidentally take an extra dose of Wakix, it's unlikely to be an issue. You may experience more side effects, such as headache, nausea, or insomnia.

But large amounts of Wakix may cause more serious problems, such as a dangerously slow or irregular heartbeat. If you or a loved one takes more Wakix than prescribed, seek medical care or call Poison Control at 1-800-222-1222 for guidance. Call 911 if your symptoms feel severe or life-threatening.

How to save on Wakix

There are ways to save on Wakix, which is only available as a brand-name medication. If you have commercial insurance, you may be eligible to pay as little as $0 for Wakix using a savings program from the manufacturer.

Wakix is a limited distribution medication. This means it may not be available at your local pharmacy. In most cases, your prescriber will work with a specialty pharmacy to fill your prescription and ship it to you. Their staff is trained to help you find the best price for your Wakix prescription.