II. Mechanism
- Nonbenzodiazepine Hypnotic Agent (Benzodiazepine Receptor Agonist)
- Acts at Gamma-Aminobutyric Acid receptors
- Isomer of Zopiclone (Imovane)
- Schedule IV Controlled Substance
III. Indication
IV. Dosing
- Starting dose: 1 mg orally at bedtime
- Maximum dosing of 1 mg indications
- Severe liver disease
- Concurrent use of CYP 3A4 inhibitor
- Maximum dosing of 2 mg indications
- Older patients (age over 65 years old): 1 mg
- Maximum of 3 mg indications
- Younger, healthy patients
V. Precaution
- These agents have a duration of effect that extends past the time patients awaken
- Eszopiclone (Lunesta) at 3 mg dose can impair driving, coordination and memory for up to 11 hours
- In 2014 FDA released a safety warning to limit maximum dosing of Lunesta and to start at 1 mg in all patients (similar to the 2013 Ambien warning)
- FDA Warning
VI. Pharmacokinetics
VII. Adverse effects
- Nonbenzodiazepine Hypnotic Agent for common effects
-
Metallic Taste
- Reported in up to 34% of patients on 3 mg
- Very bothersome - discontinuation is common
- Amnesia
- Hallucinations
- Worsening depression
VIII. Advantages
- See Nonbenzodiazepine Hypnotic Agent
- Effective
IX. Disadvantages
- Expensive: Over $100 for 1 month supply
Images: Related links to external sites (from Bing)
Related Studies
| lunesta (on 12/16/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| LUNESTA 3 MG TABLET | Generic | $0.12 each |
| eszopiclone (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| ESZOPICLONE 1 MG TABLET | Generic | $0.19 each |
| ESZOPICLONE 2 MG TABLET | Generic | $0.18 each |
| ESZOPICLONE 3 MG TABLET | Generic | $0.12 each |