eszopiclone LUNESTA

Class: Nonbenzodiazepine/​Cyclopyrrone
FDA Indications: Insomnia
Off-Label Use: NONE
Prescribing
FDA Schedule IV
Forms: 1, 2, 3mg tablet
Dose Range: 1-3 mg/day
Starting: 1 mg qhs for elderly, 2-3 mg qhs otherwise
Stopping: Taper to avoid rebound insomnia

NAMI drug fact sheet

Precautions
Contraindications: None, other than patients with known hypersensitivity to eszopiclone
Serious Side Effects: "complex" behaviors i.e., somnambulism, sleep related eating and sleep-driving
Side Effects: headache, amnesia, dysgeusia, daytime somnolence
Pharmacodynamics
1° MOA: GABAAR α1 subunit agonist
Target: GABAA α1
Pharmacokinetics
t½: 6 (6-9)° TMAX:
Absorption Rate: Rapid
Substrate of: 3A4; 2E1
Inhibits: ∅ ; Induces:
Active Metabolites:
DDIs
Misc
  • - longest t½ of the nonbenzodiazepine hypnotics
  • - only hypnotoic FDA approved for long-term use
  • - preferential binding of GABAAR α1 subunits > α23 subunits → sedation > anxiolysis
Special Populations

Category C—Based on animal data, may cause fetal harm

RID 1.5%; probably safe, but studies incomplete


Start at 1mg qhs, max dose 2 mg


No dosage adjustment necessary.


No dosage adjustment for mild-moderate impairment; for severe impairment start at 1 mg, max dose 2 mg

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Last updated January 22 2018 19:18:05. Disclaimer: This website does not provide medical advice, nor is it a substitute for clinical judgment.