Lunesta vs Ambien: How do they compare?

Key Points

• Lunesta (eszopiclone) and Ambien (zolpidem) are both prescription medications used to treat insomnia.
• Ambien comes in immediate-release and extended-release formulations, and Lunesta comes in immediate-release tablets.
• Ambien may work faster to help you fall asleep, but Lunesta can help you stay asleep longer.
• Both medications can cause next-day impairment and should be taken with at least 7-8 hours left before you need to wake up.
• Headache and unpleasant taste are more common side effects with Lunesta than Ambien.
• Ambien is only meant for short-term use (a few weeks), but Lunesta does not have a specified amount of time that it can be taken.

What is the difference between Lunesta and Ambien?

Both Lunesta and Ambien are sedative-hypnotics (also called nonbenzodiazepines and “Z”drugs). They both require a prescription and are classified as Schedule IV controlled substances by the US Drug Enforcement Administration. However, they have some notable differences. These include what each medication is FDA approved to treat, their dosage forms, and side effect profiles.

FDA-approved uses

Immediate-release Ambien tablets are FDA approved for the short-term treatment of insomnia in adults who are having trouble falling asleep. The extended-release tablets (Ambien CR) are approved for the short-term treatment of insomnia characterized by trouble falling asleep and/or staying asleep.

Lunesta is FDA approved for the treatment of insomnia, and helps adults fall asleep and stay asleep.

Dosage forms

The active ingredient in Ambien, zolpidem, is available in a few different formulations, including an oral capsule, oral tablet, and sublingual tablet. It comes as both immediate-release and extended-release formulations. Lunesta is only available as an immediate-release tablet (1 mg, 2 mg, and 3 mg).

The immediate-release Ambien tablets are available in 5 mg and 10 mg strengths. Other dosage forms of zolpidem include:

• Immediate-release capsules (7.5 mg)
• Extended-release tablets (6.25 mg, 12.5 mg)
• Sublingual tablets (1.75 mg, 3.5 mg, 5 mg, 10 mg)

Side effects

In clinical studies of Lunesta, the most common side effects (≥5%) reported by adults ages 18-64 years old were:

• Unpleasant taste (up to 34%)
• Headache (up to 21%)
• Drowsiness (up to 10%)
• Infection (up to 10%)
• Dizziness (up to 7%)
• Dry mouth (up to 7%)
• Indigestion (up to 5%)
• Nausea (up to 5%)
• Nervousness (up to 5%)

In clinical studies of Ambien, the most common side effects (≥5%) reported by people taking it for up to 35 nights were:

• Drowsiness (8%)
• Dizziness (5%)

Both Lunesta and Ambien can cause complex sleep behaviors, which include sleep-driving, sleep-walking, cooking, making phone calls, having sex, and performing other activities while not being fully awake. If this happens, you should stop taking the medication and contact your healthcare provider.

Additionally, both medications can cause next-day impairment. This can make it dangerous for you and others to drive or perform tasks that require you to be alert. The risk of feeling drowsy the next day is higher if you are taking a higher dose, do not leave at least 7-8 hours of sleep after taking the medication, and if you combine the medication with other CNS depressants (e.g., alcohol, benzodiazepines, opioids).

Is Lunesta better than Ambien for sleep?

There are not many head-to-head clinical trials comparing Lunesta to Ambien for sleep. However, there have been multiple studies looking at the effect of each medication separately. Studies have generally shown that Lunesta and Ambien have similar effectiveness for treating insomnia. Ambien may help you fall asleep faster, but Lunesta helps people stay asleep longer.

In one comparative study, patients received either eszopiclone, zolpidem, or placebo for 2 nights.

• The median latency to persistent sleep (LPS), or time it took to fall asleep and stay asleep, was 29 minutes for placebo, compared to 16.8 minutes for Lunesta 1 mg, 15.5 minutes for Lunesta 2 mg, and 13 minutes for Lunesta 3 mg and Ambien 10 mg.
• Patients reported falling asleep slightly faster with Ambien 10 mg (31 minutes) compared to Lunesta 1 mg (38 minutes), Lunesta 2 mg (32 minutes), Lunesta 3 mg (33 minutes), and placebo (39 minutes).
• The time spent awake after falling asleep was reduced in people taking either Lunesta or Ambien.
• The total sleep time reported was 362 minutes, 453 minutes, and 439 minutes in people taking a placebo, Lunesta 3 mg, and Ambien 10 mg, respectively.

Related questions

• Why am I unable to sleep after taking Ambien?
• Quviviq vs. Ambien: How do they compare?
• Is Ambien safe for long-term use?

Lunesta clinical studies

Below is a summary of research of the effects of Lunesta on sleep in people taking it during clinical studies.

• Data from six studies showed that Lunesta 2 mg reduces the time it takes to fall asleep by about 18 minutes compared to placebo (no active medication).
• In two studies of Lunesta 2 mg, the medication reduced wake time after falling asleep by about 10 minutes compared to placebo.
• In two studies of Lunesta 3 mg in menopausal women, the medication reduced wake time after falling asleep by up to 37 minutes compared to placebo.
• In a review of four studies, Lunesta 2mg extended total sleep time by about 27 minutes compared to placebo, and the 3 mg dose extended total sleep time by 57 minutes.

Ambien clinical studies

Most studies of Ambien included the 10 mg dose, before the FDA recommended a lower starting dose.

In one study, the time it took until 10 minutes of persistent sleep was about 12-14 minutes for people taking Ambien compared to about 30 minutes for people taking a placebo. The total sleep time for people taking Ambien was up to 418 minutes, compared to up to 383 minutes for people taking a placebo. Also, Ambien reduced the time awake after falling asleep by 40 minutes.

How do you switch from Ambien to Lunesta (or the other way around)?

If one sedative/hypnotic is not working well for you, your healthcare provider might suggest trying a different one. Follow their instructions carefully on how to switch from Ambien to Lunesta, or from Lunesta to Ambien. There are a few different ways you can switch from one sleeping medication to another:

• Method 1: Slowly reduce your dose of your current sleeping medication every few days over about 4 weeks, until the medication is stopped completely. Then, start the new sleeping medication the following night.
• Method 2: Similar to method 1, slowly reduce the dose over 4 weeks and then wait 1-2 days before starting the new sleep medication. This is done more often with medications with a longer half-life, such as Lunesta, that may take 1-2 days to fully leave the system.
• Method 3: Stop your current sleeping medication and start the new medication the next night. With this method, you might notice some withdrawal symptoms for 1-2 days.

Experts suggest using Method 2 when switching from Lunesta to Ambien, or from Ambien to Lunesta. Work together with your healthcare provider to determine the best way to change medications. They will consider your current medication and dose.

Can you take Lunesta and Ambien together?

No, it is not recommended to take Lunesta and Ambien together. Both medications work very similarly to each other, and taking them at the same time will not give you much additional benefit. Taking these medications together can lead to dangerous side effects, such as extreme dizziness and confusion.

Ask your healthcare provider before taking either Lunesta or Ambien with any other sleep medication. It is best to share a list of your current medications with them so they can check for interactions.

Can you alternate between Ambien and Lunesta?

It is generally not recommended to alternate between Ambien and Lunesta, because both medications belong to the same drug class. This means that alternating between them will not help with tolerance that can develop. Tolerance is when your body gets used to the medication in a way that it does not work as well as it used to anymore. In order for this tolerance to wear off, you would need to alternate with a medication that is not in the same class as Ambien and Lunesta, or take a break from these medications before restarting them again.

This is not all the information you need to know about Lunesta (eszopiclone) or Ambien (zolpidem) for safe and effective use and does not take the place of your doctor’s directions. Review the full product information and discuss this information and any questions you have with your doctor or other health care provider.