Skip to main content
MyDeficiencies

Solriamfetol

Dopamine-norepinephrine reuptake inhibitor, wakefulness agent

Also sold as Sunosi.

Analyze another medication Medication directory

Findings for this medication

Research about this medication, graded for how strongly each finding can be attributed to it. Nothing here describes your own levels.

Solriamfetol has almost none of the classical machinery that produces drug-induced nutrient depletion. Per its FDA label, it is minimally metabolized, does not inhibit or induce any of the nine CYP450 isoforms tested, is not chelating or acid-suppressing, and roughly 95% of each dose leaves the body in urine as unchanged parent drug, mainly through active renal tubular secretion rather than glomerular filtration alone. That pharmacokinetic profile sets a low prior probability for any red- or orange-tier finding, and none was found.

Dopamine-norepinephrine reuptake inhibitor, wakefulness agent · ATC N06BA14 · also sold as Sunosi · reviewed 2026-10-02. This describes research about the medication. It does not say anything about your own levels or health.

How to read the evidence grades

These colours describe how strongly a finding can be attributed to the medication in the research. They are not a severity score and they say nothing about your own health.

Grades describe how strongly a finding can be attributed to Solriamfetol in the research — not how common it is, how serious it would be, and not anything about you personally.

Red — Severe
Two or more independent Tier A sources, this drug in the cohort, the nutrient directly measured, consistent direction, clinically meaningful magnitude, a named mechanism, no substantial contradicting Tier A evidence.
Orange — Moderate
At least one Tier A source with this drug in the cohort showing a real but bounded deficit: an exposure window, a subgroup, low frequency, or a functional rather than circulating deficit.
Yellow — Low
Mechanistic plausibility only (Tier B), or class extrapolation (Tier C) with no drug-specific human status data; also used for context flags and interactions running the other direction.
Not graded — disclosed evidence gap
Nothing has been measured here, so this finding cannot be graded. That does not establish either safety or harm, and it is not the same as a White result.Source definition: Not gradeable under the rules above because nothing has been measured. Published as a documented gap, never as reassurance that there is no effect.

What the research found

Carnitine - low-avidity transporter engagement (theoretical)

Yellow — Low

See study details

Solriamfetol's labeled low-avidity engagement of the renal carnitine transporters OCTN1 and OCTN2 is a real, named, drug-specific pharmacokinetic fact, but no study has measured carnitine status in anyone taking the drug, so the depletion question itself remains theoretical.

Full detail and limits

What the grade means here: Mechanistic plausibility only (Tier B), or class extrapolation (Tier C) with no drug-specific human status data; also used for context flags and interactions running the other direction. yellow

Limits on what this shows

  • Key negative/null findings: None reported, because no study has measured the outcome either way; this is an absence of data, not a confirmed null result.
  • At-risk subgroups: None established. If the mechanism were ever shown to be real, it would be expected to concentrate in renal impairment, where both solriamfetol exposure and transporter engagement increase.
  • Counter-evidence on record: The label's "low-avidity" characterization of the transporter interaction itself argues against meaningful competition with endogenous carnitine at therapeutic doses.

Regulatory status

FDA label and DailyMed both describe solriamfetol as a "low-avidity substrate" of renal transporters OCT2, MATE1, OCTN1, and OCTN2. Neither mentions carnitine, carnitine deficiency, or any functional consequence.

Population evidence

None located. No interventional or observational study measuring plasma free carnitine, acylcarnitine ratio, or any carnitine-deficiency marker in solriamfetol-treated patients was found via Crossref (clean zero result) or the other channels listed under Sources.

Mechanism

Named but unconfirmed. OCTN2 is the principal high-affinity transporter for cellular and renal-tubular carnitine handling; a co-substrate at the same transporter could, in principle, compete for capacity. The label's own "low-avidity" wording is the strongest argument against this being clinically meaningful at labeled doses.

Counter-evidence held on record

Theoretical only. Do not recommend carnitine supplementation on the basis of this entry. If this is ever investigated, a validated functional marker (plasma free carnitine or acylcarnitine ratio) would be required before the claim could move above yellow.

Caloric and micronutrient intake - appetite suppression and weight loss (outcome-derived, bounded)

Yellow — Low

See study details

Decreased appetite and weight loss are labeled, drug-specific adverse effects of solriamfetol; by themselves they are behavioral outcomes, not evidence of a deficiency in any specific vitamin, mineral, or other nutrient.

Full detail and limits

What the grade means here: Mechanistic plausibility only (Tier B), or class extrapolation (Tier C) with no drug-specific human status data; also used for context flags and interactions running the other direction. yellow

Limits on what this shows

  • Key negative/null findings: No study has measured a resulting micronutrient deficit in solriamfetol users; this entry is a theoretical downstream consequence of a real, measured behavioral effect, not a confirmed nutrient finding. Pivotal trials (up to 12 weeks) showed only modest group-mean weight change, and discontinuation for this effect was uncommon.
  • At-risk subgroups: Patients already at nutritional risk (older adults, low baseline body weight, restrictive diets) on long-term therapy at the 150 mg dose.
  • Counter-evidence on record: Short-term pivotal-trial data show only a modest average weight effect; this is not a large-magnitude, uniformly-experienced effect.

Regulatory status

FDA label and DailyMed report decreased appetite in roughly 1-9% of patients across narcolepsy and obstructive-sleep-apnea trials, dose-dependent, and weight decreased in under 2%. The consumer monograph on Drugs.com corroborates a 2-8% appetite-decrease rate and under-2% weight-loss rate, and notes that higher doses may worsen appetite loss.

Population evidence

Phase 3 randomized trials in narcolepsy and obstructive sleep apnea (cohort: solriamfetol, 37.5-150 mg), per label. Frequencies are dose-dependent. No micronutrient panel was collected in these trials, so no specific nutrient deficit was ever measured.

Mechanism

Appetite suppression via dopamine/norepinephrine reuptake inhibition. Labeled class extrapolation: bupropion and amphetamine-class stimulants, which share the broad dopaminergic/noradrenergic appetite-suppression pathway, have their own real Tier A appetite and weight data in their own cohorts, which supports the plausibility of this pathway in general; those drugs differ from solriamfetol in receptor and release profile, so this is cited as mechanistic plausibility, not as direct evidence for solriamfetol.

Counter-evidence held on record

This is an outcome-derived, bounded concern, not a diagnosed deficiency in any named nutrient, per Hard Rule 2. No specific supplement is indicated. The appropriate response is monitoring overall weight and dietary intake, not treating any single nutrient.

The five body-system areas

Each finding is counted once, in a single area. Where a study is mentioned in a second area it is context only.

Mitochondrial Burden

Each finding below is counted once, in this area only.

Mitochondrial burden

Not graded — disclosed evidence gap

See study details

No drug-specific or genuinely class-verifiable evidence links solriamfetol to mitochondrial structure, membrane integrity, electron transport, or biogenesis.

Full detail and limits

What the grade means here: Nothing has been measured here, so this finding cannot be graded. That does not establish either safety or harm, and it is not the same as a White result. ungraded

Limits on what this shows

  • Why no grade: Dual condition met and now corroborated on two independent reachable channels (Crossref and, on this second pass, PubMed), both a clean zero-hit rather than a block, with no circulating consumer claim about solriamfetol and mitochondrial harm found in the consumer reference checked (Drugs.com). Europe PMC, OpenAlex, and Semantic Scholar remain blocked across both review passes, consistent with a persistent org-level network restriction on this project rather than a one-off block; a later revision with working access to those specific hosts should still re-check this category, though the two-channel clean-zero result makes a genuine literature gap the more likely reading.

Mechanism screen

No named mechanism from the label: no CYP induction, no conjugation pathway, no documented direct mitochondrial chemistry.

Channels tried

Crossref REST API (combined query across mitochondria/oxidative stress/carnitine/iron/copper/microbiome) - reachable, clean zero drug-specific hits. PubMed search-listing page, query "solriamfetol mitochondria" - blocked by a bot-verification challenge on the first review pass; reachable on this second pass and returned an explicit "No results were found" page (a genuine zero-hit, not a block). Europe PMC REST API - rejected at the proxy/policy level (HTTP 429) on both passes. OpenAlex works search, repeated query forms across both passes - reached the target but rate-limited by OpenAlex itself (HTTP 429) every time. Semantic Scholar Graph API - reached the target but rate-limited (HTTP 429) on both passes. DailyMed/FDA label reviewed directly - no mitochondrial content.

Oxidative Stress

Each finding below is counted once, in this area only.

Oxidative stress

Not graded — disclosed evidence gap

See study details

No drug-specific evidence connects solriamfetol to systemic or tissue-level oxidative stress or antioxidant-capacity markers, and no mechanism is named.

Full detail and limits

What the grade means here: Nothing has been measured here, so this finding cannot be graded. That does not establish either safety or harm, and it is not the same as a White result. ungraded

Limits on what this shows

  • Why no grade: Dual condition met and corroborated on two independent reachable channels (Crossref and, on this second pass, PubMed), both clean zero-hit, with no circulating claim found. Europe PMC, OpenAlex, and Semantic Scholar remain a disclosed, persistent tooling limitation across both review windows, not a confirmed literature absence on those specific hosts.

Mechanism screen

Solriamfetol does not undergo oxidative hepatic metabolism and has no documented pro- or antioxidant chemistry in its label.

Channels tried

Same channel set as mitochondrial burden: Crossref clean zero (both passes); PubMed query "solriamfetol oxidative stress" blocked by bot-verification on the first pass, reachable on this second pass with an explicit "No results were found" page; Europe PMC blocked (HTTP 429, proxy/policy level, both passes); OpenAlex blocked (HTTP 429, target level, both passes); Semantic Scholar blocked (HTTP 429, target level, both passes); label reviewed directly, no mention.

Copper and Iron Balance

Copper and iron are assessed separately. Nothing here is counted twice.

Copper

Not graded — disclosed evidence gap

See study details

No drug-specific evidence connects solriamfetol to copper status, ceruloplasmin, or copper-dependent enzymes, and no mechanism is named.

Full detail and limits

What the grade means here: Nothing has been measured here, so this finding cannot be graded. That does not establish either safety or harm, and it is not the same as a White result. ungraded

Limits on what this shows

  • Why no grade: Dual condition met and corroborated on two independent reachable channels (Crossref and, on this second pass, PubMed), with no circulating claim found in the consumer reference checked. The ceruloplasmin-specific follow-up remains tooling-limited and is disclosed as such rather than treated as an additional clean result.

Mechanism screen

No chelation, no hepatic copper-handling effect, and no copper-dependent enzyme interaction documented in the label.

Channels tried

Crossref combined query (including copper as a search term) - clean zero drug-specific hits on the first pass. A dedicated Crossref query ("solriamfetol copper") on this second pass returned only broad relevance-ranked matches (hundreds of thousands of total results); the only two results actually titled "solriamfetol" were a generic BNF formulary entry and a pharmacology-textbook chapter, neither copper-specific. A dedicated PubMed query ("solriamfetol copper") was blocked by bot-verification on the first pass and reachable on this second pass, returning an explicit "No results were found" page. A follow-up PubMed query ("solriamfetol ceruloplasmin") was rate-limited (HTTP 429) this pass before returning a result. Europe PMC, OpenAlex, and Semantic Scholar remained blocked or rate-limited on both passes.

Iron

Not graded — disclosed evidence gap

See study details

No drug-specific evidence connects solriamfetol to iron status, ferritin, or hemoglobin synthesis; the label documents no gastrointestinal blood-loss signal or hepcidin-pathway effect.

Full detail and limits

What the grade means here: Nothing has been measured here, so this finding cannot be graded. That does not establish either safety or harm, and it is not the same as a White result. ungraded

Limits on what this shows

  • Why no grade: Dual condition met on the Crossref channel (no iron-specific drug content found on either pass), with no circulating claim found. Unlike mitochondrial burden, oxidative stress, copper, gut microbiome risk, and oxygen delivery/utilization, iron has not yet gotten a clean, non-blocked PubMed read on either review pass; this is disclosed explicitly as a continuing tooling limitation specific to this category, not a confirmed PubMed zero-result search.

Mechanism screen

No absorption-interference, no GI bleeding signal, no hepcidin or iron-regulatory pathway effect documented.

Channels tried

A dedicated PubMed query ("solriamfetol iron") returned a bot-verification/reCAPTCHA challenge page on the first pass; a repeat attempt on this second pass, plus a further dedicated query ("solriamfetol ferritin"), were both rejected at the proxy level (HTTP 429) rather than returning a clean result. So iron has never actually gotten a clean PubMed read across two passes, unlike the five categories that did. The combined Crossref query (including iron as a term) returned a clean zero on the first pass. A dedicated Crossref query ("solriamfetol iron") on this second pass returned only broad relevance-ranked matches (hundreds of thousands of total results), with the only two results titled "solriamfetol" being a generic BNF formulary entry and a pharmacology-textbook chapter, neither iron-specific. Europe PMC, OpenAlex, and Semantic Scholar were blocked or rate-limited on both passes.

Gut Microbiome Risk

Each finding below is counted once, in this area only.

Gut microbiome risk

Not graded — disclosed evidence gap

See study details

No study has measured gut microbiome composition or function in solriamfetol-treated patients. The label's gastrointestinal adverse effects (nausea, dry mouth, constipation, diarrhea) are symptom reports, not microbiome measurements, and do not by themselves establish a mechanism.

Full detail and limits

What the grade means here: Nothing has been measured here, so this finding cannot be graded. That does not establish either safety or harm, and it is not the same as a White result. ungraded

Limits on what this shows

  • Why no grade: Dual condition met and corroborated on two independent reachable channels (Crossref on the first pass, PubMed on this second pass), both clean zero-hit, with no circulating claim found in the consumer reference checked.

Mechanism screen

No antibiotic-like or gut-flora-targeting activity documented. Labeled GI adverse effects are symptom-level only; altered transit time was considered as a possible indirect route to microbiome change but no study has tested it, so it is not entered as a confirmed mechanism per the project's prohibition on softening an absent mechanism into a possible one.

Channels tried

A dedicated PubMed query ("solriamfetol microbiome OR gut bacteria") was rate-limited before returning a result on the first pass. On this second pass, a dedicated PubMed query ("solriamfetol gut microbiome") was reachable and returned an explicit "No results were found" page; a further query ("solriamfetol microbiota") was rate-limited (HTTP 429). The combined Crossref query (including microbiome as a term) returned a clean zero on the first pass; a dedicated Crossref query ("solriamfetol microbiome gut bacteria") on this second pass was rate-limited (HTTP 429). Europe PMC, OpenAlex, and Semantic Scholar were blocked or rate-limited on both passes.

Oxygen and ATP Output

Oxygen delivery and ATP production are assessed separately. Nothing here is counted twice.

Oxygen delivery/utilization

Not graded — disclosed evidence gap

See study details

No drug-specific evidence on hemoglobin, hematocrit, red-cell mass, arterial oxygenation, or tissue oxygen delivery was found for solriamfetol.

Full detail and limits

What the grade means here: Nothing has been measured here, so this finding cannot be graded. That does not establish either safety or harm, and it is not the same as a White result. ungraded

Limits on what this shows

  • Why no grade: Dual condition met and corroborated on two independent reachable channels (Crossref and, on this second pass, PubMed), both clean zero-hit, with no circulating claim found.

Mechanism screen

Solriamfetol's labeled dose-dependent increases in blood pressure and heart rate are its own sympathomimetic pharmacodynamic effect, documented in the Pharmacokinetic basis section above. Per Hard Rule 2, this is written up as a mechanism clarification, not filed here as an oxygen-delivery nutrient deficiency.

Channels tried

A dedicated Crossref query combining solriamfetol with hemoglobin, hematocrit, oxygen saturation, ATP, and energy metabolism returned a clean zero on the first pass. A dedicated PubMed query ("solriamfetol oxygen saturation hemoglobin") was reachable on this second pass and returned an explicit "No results were found" page. A further Crossref query ("solriamfetol hemoglobin erythropoiesis red blood cell") on this second pass returned only broad relevance-ranked matches (over 4 million total results), with the displayed items being unrelated sickle-cell-disease papers on erythropoiesis and fetal hemoglobin, not solriamfetol content. Europe PMC, OpenAlex, and Semantic Scholar were blocked or rate-limited on both passes. The label itself was reviewed directly and reports no hematologic laboratory findings.

ATP production

Not graded — disclosed evidence gap

See study details

No study measures mitochondrial ATP synthesis or cellular energy output specifically in solriamfetol-treated patients or tissue.

Full detail and limits

What the grade means here: Nothing has been measured here, so this finding cannot be graded. That does not establish either safety or harm, and it is not the same as a White result. ungraded

Limits on what this shows

  • Why no grade: Dual condition met on the one combined-query channel that returned a clean result (Crossref, first pass), with no circulating claim found. Every dedicated, ATP-specific query attempted on this second pass was blocked rather than clean, so ATP production remains, alongside iron, one of the two categories where the genuine-gap reading rests on a combined query rather than a dedicated one; this is disclosed explicitly so a later revision with working PubMed/Crossref access prioritizes a dedicated ATP-specific recheck. This category is distinct from mitochondrial burden and oxygen delivery/utilization and is not merged with either, per Hard Rule 7.

Mechanism screen

Sustained wakefulness and arousal could in principle raise overall metabolic turnover, but this is unfalsifiable as a nutrient-adjacent claim without a named, measured biomarker, and is not entered as a mechanism.

Channels tried

The same combined Crossref query used for oxygen delivery (hemoglobin/hematocrit/oxygen saturation/ATP/energy metabolism) returned a clean zero on the first pass. On this second pass, dedicated PubMed queries ("solriamfetol ATP" and "solriamfetol adenosine triphosphate") were both rejected at the proxy level (HTTP 429), and a dedicated Crossref query ("solriamfetol ATP adenosine triphosphate") was also rate-limited (HTTP 429) before returning a result. Europe PMC, OpenAlex, and Semantic Scholar were blocked or rate-limited on both passes.

How the body handles this medication

Metabolism
Minimally metabolized in humans; not a substrate of the nine major CYP450 isoforms tested, and does not inhibit CYP1A2, 2A6, 2B6, 2C8, 2C9, 2C19, 2D6, 2E1, or 3A4, nor induce CYP1A2, 2B6, 3A4, or UGT1A1 at clinically relevant concentrations.FDA label, accessdata.fda.gov, 2019 [1]
Elimination
Approximately 95% of a dose is recovered unchanged in urine; renal clearance proceeds mainly through active tubular secretion rather than passive filtration alone, with minor metabolites accounting for 1% or less.FDA label [1]; DailyMed [2]
Absorption and transport
Approximately 95% oral bioavailability; peak plasma concentration at about 2 hours; a high-fat meal delays time-to-peak by roughly 1 hour with minimal change to peak concentration or total exposure. Solriamfetol is a low-avidity substrate of the renal organic-cation/carnitine transporters OCT2, MATE1, OCTN1, and OCTN2. No antacid interaction is documented.FDA label [1]
Renal impairment
No dose adjustment for mild impairment (eGFR 60-89); start at 37.5 mg for moderate impairment (eGFR 30-59) with a 75 mg daily maximum; 37.5 mg daily maximum for severe impairment (eGFR 15-29); not recommended in end-stage renal disease (eGFR under 15).FDA label [1]; DailyMed [2]
Cardiovascular pharmacodynamics
Dose-dependent increases in systolic blood pressure (about 2.4 to 6.8 mmHg), diastolic blood pressure (about 1.8 to 4.2 mmHg), and heart rate (about 2.3 to 6.5 bpm). This is the drug's own labeled sympathomimetic effect, not an electrolyte or oxygen-delivery nutrient finding.DailyMed [2]
Interactions and special populations
Contraindicated with MAOIs or within 14 days of MAOI discontinuation (hypertensive-crisis risk, a timing interaction, not a depletion mechanism). Human pregnancy data are insufficient to establish risk; animal studies showed teratogenicity only at supratherapeutic multiples. Present in breast milk at a relative infant dose of about 5.5%. Pediatric safety and effectiveness are not established.DailyMed [2]

What the research says is worth watching

General information from the medication label and the studies above. It is not personal medical advice, and any change belongs with your prescriber.

  • Behavioral

    Weight and appetite

    Track body weight and appetite at baseline and periodically during therapy, particularly at the 150 mg dose or with long-term use.

  • Cardiovascular

    Blood pressure and heart rate

    Monitor per label. This is a cardiovascular safety parameter, not a nutrient marker, but relevant context for anyone on this drug.

  • Renal

    Renal function

    Check eGFR before and during therapy. Dose reductions are required in moderate or severe impairment; the drug is not recommended in end-stage renal disease.

  • Interaction

    MAOI washout

    A 14-day separation from MAOIs is required because of hypertensive-crisis risk. This is a timing interaction, not a nutrient depletion.

  • Theoretical

    Carnitine, if ever investigated

    No testing is routinely recommended on current evidence. If carnitine status is ever clinically indicated for another reason, use plasma free carnitine or acylcarnitine ratio, not a single blood level alone.

  • Special population

    Pregnancy and lactation

    Human pregnancy data are limited; the drug is present in breast milk at roughly 5.5% relative infant dose. Discuss with the prescriber; this is not a nutrient-replacement issue.

Overlap map, to prevent double counting

  • Carnitine (low-avidity OCTN1/OCTN2 engagement)

    Shares evidence with: Pharmacokinetic basis - "Absorption and transport" row

    Note: Both rest on the same FDA-label statement that solriamfetol is a low-avidity substrate of OCT2/MATE1/OCTN1/OCTN2. Do not count the pharmacokinetic fact and this entry as two independent confirmations.

  • Caloric and micronutrient intake (appetite suppression)

    Shares evidence with: Headline finding narrative; FDA label and DailyMed adverse-event tables; Drugs.com consumer monograph

    Note: The entry, the headline paragraph, and the consumer-claim audit all cite the same underlying decreased-appetite and weight-decreased frequency data. One underlying data source, not three independent ones.

  • Sibling dossiers in this batch

    Shares evidence with: None identified

    Note: No source or mechanism overlap was found with the other dossiers currently in this batch (several antipsychotics, two VMAT2 inhibitors, two dopamine agonists, an MAO-B inhibitor, a tricyclic antidepressant, and an anticholinergic). None share solriamfetol's dopamine-norepinephrine reuptake-inhibitor/wakefulness mechanism or any of the sources cited above.

  • Armodafinil (candidate cross-reference)

    Shares evidence with: None - no armodafinil dossier exists yet in this batch

    Note: Considered per the project's class-extrapolation cohort-test rule and explicitly not used: armodafinil's modafinil-class wakefulness mechanism (weak dopamine-transporter inhibition plus orexin/histamine-pathway effects) is pharmacologically distant from solriamfetol's classic reuptake-inhibitor profile. The class extrapolation actually used in this dossier (caloric/intake entry) draws instead on bupropion and amphetamine-class stimulants. If an armodafinil dossier is produced later in this batch, re-check for shared general-reference sources at that time.

All references used above
  1. FDA. SUNOSI (solriamfetol) tablets, prescribing information, initial approval label. — Regulatory label (Tier A). accessdata.fda.gov, 2019.Opened successfully for pharmacokinetic data. A later same-session re-fetch attempt to this host was blocked (HTTP 403, policy-level rejection) - noted for a future revision.
  2. DailyMed. SUNOSI (solriamfetol) tablet, label set, setid 362f206b-73e7-4009-8c34-5a9df55679ab. — Regulatory label (Tier A). National Library of Medicine, label updated 2026-05-05.Opened successfully for adverse-event, interaction, and special-population data. Later re-fetch attempts to this host in the same session were blocked (HTTP 403, policy-level rejection).
  3. Drugs.com. Sunosi (solriamfetol) consumer drug information. — Consumer reference (Tier D). Used only for the circulating-claim audit and as a cross-check on appetite/weight frequencies, not to support any grade above yellow.
  4. WHO Collaborating Centre for Drug Statistics Methodology. ATC/DDD Index, code N06BA14. — Confirms N06BA14 = solriamfetol.
  5. Crossref REST API. Query: solriamfetol AND (mitochondria OR oxidative stress OR carnitine OR iron OR copper OR microbiome). — Reachable; returned a clean zero drug-specific hits across all six terms.
  6. Crossref REST API. Query: solriamfetol carnitine OCTN2 transporter. — Reachable; returned a clean zero hits.
  7. Crossref REST API. Query: solriamfetol hemoglobin hematocrit oxygen saturation ATP energy metabolism. — Reachable; returned a clean zero hits.
  8. Crossref REST API. Query: solriamfetol weight appetite decreased. — Attempted for the appetite/weight entry.Could not be opened this session; rejected at the proxy level (HTTP 429, rate limit). Marked excluded/inaccessible; the appetite/weight entry instead relies on the FDA label and DailyMed directly.
  9. PubMed search-listing page. Query: solriamfetol nutrient. — Term search.Opened once; returned a clean "no results" page for this exact phrasing.
  10. PubMed search-listing page. Query: solriamfetol iron. — Term search.Blocked by a bot-verification/reCAPTCHA challenge on this access, not a clean zero-result page. Marked excluded/inaccessible.
  11. PubMed search-listing pages. Queries: solriamfetol OCTN2 carnitine; solriamfetol mitochondria; solriamfetol oxidative stress; solriamfetol copper; solriamfetol microbiome OR gut bacteria; solriamfetol weight loss appetite. — Six separate term searches, one per category/nutrient, attempted on the first review pass.All six were rejected at the proxy level (HTTP 429, rate limit) on the first pass. Four of the five Step-3-category queries (mitochondria, oxidative stress, copper, microbiome) were successfully re-run on the second (repair) pass - see the next entry.
  12. PubMed search-listing pages, repair-pass re-attempts. Queries: solriamfetol mitochondria; solriamfetol oxidative stress; solriamfetol copper; solriamfetol gut microbiome; solriamfetol oxygen saturation hemoglobin. — Five separate term searches, one per Step 3 category, attempted on the second (repair) review pass, 2026-10-02.All five were reachable this time and returned an explicit "No results were found" page (clean zero-hit, not a bot-check or rate limit).
  13. PubMed search-listing pages, repair-pass blocked re-attempts. Queries: solriamfetol iron; solriamfetol ferritin; solriamfetol ceruloplasmin; solriamfetol ATP; solriamfetol adenosine triphosphate; solriamfetol microbiota. — Six further term searches attempted on the second (repair) review pass, targeting iron, copper (secondary marker), and ATP production specifically.All six were rejected at the proxy level (HTTP 429, rate limit) this pass. Marked excluded/inaccessible; iron and ATP production remain the two categories with no clean PubMed read across either pass.
  14. Crossref REST API, repair-pass queries: solriamfetol copper; solriamfetol iron; solriamfetol hemoglobin erythropoiesis red blood cell. — Three dedicated single-term queries attempted on the second (repair) review pass.All three were reachable (not blocked) but returned broad relevance-ranked matches in the hundreds of thousands to millions of total results, since Crossref's query parameter does not perform a strict AND match. The only items actually titled "solriamfetol" were a generic BNF formulary entry and a pharmacology-textbook chapter, neither nutrient-specific; the top hemoglobin/erythropoiesis results were unrelated sickle-cell-disease papers. Treated as a non-specific, effectively null result for drug-specific content, not as a positive hit.
  15. Crossref REST API, repair-pass blocked queries: solriamfetol microbiome gut bacteria; solriamfetol ATP adenosine triphosphate. — Two further dedicated queries attempted on the second (repair) review pass.Both were rejected at the proxy level (HTTP 429, rate limit) this pass. Marked excluded/inaccessible; the gut-microbiome and ATP-production entries instead rely on the first pass's combined-query clean zero plus (for microbiome) the second pass's clean PubMed zero.
  16. Semantic Scholar Graph API, repair-pass query: solriamfetol nutrient. — Dedicated paper search attempted on the second (repair) review pass.Rejected with an HTTP 429 client error. Marked excluded/inaccessible, consistent with the first pass.
  17. OpenAlex API, repair-pass query: works search combining solriamfetol with iron, copper, microbiome, ATP, and mitochondria. — Combined works search attempted on the second (repair) review pass.Rejected with an HTTP 429 client error. Marked excluded/inaccessible, consistent with the first pass.
  18. Europe PMC REST API, repair-pass query: solriamfetol AND (copper OR iron OR ATP). — Dedicated search attempted on the second (repair) review pass.Rejected at the proxy/policy level (HTTP 429). Marked excluded/inaccessible, consistent with the first pass.
  19. ScienceDirect, Cureus, Frontiers, NCBI Bookshelf/StatPearls - repair-pass direct-publisher attempts. — Attempted direct site search for "solriamfetol" as an additional channel per the repair-pass instructions.ScienceDirect redirected to an institutional-login wall (not independently accessible). Cureus and the NCBI eutils API were disallowed by robots.txt. Frontiers' search page loaded but required client-side script execution that this tool could not complete, returning no results list. None of these channels produced a usable result either way; none are relied on for any grade.
  20. Europe PMC REST API. Query: solriamfetol AND (mitochondria OR "oxidative stress" OR iron OR copper OR microbiome OR carnitine). — Combined search query.Rejected at the proxy/policy level (HTTP 429). Marked excluded/inaccessible.
  21. OpenAlex API. Works search, two query forms: search=solriamfetol; filter=title.search:solriamfetol. — General works search and title-filtered search.Both reached OpenAlex itself but were rate-limited by OpenAlex (HTTP 429, target-level). Marked excluded/inaccessible; the single-record lookup endpoint was not used because no candidate DOI/PMID had yet been found.
  22. Semantic Scholar Graph API. Query: solriamfetol microbiome OR mitochondria OR oxidative stress OR iron OR copper. — Paper search.Reached Semantic Scholar but was rate-limited (HTTP 429, target-level). Marked excluded/inaccessible.
  23. NCBI Bookshelf / StatPearls, generic chapter fetch attempt. — Attempted to locate a solriamfetol-specific StatPearls chapter.No solriamfetol-specific chapter was confirmed to exist via the channels reachable this session; this is inconclusive rather than a confirmed absence, and is not relied on for any grade.