eszopiclone LUNESTA

Class: Nonbenzodiazepine/​Cyclopyrrone
FDA Indications: Insomnia
Off-Label Use: NONE
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

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: dysgeusia, headache, daytime somnolence, amnesia
1° MOA: GABAAR α1 subunit agonist
Target: GABAA α1
t½: 6 (6-9)° TMAX:
Absorption Rate: Rapid
Substrate of: 3A4; 2E1
Inhibits: ∅ ; Induces:
Active Metabolites:
  • - 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

2019 BEE℞S Recommendation: Avoid. Nonbenzodiazepine benzodiazepine receptor agonist hypnotics (ie, Z drugs) have adverse events similar to those of benzodiazepines in older adults (eg, delirium, falls, fractures); increased emergency room visits/ hospitalizations; motor vehicle crashes; minimal improvement in sleep latency and duration.

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 February 29 2024 20:54:18. Disclaimer: This website does not provide medical advice, nor is it a substitute for clinical judgment.