Pronunciation: e-ZOP-i-klone
Generic name: eszopiclone
Brand name: Lunesta
Dosage form: oral tablet (1 mg, 2 mg, 3 mg)
Drug class: Miscellaneous anxiolytics, sedatives and hypnotics

Medically reviewed by Carmen Pope, BPharm. Last updated on Nov 7, 2024.

What is eszopiclone?

Eszopiclone (brand name Lunesta) is a sedative, also called a hypnotic. It affects chemicals in your brain that may be unbalanced in people with sleep problems (insomnia).

Eszopiclone is used to treat insomnia. Symptoms include trouble falling asleep or waking up often during the night. Eszopiclone's effects typically begin within 30 minutes and it helps reduce the time it takes to fall asleep and increases the total time spent sleeping.

Eszopiclone's mechanism of action is thought to involve enhancing the effects of GABA, the main inhibitory neurotransmitter in the brain. This slows down brain activity and promotes sleep. Eszopiclone is not a benzodiazepine but it has benzodiazepine-like effects; notably a more selective binding profile that targets specific GABA receptors involved in sleep. Eszopiclone belongs to the drug class called non-benzodiazepine sedative-hypnotics.

Eszopiclone gained FDA approval on December 15, 2004, under the brand name Lunesta. Eszopiclone is a Schedule IV controlled substance which means there are limits on how much can be dispensed because of its potential for abuse and dependence.

• Keep eszopiclone in a safe place to prevent misuse and abuse.
• Selling or giving away eszopiclone may harm others and is against the law.

Eszopiclone is available as a generic and as the brand name Lunesta.

Eszopiclone side effects

The most common side effects of eszopiclone are:

• an unpleasant taste in the mouth or a dry mouth
• day-time drowsiness or a "hangover" feeling. You may still feel drowsy the next day after taking eszopiclone. Do not drive or do other dangerous activities after taking eszopiclone until you feel fully awake
• dizziness
• headache
• symptoms of the common cold.

Serious side effects and warnings

Eszopiclone carries a Boxed Warning for Complex Sleep Behaviors.

Complex Sleep Behaviors have caused serious injury and death. After taking eszopiclone, you may get up out of bed while not being fully awake and do an activity that you do not know you are doing (complex sleep behaviors). The next morning, you may not remember that you did anything during the night. These activities may occur with eszopiclone whether or not you drink alcohol or take other medicines that make you sleepy. Reported activities and behaviors include doing activities when you are asleep like:

• making and eating food
• talking on the phone
• having sex
• driving a car ("sleep-driving")
• sleep-walking.

Stop taking eszopiclone and call your healthcare provider right away if you find out that you have done any of the above activities after taking eszopiclone.

• See Is Ambien-Tweeting or Sleep-Tweeting a thing? for more information about complex sleep behaviors with nonbenzodiazepine hypnotics.

The morning after you take eszopiclone your ability to drive safely and think clearly may be decreased. You also may experience sleepiness during the day. Until you know how this medication will affect you during waking hours, be careful if you drive, operate machinery, pilot an airplane, or do anything that requires you to be awake and alert.

Worsening depression, including suicidal thoughts and actions, has been reported in patients with pre-existing depression in association with the use of sedatives such as eszopiclone. Tell your healthcare provider if your mood worsens or you have thoughts of harming yourself.

Eszopiclone will make you fall asleep. Never take this medication during your normal waking hours, unless you have at least 8 hours to dedicate to sleeping.

Do not drink alcohol while you are taking eszopiclone. It can increase some of the side effects, including drowsiness.

Eszopiclone may be habit-forming and should be used only by the person it was prescribed for. Eszopiclone should never be shared with another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it.

You may have withdrawal symptoms if you stop taking eszopiclone after taking it over several days in a row. Do not stop taking this medicine suddenly without first talking to your doctor. You may need to taper off the dosage (use less and less) before you stop the medication completely.

Eszopiclone may cause a severe allergic reaction. Stop taking eszopiclone and get emergency medical help if you have signs of an allergic reaction to eszopiclone such as hives; nausea, vomiting; difficulty breathing; or swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

• anxiety, depression, aggression, agitation;

• memory problems, unusual thoughts or behavior;

• thoughts of hurting yourself; or

• confusion, hallucinations (hearing or seeing things).

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Before taking

Do not take eszopiclone if you:

• are allergic to eszopiclone, Lunesta, or any of the inactive ingredients in the tablets
• have ever experienced a complex sleep behavior (such as driving a car, making and eating food, talking on the phone, or having sex while not fully awake) after taking eszopiclone or any other sleep medicine
• drank alcohol that evening or before bed
• take other medicines that can make you sleepy. Talk to your doctor about all of your medicines. Your doctor will tell you if you can take eszopiclone with your other medicines.
• cannot get a full night's sleep
• are younger than 18 years old.

Eszopiclone is not approved for use by anyone younger than 18 years old.

Before starting eszopiclone, tell your doctor about all of your health conditions, including if you:

• have a history of depression, mental illness, or suicidal thoughts
• have a history of drug, substance, or alcohol abuse or addiction
• have ever abused or been dependent on prescription medicines
• have liver disease
• have a breathing disorder
• have depression, a mental illness, or suicidal thoughts
• are pregnant or planning to become pregnant
• are breastfeeding or plan to breastfeed.

The sedative effects of eszopiclone may be stronger in older adults and accidental falls and injuries are more common in elderly patients who take sedatives.

Pregnancy

It is not known if eszopiclone will harm an unborn baby. Talk to your healthcare provider about the risks associated with eszopiclone use during pregnancy.

Breastfeeding

It is not known if eszopiclone passes into breastmilk. Talk to your healthcare provider about the best way to feed your baby if you are taking eszopiclone.

How should I take eszopiclone?

Take eszopiclone exactly as it was prescribed for you. Do not take more eszopiclone than is prescribed for you.

• Take eszopiclone right before you get into bed.
• Do not take eszopiclone with or right after a meal.
• Do not take eszopiclone unless you are able to get a full night's sleep, and there are at least 7 to 8 hours before you must be active again.

Call your doctor if your insomnia worsens or is not better within 7 to 10 days. This may mean that there is another condition causing your sleep problems.

Eszopiclone may be habit-forming. Misuse can cause addiction, overdose, or death. Keep the medication in a place where others cannot get to it. Selling or giving away this medicine is against the law.

Do not stop using eszopiclone suddenly after taking it over several days in a row, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using this medicine.

Insomnia symptoms may also return after you stop taking eszopiclone and may be even worse than before. Tell your doctor if your insomnia worsens after stopping eszopiclone.

Eszopiclone dosing

Use the lowest effective eszopiclone dose.

Usual adult eszopiclone dose for insomnia:

Initial dose: eszopiclone 1 mg orally, once a day immediately before bedtime.

• The dosage of eszopiclone may be increased to 2 mg or 3 mg if insomnia persists after 7 to 10 days of treatment, but doing this may increase the risk of sleepiness the next day.
• The maximum dose of eszopiclone is 3 mg/day.

Usual geriatric eszopiclone dose for insomnia:

Initial dose: eszopiclone 1 mg orally, once a day immediately before bedtime.

• The dosage of eszopiclone may be increased to 2 mg if insomnia persists after 7 to 10 days of treatment, but doing this may increase the risk of sleepiness the next day.
• The maximum dose of eszopiclone is 2 mg/day.

Related/similar drugs

Lunesta, Restoril, lorazepam, melatonin, zolpidem, diphenhydramine, Ativan, Ambien

What happens if I miss a dose?

Since eszopiclone is taken only at bedtime, you will not be on a frequent dosing schedule. Never take this medicine if you do not have at least 7 to 8 hours to sleep before being active again.

Do not take two doses at one time.

What happens if I overdose?

If you take too much eszopiclone or overdose, seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of eszopiclone can be fatal, especially when it is taken together with other medications that can cause drowsiness.

What to avoid

Avoid taking eszopiclone during travel, such as to sleep on an airplane. You may be awakened before the effects of the medication have worn off. Amnesia (forgetfulness) is more common if you do not get at least 8 hours of sleep after taking eszopiclone.

Avoid drinking alcohol with eszopiclone. Dangerous side effects or death could occur.

Avoid taking eszopiclone within 1 hour after eating a high-fat or heavy meal. This will make it harder for your body to absorb the medication.

Eszopiclone can cause side effects that may impair your thinking or reactions. You may still feel sleepy the next day after taking this medicine. Until you know how this medicine will affect you during waking hours, be careful if you drive, operate machinery, pilot an airplane, or do anything that requires you to be awake and alert.

What other drugs will affect eszopiclone?

Tell your doctor about all of the medicines you take including prescription and nonprescription medicines, vitamins, and herbal supplements. Medicines can interact with each other, sometimes causing serious side effects.

Do not take eszopiclone with other medicines that can make you sleepy.

• Using eszopiclone with other drugs that make you drowsy or slow your breathing can cause dangerous side effects or death.
• Ask your doctor before using opioid medication, an antihistamine, another sleep medicine, a muscle relaxant, or a medicine for anxiety or seizures.

Know the medicines you take. Keep a list of your medicines with you to show your doctor and pharmacist each time you get a new medicine. This is not a complete list of interactions. See the eszopiclone Prescribing Information for a complete list.

Eszopiclone storage

Store at room temperature away from moisture and heat. Keep track of your medicine. You should be aware if anyone is using it improperly or without a prescription.

Eszopiclone ingredients

Active Ingredient: eszopiclone

Eszopiclone is available as a generic or under the brand name Lunesta. Refer to the eszopiclone Package Insert for a list of inactive ingredients in your generic medicine.

Lunesta inactive ingredients: calcium phosphate, colloidal silicon dioxide, croscarmellose sodium, hypromellose, lactose, magnesium stearate, microcrystalline cellulose, polyethylene glycol, titanium dioxide, and triacetin. In addition, both the 1 mg and 3 mg tablets contain FD&C Blue #2.

Available as eszopiclone 1 mg, eszopiclone 2 mg, and eszopiclone 3 mg tablets.

Who makes eszopiclone?

Waylis Therapeutics LLC manufactures eszopiclone under the brand name Lunesta.

Aurobindo Pharma Limited, Dr. Reddy’s Laboratories Limited, Camber Pharmaceuticals, and many others make generic eszopiclone.

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Further information

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