Eszopiclone, Oral Tablet

Highlights for eszopiclone

1. Eszopiclone oral tablet is available as a generic drug and as a brand-name drug. Brand name: Lunesta.
2. Eszopiclone comes only as a tablet you take by mouth.
3. Eszopiclone is used in adults to treat insomnia (trouble falling asleep, staying asleep, or both).

What is eszopiclone?

Eszopiclone is a prescription drug. It comes only as an oral tablet.

Eszopiclone is available as the brand-name drug Lunesta. It’s also available as a generic drug. Generic drugs usually cost less than the brand-name version. In some cases, the brand-name drug and the generic version may be available in different forms and strengths.

Eszopiclone is a controlled substance. This means this drug has a risk of misuse and may cause dependence.

Why it’s used

Eszopiclone is used to treat insomnia. With this condition, you can have trouble falling asleep, staying asleep, or both.

How it works

Eszopiclone belongs to a class of drugs called sedative-hypnotics. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

Exactly how eszopiclone works is unknown. However, it may increase the amount of a natural chemical in your brain called gamma-aminobutyric acid (GABA). This chemical slows activity in your brain, helping you to sleep.

You shouldn’t take eszopiclone unless you’re able to stay in bed and have a full night’s sleep (7 to 8 hours) before you must be awake again. Also, you should take this drug right before you get in bed. You shouldn’t take it any sooner.

Eszopiclone side effects

Eszopiclone oral tablet can cause mild or serious side effects. The following list contains some of the key side effects that may occur while taking eszopiclone.

This list doesn’t include all possible side effects. For more information on the possible side effects of eszopiclone, or tips on how to deal with a troubling side effect, talk with your doctor or pharmacist.

More common side effects

The more common side effects of eszopiclone can include:

• unpleasant taste in your mouth
• dry mouth
• drowsiness
• rash
• dizziness
• headache
• symptoms of the common cold, such as sneezing or runny nose

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 or go to the nearest emergency room if your symptoms feel life threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

• Extreme sleepiness during the day.
• Doing an activity while you’re not fully awake (you may not remember doing these activities). Examples can include:
  • preparing and eating food
  • talking
  • having sex
  • driving a vehicle
• Abnormal thoughts and behavior. Symptoms can include:
  • acting more outgoing or aggressive than normal
  • confusion
  • agitation
  • hallucinations (seeing or hearing something that isn’t real)
  • new or worsening symptoms of depression, such as:
    • sadness
    • loss of interests
    • feeling guilty
    • fatigue
    • trouble concentrating or thinking
    • loss of appetite
  • suicidal thoughts or actions
• Memory loss.
• Anxiety.
• Severe allergic reaction. Symptoms can include:
  • swelling of your tongue or throat
  • trouble breathing
  • nausea
  • vomiting
• Complex sleep behavior, in which people engage in activities while asleep. Potentially hazardous activities include:
  • sleepwalking
  • sleep-driving
  • cooking
  • making phone calls
  • having sex

Some of these events may result in serious injuries, including death. Anyone who has this kind of experience while using eszopiclone should stop using the drug and contact their healthcare provider.

How to take eszopiclone

The eszopiclone dosage your doctor prescribes will depend on several factors. These include:

• your age
• your liver function
• other medications you may be taking

Typically, your doctor will start you on a low dosage and adjust it over time to reach the dosage that’s right for you. They’ll ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to suit your needs.

Dosage for insomnia

Generic: Eszopiclone

• Form: oral tablet
• Strengths: 1 milligram (mg), 2 mg, 3 mg

Brand: Lunesta

• Form: oral tablet
• Strengths: 1 mg, 2 mg, 3 mg

Adult dosage (ages 18 to 64 years):

• Typical starting dosage: 1 mg once per day, taken right before bedtime.
• Dosage increases: Your doctor may increase your dose to 2 mg or 3 mg if lower doses aren’t helping with your sleep problems.
• Maximum dosage: 3 mg once per day, taken right before bedtime.

Child dosage (ages 0 to 17 years):

It hasn’t been confirmed that this drug is safe and effective for use in people younger than 18 years. It shouldn’t be used in children.

Senior dosage (ages 65 years and older):

• Typical starting dosage: 1 mg once per day, taken right before bedtime.
• Maximum dosage: 2 mg once per day, taken right before bedtime.
• For all: Don’t take a dose that’s higher than what your doctor prescribed. Higher doses increase your risk of extreme drowsiness.
• For people with severe liver problems: Your total dosage shouldn’t be more than 2 mg once per day, taken right before bedtime.

Special dosage warnings

• For all: Don’t take a dose that’s higher than what your doctor prescribed. Higher doses increase your risk of extreme drowsiness.
• For people with severe liver problems: Your total dosage shouldn’t be more than 2 mg once per day, taken right before bedtime.

Take as directed

Eszopiclone is used for short-term treatment. It comes with risks if you don’t take it as prescribed.

If you stop taking the drug or don’t take it at all: If you don’t take this drug at all, you’ll still have trouble sleeping. If you stop taking it suddenly, you may experience withdrawal. Symptoms can include:

• anxiety
• strange dreams
• nausea
• upset stomach

Don’t stop taking this drug without talking to your doctor. If you need to stop taking eszopiclone, your doctor will slowly reduce your dosage so you don’t go through withdrawal.

If you miss doses or don’t take the drug on schedule: If you miss a dose, you may not sleep as well as you would if you took the medication.

You should take this drug immediately before bedtime. If you take it too early, you may feel sleepy before your bedtime. If you take it too late, you increase your risk of feeling drowsy in the morning.

If you take too much: You could have dangerous levels of the drug in your body. Symptoms can include:

• excessive drowsiness
• coma (being unconscious for a long time)

If you think you’ve taken too much of this drug, call your doctor or seek guidance from the American Association of Poison Control Centers at 800-222-1222 or through their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

What to do if you miss a dose: If you don’t take your drug right before bedtime and remember to take it with less than 7 to 8 hours left to sleep, you shouldn’t take the medication. This could make you very drowsy the next day.

How to tell if the drug is working: You should be able to fall asleep and stay asleep better.

When to call the doctor

Call your doctor if you still have trouble sleeping after taking this drug for 7 to 10 days.

Eszopiclone warnings

This drug comes with several warnings.

Next-day drowsiness

Even if you take this drug as prescribed, the next day you may still have effects from the drug. These may include significant drowsiness, trouble thinking, mental fogginess, or weakness, even if you feel fully awake.

These effects happen with all doses, but they’re more likely to occur if you take the 2-mg or 3-mg doses. You shouldn’t drive, use machinery, or do other activities that require alertness the day after taking this drug until you know how it affects you.

Next-day drowsiness can also occur if you don’t get a full night’s sleep (7 to 8 hours) when taking this drug.

Over time, you may become tolerant to these effects, which means they may not affect you as much. (This tolerance is unlikely with the 3-mg dose.) However, even if you become tolerant, you should still be cautious the day after taking this drug. Be careful with driving or other activities that require you to be alert.

Abnormal behaviors

This drug can cause abnormal thinking and behavior changes. You may also do activities while you’re not fully awake. These can include driving, preparing and eating food, making phone calls, or having sex. Call your doctor right away if this happens.

Suicidal thoughts or behaviors warning

Call your doctor right away if you have any suicidal thoughts (thoughts of harming yourself) while taking this drug.

Alcohol warning

Consuming alcoholic drinks can increase your risk of side effects from this drug. These effects include drowsiness, sleepiness, and confusion. You shouldn’t take this drug if you’ve had any alcohol the evening you want to take it.

Allergy warning

Eszopiclone can cause a severe allergic reaction. Symptoms can include:

• swelling of your tongue or throat
• trouble breathing
• nausea
• vomiting

If you have an allergic reaction, call your doctor or local poison control center right away. If your symptoms are severe, call 911 or go to the nearest emergency room.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

Food interaction warning

You shouldn’t eat heavy, high-fat meals right before or right after taking eszopiclone. Doing so can reduce how well the drug works.

Warnings for people with certain health conditions

For people with history of liver problems: This drug is broken down by your liver. If you have liver problems, you may not be able to break down this drug well. It may build up in your body and cause more side effects. These include trouble thinking or concentrating, drowsiness, and problems with coordination.

To avoid these effects, your doctor may give you a lower dose of this drug.

For people with mental health issues, such as depression: If you have a history of depression, you may be at an increased risk of suicidal thoughts while taking this drug. Your doctor should give you a lower dose of this drug.

Warnings for other groups

For pregnant women: There haven’t been enough studies done in humans to show if eszopiclone poses a risk to a human fetus.

Research in animals has shown negative effects to the fetus when the mother takes the drug. However, animal studies don’t always predict the way humans would respond.

Talk to your doctor if you’re pregnant or planning to become pregnant. This drug should only be used if the potential benefit justifies the potential risk to the fetus.

Call your doctor if you become pregnant while taking this drug.

For women who are breastfeeding: It isn’t known if eszopiclone passes into breast milk. If it does, it may cause side effects in a child who is breastfed.

Talk to your doctor if you breastfeed your child. You may need to decide whether to stop breastfeeding or stop taking this medication.

For seniors: The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects.

If you’re over the age of 65 years, you have an increased risk of mental and motor side effects from this drug. These include trouble thinking or concentrating, drowsiness, and problems with coordination. Seniors should not take more than 2 mg per dose.

For children: This drug hasn’t been studied in children. It shouldn’t be used in people younger than 18 years.

Eszopiclone may interact with other medications

Eszopiclone can interact with several other medications. Different interactions can cause different effects. For instance, some can interfere with how well a drug works, while others can cause increased side effects.

Below is a list of medications that can interact with eszopiclone. This list doesn’t contain all drugs that may interact with eszopiclone.

Before taking eszopiclone, be sure to tell your doctor and pharmacist about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Drugs that cause more side effects

Taking eszopiclone with certain medications may cause more side effects. Examples of these drugs include:

• Antipsychotics, such as haloperidol, fluphenazine, and olanzapine. Taking these drugs with eszopiclone may slow your brain function.
• Muscle relaxants, such as baclofen, cyclobenzaprine, or methocarbamol. Taking these drugs with eszopiclone may slow your brain function.
• Certain antifungals, such as ketoconazole, itraconazole, and fluconazole. Taking these drugs with eszopiclone increases your risk of all side effects. Your doctor should watch you more closely for side effects if you take these drugs together.
• Certain antibiotics, such as clarithromycin, erythromycin, and chloramphenicol. Taking these drugs with eszopiclone increases your risk of all side effects. Your doctor should watch you more closely for side effects if you take these drugs together.
• Certain HIV drugs, such as atazanavir, ritonavir, nelfinavir, and darunavir. Taking these drugs with eszopiclone increases your risk of all side effects. Your doctor should watch you more closely for side effects if you take these drugs together.
• Certain heart drugs, such as verapamil and diltiazem. Taking these drugs with eszopiclone increases your risk of all side effects. Your doctor should watch you more closely for side effects if you take these drugs together.

Drugs that reduce the amount of eszopiclone in your body

Taking eszopiclone with certain medications reduces the amount of eszopiclone in your body. This means that it may not work as well to treat your insomnia. Examples of these drugs include:

• antibiotics, such as rifampin, rifabutin, and rifapentine
• anticonvulsants, such as carbamazepine, phenytoin, and phenobarbital

Important considerations for taking eszopiclone

Keep these considerations in mind if your doctor prescribes eszopiclone for you.

General

• Don’t take eszopiclone with food. Taking this drug with food will make it not work as well.
• Take eszopiclone right before bedtime. Taking it earlier than that may cause short-term memory problems, dizziness, lightheadedness, and abnormal thoughts.
• If you think this drug isn’t working, don’t change your dose on your own. Talk to your doctor about any medication changes.

Storage

• Store eszopiclone as close to 77°F (25°C) as possible. It may also be kept at a controlled room temperature between 59°F and 86°F (15°C and 30°C).
• Keep this drug away from light.
• Don’t store this medication in moist or damp areas, such as bathrooms.

Refills

A prescription for this medication is refillable. You shouldn’t need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

• Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
• Don’t worry about airport X-ray machines. They won’t damage your medication.
• You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled container with you.
• Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Clinical monitoring

You and your doctor should monitor certain health issues during your treatment. This can help make sure you stay safe while you take this drug. These issues include:

• excessive drowsiness
• dizziness
• reduced mental functioning
• problems with liver function

Your diet

You shouldn’t eat heavy, high-fat meals right before or right after taking eszopiclone. It can reduce how well the drug works.

Prior authorization

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

Are there any alternatives?

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.