The orexin receptor (also referred to as the hypocretin receptor) is a G-protein-coupled receptor that binds the neuropeptide orexin. There are two variants, OX1 and OX2, each encoded by a different gene (HCRTR1, HCRTR2). Both orexin receptors exhibit a similar pharmacology – the 2 orexin peptides, orexin-A and orexin-B, bind to both receptors and, in each case, agonist binding results in an increase in intracellular calcium levels. However, orexin-B shows a 5- to 10-fold selectivity for orexin receptor type 2, whilst orexin-A is equipotent at both receptors. Several orexin receptor antagonists are in development for potential use in sleep disorders. The first of these, suvorexant, has been on the market in the United States since 2015. There were two orexin agonists under development as of 2025: oveporexton and TAK-360.
Ligands Several drugs acting on the orexin system are under development, either orexin agonists for the treatment of conditions such as narcolepsy, or orexin antagonists for insomnia. In August 2015, Nagahara et al. published their work in synthesizing the first HCRT/OX2R agonist, compound 26, with good potency and selectivity. No neuropeptide agonists are yet available, although synthetic orexin-A polypeptide has been made available as a nasal spray and tested on monkeys. One non-peptide antagonist is currently available in the U.S., Merck's suvorexant (Belsomra), two additional agents are in development: SB-649,868 by GlaxoSmithKline, for sleep disorders, and ACT-462206, currently in human clinical trials. Another drug in development, almorexant (ACT-078573) by Actelion, was abandoned due to adverse effects. Lemborexant, an orexin receptor antagonist, was approved for use in the United States in 2019. Most ligands acting on the orexin system so far are polypeptides modified from the endogenous agonists orexin-A and orexin-B, however there are some subtype-selective non-peptide antagonists available for research purposes.
Agonists
Non-selective Orexins – dual OX1 and OX2 receptor agonists Orexin-A – approximately equipotent at the OX1 and OX2 receptors Orexin-B – approximately 5- to 10-fold selectivity for the OX2 receptor over the OX1 receptor AEX-5 – selective OX1 receptor agonist; also a cathepsin H inhibitor and dopamine reuptake inhibitor AEX-19 – dual OX1 and OX2 receptor agonist AEX-24 – selective OX2 receptor agonist; also an "S1R" agonist
Selective Alixorexton (ALKS-2680) – selective oral OX2 receptor agonist ALKS-7290 – selective OX2 receptor agonist ALKS-4510 – selective OX2 receptor agonist Balumorexton (TAK-360) – selective OX2 receptor agonist Cleminorexton (ORX750) – selective OX2 receptor agonist Danavorexton (TAK-925) – selective OX2 receptor agonist Firazorexton (TAK-994) – selective OX2 receptor agonist Ledasorexton (E-2086) – selective OX2 receptor agonist Oveporexton (Orzeyful; TAK-861) – selective OX2 receptor agonist SB-668875 – selective OX2 receptor agonist Suntinorexton – selective OX2 receptor agonist PhotOrexin – photoswitchable orexin-B analogue to control the OX2 receptor at nanomolar concentration in vivo.
Antagonists
Non-selective Almorexant (ACT-078573) – dual OX1 and OX2 receptor antagonist Daridorexant (Quviviq; ACT-541468) – dual OX1 and OX2 receptor antagonist Filorexant (MK-6096) – dual OX1 and OX2 receptor antagonist GSK-649868 (SB-649868) – dual OX1 and OX2 receptor antagonist Lemborexant (Dayvigo) – dual OX1 and OX2 receptor antagonist Suvorexant (Belsomra) – dual OX1 and OX2 receptor antagonist Vornorexant (ORN-0829, TS-142) – dual OX1 and OX2 receptor antagonist
Selective ACT-335827 – selective OX1 receptor antagonist AZD-4041 – selective OX1 receptor antagonist CVN-766 – selective OX1 receptor antagonist EMPA – selective OX2 receptor antagonist JNJ-10397049 – selective OX2 receptor antagonist Nivasorexant (ACT-539313) – selective OX1 receptor antagonist Rocavorexant (C4X-3256; INDV-2000) – selective OX1 receptor antagonist RTIOX-276 – selective OX1 receptor antagonist SB-334867 – selective OX1 receptor antagonist SB-408124 – selective OX1 receptor antagonist Seltorexant (MIN-202, JNJ-42847922, JNJ-922) – selective OX2 receptor antagonist TCS-OX2-29 – selective OX2 receptor antagonist Tebideutorexant (JNJ-61393215; JNJ-3215) – selective OX1 receptor antagonist
See also List of investigational insomnia drugs List of investigational narcolepsy and hypersomnia drugs
References
External links "Orexin Receptors". IUPHAR Database of Receptors and Ion Channels. International Union of Basic and Clinical Pharmacology. Orexin+Receptors at the U.S. National Library of Medicine Medical Subject Headings (MeSH)
