Eszopiclone

LUNESTA

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Pronunciation: es-ZOE-pi-kloen

Eszopiclone ballicule: receptor binding, kinetics and half-life diagram — Mechanism of action: Eszopiclone ballicule

Eszopiclone LUNESTA mascot mnemonic cartoon — Visual mnemonic: Eszopiclone mascot
**“Lunar Easy pic”**
Z-drug

What it isNon-benzodiazepine GABA-A modulator; insomnia, particularly sleep maintenance.

Why this oneLonger half-life than zolpidem, so it holds sleep through the night, and it is licensed for long-term use.

What limits itMetallic aftertaste and next-day impairment; start 1 mg in all adults, since 3 mg impairs morning driving.

Pearls

Take on an empty stomach; a meal delays onset
Off-label in perimenopause: improves sleep, mood and nighttime hot flashes

Eszopiclone molecular structure (skeletal formula) — Molecular structure: Eszopiclone

Eszopiclone prescription history

Animated chart of estimated U.S. prescriptions per year, Sleep meds (1869–2026). Eszopiclone enters in 2005 (estimated).

FDA-approved for

insomnia (2004)

Classes and tags

Clinical profile

Therapeutic safety burden2 / 4

Overdose danger2 / 4

Weight-gain liability0 / 4

Sedation liability4 / 4

QT / Torsades0 / 4

Direct muscarinic antagonism0 / 4

Embryofetal risk2 / 4

Legacy pregnancy categoryC

Defining liabilityComplex sleep behaviors, next-day impairment and additive CNS depression.

FDA label

Read the full label on DailyMed ↗

BOXED WARNING Complex sleep behaviors (sleep-walking, sleep-driving, and other activities while not fully awake) may occur and can cause serious injury or death.

FDA dosing	Population	Start	Target	Max
Insomnia	Adults	1 mg QHS	1-3 mg QHS	3 mg QHS
Insomnia	Elderly / debilitated	1 mg QHS	1-2 mg QHS	2 mg QHS

Renal Undefined

Hepatic Severe hepatic impairment: do not exceed 2 mg

Max 3 mg; do not exceed 2 mg in elderly/debilitated patients, severe hepatic impairment, or with potent CYP3A4 inhibitors

Instructions

Take immediately before bedtime with at least 7-8 hours remaining before awakening
Do not take with or immediately after a heavy, high-fat meal
Taper to discontinue to avoid withdrawal effects

Available strengths

tab 1, 2, 3 mg

Contraindications

Prior complex sleep behaviors after taking eszopiclone

Cautions

CNS depression and next-day impairment (esp. 3 mg; caution driving)
Anaphylaxis and angioedema (do not rechallenge)
Abnormal thinking and behavioral changes
Worsening depression / suicidal thinking
Withdrawal effects with rapid reduction/discontinuation
Caution in elderly and impaired respiratory/hepatic function

Adverse reactions

Unpleasant taste (dysgeusia)
Headache
Somnolence
Respiratory infection
Dizziness
Dry mouth
Rash
Anxiety
Hallucinations

Pregnancy Insufficient human data; animal studies show offspring toxicity

Lactation Undefined

Cost

Eszopiclone (LUNESTA)

What pharmacies pay · NADAC 9/30/26

Strength		#/mo	generic $/mo	CostPlus
1 mg	tab	30 qd	$2.98	not offered
2 mg	tab	30 qd	$2.73	not offered
3 mg	tab	30 qd	$2.63	not offered

Generic entry2011

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Memory aids: interaction avatars

CYP3A4 substrate

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Self-check

How does eszopiclone’s half-life compare with zolpidem’s?
Longer.
What distinctive taste adverse effect can eszopiclone cause?
Metallic taste.