Mechanism of Action: Enhances GABA neurotransmission, inducing sedation and facilitating sleep initiation and maintenance.
Indications
Primary Use: Treatment of insomnia, particularly difficulties with sleep onset and maintenance.
Other Uses: Sometimes used off-label to manage sleep disturbances related to mood disorders or other medical conditions.
Dosage
Adults: Typically 1 mg to 3 mg taken orally once daily immediately before bedtime. Dosage can be adjusted based on individual response and tolerance, but should not exceed 3 mg per night.
Elderly: Start with a lower dose (1 mg) due to increased sensitivity to side effects.
Children: Not recommended for use in children.
Administration
Method: Oral intake.
Precautions: Should only be taken when you can guarantee a full night’s sleep (at least 7 to 8 hours). Avoid taking it with or immediately after a high-fat meal, as this can reduce its effectiveness.
Less Common: Anxiety, depression, memory impairment, coordination difficulties.
Rare but Serious: Sleep-driving and other complex behaviors while not fully awake, severe allergic reactions, hallucinations.
Warnings
Black Box Warning: May cause complex sleep behaviors such as sleep-driving, which can be dangerous.
Contraindications: Severe liver impairment, hypersensitivity to any component of the product.
Precautions
General: Use with caution in patients with a history of drug or alcohol abuse, depression, or suicidal thoughts.
Health Conditions: Adjust dose or use with caution in patients with liver impairment, respiratory insufficiency, or sleep apnea.
Interactions
Medications: Enhanced sedation when used with other CNS depressants (e.g., benzodiazepines, opioids, alcohol).
Food: Absorption can be delayed by high-fat meals, reducing the drug’s effectiveness.
Monitoring Parameters
Sleep Patterns: Monitor effectiveness in improving sleep.
Mental Health: Assess for signs of worsening depression or unusual behavior changes.
General Safety: Monitor for signs of complex sleep behaviors and other serious side effects.
Use in Pregnancy
FDA Category: C. Should only be used if the potential benefits justify the potential risks to the fetus.
Use in Elderly
Considerations: Lower starting doses are recommended due to the increased risk of CNS depression and impaired motor coordination.
Use in Kidney Disease
Adjustments: Usually not required, but patient should be monitored closely.
Use in Liver Disease
Caution: Lower doses or alternative treatments should be considered due to reduced drug clearance.
Patient Counselling Points
Medication Use: Take only as prescribed, immediately before bedtime. Ensure the ability to have a full night’s sleep.
Side Effects: Report any episodes of unusual behavior, memory loss, or hallucinations.
Lifestyle: Avoid alcohol and other CNS depressants. Do not engage in activities that require complete alertness, like driving, until you know how eszopiclone affects you.
Table of Brand Names, Manufacturer, and Prices in USD
Brand Name
Manufacturer
Strength/Dosage Form
Price (USD)
Lunesta
Sunovion
3 mg Tablet
$2.00
15 FAQs with Answers
What is Eszopiclone used for? – Primarily for treating insomnia.
Can I take Eszopiclone if I wake up in the middle of the night? – No, it should only be taken if you can sleep for at least 7 to 8 hours before becoming active again.
Are there any serious side effects? – Yes, including sleep-driving and other complex behaviors.
How long can I take Eszopiclone? – It is usually prescribed for short-term use, such as a few weeks.
What should I avoid while taking Eszopiclone? – Avoid taking it with high-fat meals and consuming alcohol.
Is Eszopiclone addictive? – It can be habit-forming; use strictly as prescribed.
What are the signs of an overdose? – Symptoms may include excessive sedation, confusion, and slowed breathing.
Can I stop taking Eszopiclone suddenly? – No, it should be tapered off under medical supervision to avoid withdrawal symptoms.
How does Eszopiclone work? – It works by enhancing the activity of GABA, a neurotransmitter that promotes sleep.
Can pregnant women take Eszopiclone? – It is rated FDA Category C; use only if clearly needed.
What if I miss a dose? – If you miss a dose at bedtime, skip it and take the next dose as scheduled.
Can Eszopiclone affect my breathing? – Yes, especially if you have existing respiratory issues like sleep apnea.
Is Eszopiclone safe for elderly patients? – Caution is advised, and a lower initial dose is recommended.
Can I drink alcohol with Eszopiclone? – No, alcohol can increase the sedative effects and risk of side effects.
Who should not take Eszopiclone? – Those with severe liver impairment or a history of complex sleep behaviors should avoid it.